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
