Test 2: Periodontal diagnosis and therapy in pediatric dentistry Flashcards
What are the two best materials to use in pedo pulp therapy?
- Formacresol
- MTA (maintain vitality)
When does primary herpetic gingivostomatitis usually occur?
-Children younger than 6
How is primary herpetic gingivostomatitis transmitted?
-Direct contact
T/F Primary infection of primary herpetic gingivostomatitis is asymptomatic
True
Primary herpetic gingivostomatitis is found where?
- Hard palate
- Attached gingiva
- Oral mucosa
With primary herpetic gingivostomatitis what type of lymphadenopathy do you see?
-Cervical lymphadenopathy
T/F Fevers of 101-105 are associated with primary herpetic gingivostomatitis
True
What is the length of primary herpetic gingivostomatitis?
-7-10 days
What medicine can you give for severe cases of primary herpetic gingivostomatitis?
-Acyclovir (200 mg daily for 5 days)
What is recurrent aphthous ulcers?
-Painful and recurrent ulceration on unattached oral mucosa
What is the treatment for recurrent aphthous ulcers?
- Topical corticosteroid triamcinolone
- nutritional diet and maintenance of oral hygiene
What are types of acute candidiasis?
- Pseudomembranous
- Erythmatous
What do you use for treat candidiasis?
- Nystatin (for infants and very young children, 1ml dropped into mouth 4x per day)
- Clotrimazole lozenge (10 mg)
- Systemic fluconazole suspension (6 mg/kg body weight)
What is eruption gingivitis?
-Gingivitis associated with tooth eruption
What is the treatment for eruption gingivitis?
- Time
- improved oral hygiene
- Chlorhexidine rinses
What is acute inflammatory gingival enlargement?
-A localized painful rapidly expanding lesion that is usually of sudden onset
What causes acute inflammatory gingival enlargement?
-Irritation from foreign substance embedded into gingiva
Where is acute inflammatory gingival enlargement limited to?
- Marginal gingiva
- Interdental papillae
What is the interdental area like in children?
-Saddle shaped gingiva
What is the interdental area like in adults?
-Papillary gingiva
What does the gingival sulcus look like in children?
-Newly erupted tooth sulcus depth is greater than deciduous predecessor
What does the gingival sulcus look like in an adult?
-1-2 mm
What does the attached gingiva look like in children?
-Width increases with age with concomitant decrease in sulcus depth
What is the color of the gums in children?
-More reddish
What does the counter of the gums look like in children?
-Rounded margin
What does the consistency of the gums like in children?
-Flabby due to less CT density and lack of organized collagen fiber bundles
What is the surface texture of the gums like in children?
-Stippling absent until age 6
T/F Dental plaque-induced gingival disease are very common in children
True
In dental plaque-induced gingival diseases you see increased subgingival levels of what bugs?
- Actinomyces
- Capnocytophaga
- Leptotrichia
- Selenomonas
What are three medicaments that have the ADA seal for control of gingivitis?
- Listerine
- Chlorhexidine
- Triclosan
Who is aggressive periodontitis more common in?
- Children
- Adolescents
What are the primary features of aggressive periodontitis?
-History of rapid attachment of bone loss with familial aggregation
What are secondary features of aggressive periodontitis?
- Phagocyte abnormalities
- Hyperresponsive macrophage phenotype
What is the definition of Localized aggressive periodontitis?
-interproximal attachment loss on at least two permanent first molars and incisors with attachment loss on no more than two teeth other than first molars and incisors
What ethnicity has a higher amount of localized aggressive periodontitis?
-African Americans
What is the definition of generalized aggressive periodontitis?
-generalized interproximal attachment loss including at least three teeth that are not first molars and incisors
Alterations in what factors are known to be present in aggressive periodontitis?
-Immunologic factors such as immunoglobulins
What is the treatment for aggressive periodontitis?
-Possible combo of surgical or non-surgical root debridement in conjunction with antimicrobial therapy
What are effective antibiotics for Localized Aggressive periodontitis?
- Tetracycline
- Metronidazole
- Amoxicillin
What is the definition of localized chronic periodontitis?
-Less than 30 percent of dentition has bone loss
What is the definition of generalized chronic periodontitis?
-Greater than 30 percent of the dentition has bone loss
What is mild chronic periodontitis?
1-2 mm of CAL
What is moderate chronic periodontitis?
-3-4 mm of CAL
What is severe chronic periodontitis?
-Greater than 5 mm CAL
What is a disease that leads to early exfoliation of teeth?
-Hypophosphotasia
When people have systemic diseases what can cause periodontitis?
-Defects in neutrophil and immune cell function
What are drug types that cause gingival hyperplasia?
- Anticonvulsants
- Immunosuppressants
- Calcium channel blocker
How do you treat mild Drug induced gingival hyperplasia?
-Oral hygiene maintenance and frequent dental care
What are findings of Necrotizing periodontal disease?
- Punched out crater like interproximal necrotic ulcerations
- Rapid onset of gingival pain
- Sloughing of gingival tissue
What are predisposing factors of Necrotizing periodontal disease?
- Poor oral hygiene
- Viral infections
- Nutritional deficienes such as VIt B and C
- Emotional stress
- Lack of sleep
- Systemic diseases
What is the treatment of Necrotizing periodontal disease?
- Mechanical debridement
- Metronidazole
- Penicillin
what is the treatment for acute inflammatory gingival enlargement caused by foreign substance embedded into gingiva?
removal of substance and possible incision and drainage
what is an early finding of localized aggressive periodontitis in children?
bone loss around primary teeth
what is diabetes associated periodontitis?
- specific form of periodontitis associated with systemic disease
- 10% type I diabetics w/perio often have localized periodontitis to first molars and incisors
describe localized periodontitis associated with systemic disease
affected sites exhibit rapid bone loss and minimal gingival inflammation
describe generalized periodontitis associated with systemic disease
rapid bone loss around nearly all teeth and marked gingival inflammation
what is the treatment for moderate drug-induced gingival hyperplasia?
- oral hygiene
- antiplaque mouthrinse
- 4 consecutive weekly office visits for prophylaxis
- 5th week - eval for improvement
- if no improvement, correct surgically
what is the treatment for severe drug-induced gingival hyperplasia?
- treatment is identical to moderate drug-induced gingival hyperplasia
- surgical correction if above treatment is unsuccessful - gingivectomy with laser or electrosurgical equipment
what is mild, moderate, and severe drug-induced gingival hyperplasia defined as?
- mild = <1/3 of clinical crown
- moderate = 1/3-2/3 of clinical crown
- severe = >2/3 of clinical crown
what is the frequency of necrotizing periodontal disease in north american and european children compared to areas of africa, asia, and south america?
low frequency (<1%) in north american and european children compared to others (2-5%)
