Treatment of Acute Periodontal Conditions Flashcards
Prevalence of ANUG
Prevalence of ANUG
What are the early clinical signs of ANUG?
Necrotic lesion of the papilla initially
Then progressing to the gingival margin, giving a ‘punched out’ appearance
Spontaneous bleeding
Incredibly painful
What are the 3 ‘absolute’ needs for it to be ANUG
Punched out appearance
Spontaneous bleeding
Pain
What are clinical signs of an Advanced Lesion of ANUG?
Lack of deep pockets
Merging of papillary and marginal involvement
Characteristic foetor (malodor)
Central necrosis resulting in crater formation
What are some ‘other findings’ of ANUG?
Fever and malaise (due to systemic involvement)
Poor oral hygiene
White membrane of desquamated cells, bacteria, and salivary proteins that can be easily removed
What bacteria are typically found in ANUG, and which are tissue invasive?
*Treponema species
Selenmonas species
Fusobacterium species
*Prevotella intermedia
How do you treat ANUG
Alleviation of acute inflammation (done by reducing the bacterial load and removing necrotic tissue)
When is the third visit for ANUG treatment and what occurs during it?
5 days later
Eval of oral cavity
Only emergency treatment
New home instruction for hygiene
What are some ‘other findings’ of ANUG?
Fever and malaise (due to systemic involvement)
Poor oral hygiene
White membrane of desquamated cells, bacteria, and salivary proteins that can be easily removed
What bacteria are typically found in ANUG, and which are tissue invasive?
*Treponema species
Selenmonas species
Fusobacterium species
*Prevotella intermedia
What are some other factors that may be associated with ANUG?
Stress Inadequate sleep Smoking (>90% of ANUG pts smoke) Alcohol abuse White Young
How do you treat ANUG
Alleviation of acute inflammation (done by reducing the bacterial load and removing
What occurs during the first visit of ANUG treatment
Eval of oral cavity and health hx
Reduction of bacterial load and removal of necrotic tissue with a prophy cup (may need to numb them)
Only emergency treatment
No antibiotics unless they have systemic involvement (fever)
Home instructions for hygiene
What are part of the home instructions for hygiene for an ANUG pt?
Avoid alcohol and tobacco
Rinse with 3% hydrogen peroxide and water (1:1) every 2 hours
Get adequate rest
Confine tooth brushing to removal of surface debris with bland dentrifice and ultra soft toothbrush
NSAIDs for pain relief
Antibiotics if there’s systemic involvement
When is the second visit for ANUG treatment and what occurs during it?
2 days after the first Evaluation of the oral cavity Scaling if necessary Only emergency treatment Confirm home instrucitons
When is the third visit for ANUG treatment and what occurs during it?
Eval of oral cavity
Only emergency treatment
New home instruction for hygiene
What is the ‘new’ home instruction for oral hygiene associated with the third ANUG treatment visit
Avoid tobacco and alcohol
Discontinue hydrogen peroxide rinse
Counsel on nutrition, smoking cessation, stress reduction
S/RP repeated if necessary
Schedule patient in one month for re-evaluation to determine complications with oral hygiene, health habits, psychological factors, and the potential need for reconstructive or elective surgery
Gingival abscess definition
A localized purulent infection that involves the marginal gingiva or interdental papilla
Confined to the gingiva only
Gingival abscess cause
Trauma
Gingival abscess pulp condition
Vital
Gingival abscess swelling location
In the gingiva
Gingival abscess treatment
Removal of noxious agent(s)
Incision and drainage (if necessary)
NO antibiotics
Home care - rinse with warm salt water
Pericoronal Abscess definition
A localized purulent infection within the tissue surrounding the crown of a partially erupted tooth
Pericoronal Abscess cause
Trauma
Pericoronal Abscess radiographic findings
Impacted
Pericoronal Abscess pulp condition
Vital
Pericoronal Abscess pain location
Localized
Gingival Abscess pain location
Localized
Pericoronal Abscess treatment
Removal of noxious agent(s)
Irrigation under the soft tissue operculum
Antibiotics if there are systemic complications
Home care - rinse with warm water
When infection is under control - extraction, operculotomy
Periodontal Abscess definition
A localized purulent infection within the tissues adjacent to the periodontal pocket that may lead to the destruction of the PDL and the alveolar bone
Pockets are present
Non-periodontitis related Periodontal Abscesses
Acute infection from bacteria originating from another source
ie foreign body impaction
Periodontal Abscess radiographic findings
Angular
Periodontal Abscess Swelling
Gingiva: fistula
Periodontal Abscess Pain
Localized and dull
Periodontal Abscess Prevalence
Emergency clinics = 8-14%
Most often in areas with PD ≥ 5mm
Most common in molars
Periodontal Abscess Complications
Tooth loss - principle cause of tooth loss in perio maintenance pts with repeated abscesses
Systemic infections
What are the types of Periodontal Abscesses
Periodontitis-related
Non-periodontitis related
Periodontitis-related Periodontal Abscesses
Acute infection as the result of subgingival biofilm in a deep perio pocket
Non-periodontitis related Periodontal Abscesses
Acute infection from bacteria originating from another source
ie foreign body impaction
Periodontal Abscess Treatment
Drainage through pocket retraction or incision SRP Perio surgery Systemic Involvement give antibiotics Extraction
Periapical Abscess definition
Inflammatory condition characterized by the formation of purulent exudate involving the dental pulp remnants and the tissue surrounding the apex of the tooth
Periapical Abscess cause
Infection
Periapical Abscess inflammation
May or may not occur
But inflammation is present in all other abscesses
Periapical Abscess Pulp condition
Nonvital
Periapical Abscess swelling
Severe and non-localized
Periapical Abscess Treatment
Tooth removal
Root canal
