1
Q
what were the aims of the 2012 guidelines
A
- to outline a method of screening children and adolescents for periodontal diseases during the routine clinical examination in order to detect the presence of gingivitis or periodontitis at the earliest opportunity
- to provide guidance on when it is appropriate to treat in practice or refer to specialist services, thus optimising periodontal outcomes for children and young people
2
Q
what are the different classifications for perio as of 2019
A
PERIODONTAL HEALTH
- periodontal health
- Intact periodontist
- reduced periodontist
- gingivitis - dental biofilm induced
- Intact periodontist
- reduced periodontium
- gingival diseases and conditions - non-dental biofilm induced
PERIODONTITIS
- necrotising periodontal disease
- periodontitis
- periodontitis as a manifestation of systemic disease
OTHER CONDITIONS AFFECTING PERIODONTIUM
- systemic disease or notions affecting periodontal supporting tissue
- periodontal abscess and eno-perio lesions
- mucogingival deformities
- truamatic occlusal force
- tooth and prosthesis related factors
3
Q
what is the mnemonic to remember the classifications
A
- Please Give Greg Nine Percy Pigs Straight Past Meal Time Tonight
4
Q
what are the 4 stages of diagnosing perio
A
- staging
- grading
- assess current perio status
- risk assessment
5
Q
how is perio staged
A
- interproximal bone loss at the worst site of bone loss
- stage I, stage II, stage III or stage IV
6
Q
how is perio graded
A
- rate of progression
- %bone loss/age
- grade A, B or C
7
Q
what are the different status of perio
A
- current stable
- currently in remission
- currently unstable
8
Q
what are features of periodontal health
A
- gingival margin several millimetres coronal to CEJ
- gingival sulcus may be 0.5-3mm deep
- alveolar crest 0.4-1.9mm apical to CEJ
9
Q
what is the biological width
A
- space between CEJ and alveolar bone crest
10
Q
what is periodontal health considered as
A
- intact periodontium
- reduced periodontium
11
Q
what is the score of BOP for clinical periodontal health
A
- <10%
12
Q
what is gingivitis
A
- inflammation of the gingiva
13
Q
what are the types of gingivitis
A
- dental biofilm induced = localised or generalised
- non-dental biofilm induced
14
Q
how is dental biofilm induced gingivitis caused
A
- as supra-gingival plaque accumulates to teeth, an inflammatory cell infiltrate develops in gingival connective tissue
- junctional epithelium becomes disrupted
- allows apical migration of plaque and an increase in gingival sulcus depth
15
Q
is gingivitis reversible
A
- yes
16
Q
why is gingivitis still reversible
A
- the most apical extension of the JE is still at the CEJ
- there is no periodontal loss of attachment = why it is called a false pocket
17
Q
how can gingivitis present
A
- marginal gingivitis and very puffy interproximal
- long-standing plaque causing irritation
18
Q
why is classification really important
A
- because it should help diagnose status which then helps inform prognosis and strategy implied to help patient
19
Q
what is the BOP score for localised gingivitis
A
- 10-30%
20
Q
what is the BOP score for generalised gingivitis
A
- > 30%
21
Q
what is the appearance of necrotising ulcerative gingivitis
A
- blunted papilla
- malodour
- painful gingival
- no attachment loss
22
Q
what causes necrotising ulcerative gingivitis
A
- fusiform and spirochete bacteria
23
Q
what are risk factors of necrotising ulcerative gingivitis
A
- smoking, spree, immunosuppression, poor diet
- HIV+
- common in developing countries
24
Q
what can necrotising ulcerative gingivitis also be called (layman’s terms)
A
- trench mouth
25
what can cause pubertal gingivitis
- increased inflammatory response to palque
- mediated by hormonal changes
- local and systemic factors can influence progression
26
what are some causes of non-dental biofilm induced gingivitis
- infective = viral, fungal
- drug induced = immunosuppressants, Ca+ channel blockers, anti-convulsants
- genetic
- trauma
- manifestations of systemic disease = haematology, immunological conditions, granulomatous inflammation
27
what is cyclosporin
- immunosuppresant
| - used in patients with underlying immune disorders such as Crohn's disease, organ transplant
28
what is phenytoin
- anti-convulsant
- for epileptic patients
- can cause exuberant gingivitis with very inflamed interproximal papilla
29
what can be seen in patient with ooo-facial granulomatous
- full thickness gingiva
30
what has gingivitis been known to be an initial presentation of (rare)
- leukaemia
31
what is agranulocytosis
- a haematological systemic disease
- acute condition
- low white blood cell count
- can lead to gingivitis
32
what is cyclic neutropenia
- a haematological systemic disease
- low neutrophil count
- occurs every 3 weeks and lasts 4-6 days
- can lead to gingivitis
33
when can granulomatous inflammation occur
- crohns disease
- sarcoidosis
- granulomatosis = autoimmune vasculitis, affects multiple systems (mainly mouth, URT, kidney)
34
what is the treatment for gingivitis
- rigorous oral hygiene/home care
- frequent scaling
- surgery may be necessary = especially with drug induced
35
when is a greater incidence of gingivitis seen
- in puberty
36
what are the 4 mainfeatures of periodontitis
- apical migration of junctional epithelium beyond CEJ
- loss of attachment of periodontal tissues to cementum
- transformation of junctional epithelium to pocket epithelium
- alveolar bone loss
37
how much loss of attachment is classified as perio
- >1mm
38
what pathogens can cause periodontal disease in both children and adults
- prophyromonas gingivalis
- prevotella intermedia
- aggregatibacter actinomycetemcomitans (AA)
39
what are the features of periodontitis in adolescents
- rapid attachment loss and bone destruction
- patient is otherwise healthy
- onset around puberty
- family history
40
what is stage I periodontitis
- <15% interproxima bone loss
41
what is stage II periodontitis
- coronal third of root bone loss
42
what is stage III periodontitis
- mid third of root bone loss
43
what is stage IV periodontitis
- apical third of root bone loss
44
what is grade A periodontitis
- <0.5 % bone loss/age
45
what is grade B periodontitis
- 0.5-1 %bone loss/age
46
what is grade C periodontitis
- >1 %bone loss/age
47
what must you be aware of in mixed dentition around erupting teeth
- false pocketing
48
what needs to be recorded about the gingival condition
- gingival colour
- contour
- swelling
- recession
- suppuration
- inflammation
49
how is OH status assessed
- description of plaque status
- describe surfaces covered in plaque
- assess if any calculus present
50
what can be risk factors to assess
- plaque retention factors
- low frenal attachment
- malocclusion
- incompetent lip seal
51
what can reduced upper lip coverage in an incompetent lip seal patient cause
- labial and palatal gingivitis
| - contributes to drying of oral mucosa
52
what can mouth breathing cause
- palatal gingivitis
53
what can complete overbite cause
- chronic continuous trauma to this area
| - end up with recession and other issues occurring
54
in what children is a simplified BPE used
- 7-11
55
what is a simplified BPE
- rapidly guides clinicians to arrive at a provisional diagnosis of periodontal health
- does not consider attachment loss, staging or grading
56
how is a simplified BPE carried out
- performed with a WHO CPITN probe
| - only do teeth 16, 11, 26, 36, 31 and 46
57
why is a simplified BPE used
- quick
- easy
- well tolerated
58
what kind of BPE do children aged 12-17 get
- normal BPE same as adults
59
what codes are used in a simplified BPE
- only codes 0-2
- 0 = healthy
- 1 = bleeding on gently probing
- 2= calculus or plaque retention factor
60
what codes are used for children 12-17
- all codes 0-4 and *
- 3 = pocketing 4-5mm
- 4 = pocketing ≥6mm
- * = furcation involvement
61
what is a plaque score of 10/10 according to SDCEP
- perfectly clean tooth
62
what is a plaque score of 8/10 according to SDCEP
- line of plaque around the cervical margin
63
what is a plaque score of 6/10 according to SDCEP
- cervical 1/3 ro crown covered
64
what is a plaque score of 4/10 according to SDCEP
- middle 1/3 of crown covered
65
what happens if a patient has a score of 3 or 4
- need to do a 6PPC
- localised to that sextant if 3
- whole mouth for 4
66
how is the alveolar bone level checked
- bitewings for posteriors
| - periodicals for anteriors
67
what are some generic treatment advice for patients with gingivitis and perio
- good toothbrushing
- emphasise need to systemically clean all surfaces
- standard toothbrushing and fluoride advice should be given to all patients
- supervised/assisted brushing = up to the age of 7 roughly
- disclosing tablets are helpful
- fluoride mouthwash recommended for those with fixed appliance therapy
68
what treatment is done for code 0
- none
| - screen again at routine recall
69
what treatment is done for code 1
- OHI and prevention
| - screen again at routine recall or after 6 month
70
what treatment is done for code 2
- OHI, prevention, scaling, removal of plaque retention factors
- screen again at routine recall or after6 months
71
what treatment is done for code 3 and 4
- full perio assessment, radiographs
- scaling, RSD, OHI, prevention
- if score 4 or * consider referral
- treat and review after 3 months
BDS3 - Paediatrics
flashcards
Decks in class (20)
# Cards
-
behaviour management techniques49
-
Safeguarding Children36
-
paediatric perio71
-
The Impact of Medically Compromising Conditions67
-
paeds medical tutorials52
-
Children with Special Needs45
-
Paediatric Oral Medicine98
-
Trauma 180
-
Trauma 229
-
Trauma 346
-
trauma 453
-
Module 170
-
Module 228
-
module 360
-
Module 442
-
Module 530
-
Module 637
-
Module 730
-
Module 818
-
Module 923
