Periodontal Diseases

Front 1

10 reasons for gingivitis:

Back 1

1. Poor Hygiene
2. Smoking
3. Bad Diet
4. Medication
5. Diabetes Mellitus
6. Metal poisoning
7. Mouth breathing
8. Susceptible stages
9. Trauma
10. Tooth crowding

Front 2

6 types of gingivitis:

Back 2

1. Plaque-related
2. Necrotizing ulcerative
3. Medication-influenced
4. Allergic gingivitis (plasma cell)
5. Specific infection-related
6. Dermatosis-related

Front 3

4 patterns of gingivitis

Back 3

Localized/generalized, papillary/marginal

Front 4

3 signs of healthy gums

Back 4

1. coral pink
2. stippled
3. knife-edge margins

Front 5

7 signs of diseased gums

Back 5

1. Malodor
2. Bleeding
3. Swollen
4. Margin blunted, rolled, etc
5. Loss of stippling
6. Light red to magenta color

Front 6

Identifying traits:

1. Interdental papillae are inflamed, edematous and hemorrhagic
2. Papillae are blunted and “punched-out” with craterlike necrosis and a gray pseudomembrane; fetid odor & exquisite pain; sometimes lymphadenopathy, fever and malaise
3. Can be limited; lead to loss of attachment and development of necrotizing periodontitis; necrotizing mucositis/stomatitis or noma (cancrum oris)
4. Debridement, improved home care, rinses with chlorhexidine, hydrogen peroxide and saline; sometimes antibiotics (metronidazole, tetracycline, penicillin); address cofactors such as poor nutrition & hygiene, smoking & stress

Back 6

Necrotizing Ulcerative Gingivitis

Front 7

Identifying traits:

1. Rapid onset of “sore mouth;” diffuse enlargement of gingiva, intense redness, loss of stippling, dry, atrophic lips with fissuring and angular cheilitis; reddening & fissuring of tongue with soreness
2. Dense plasmacytic infiltration of gingiva
3. Identification and removal of allergen; topical steroids for cases without agent identity with varied response

Back 7

Plasma cell (allergic) Gingivitis

Front 8

Identifying traits:

1.Defined by the presence of granulomatous inflammation in the gingiva; most often in adult patients; solitary or multifocal red or red/white macules in the interdental papillae < 2 mm diameter.
2. Must search for cause; foreign material, fungal infection, acid-fast bacterial infection, Crohn’s disease, sarcoidosis, chronic granulomatous disease, Wegener’s granulomatosis
3. Most cases are related to foreign material (“foreign-body gingivitis”) but can produce lichenoid reaction or mixed with than foreign-body reaction
4. Surgical removal of affected tissues

Back 8

Granulomatous Gingivitis

Front 9

Identifying traits:

1. Due to excess collagen formation in the gingiva (fibrous enlargement) secondary to the use of a systemic medication
2. Strong association with cyclosporine (transplant rejection suppressant), Dilantin (phenytoin--anticonvulsant) and nefedipine (calcium channel blocker)
3. Degree of enlargement related to patient’s susceptibility and level of oral hygiene
4. Enlargement begins 1-2 months of drug use, first in the anterior facial segment; the interdental papillae enlarges and spreads across facial surface; later lingual and posterior areas; pseudopockets leads to inflammatory changes
5. Treatment may involve removal of offending medication (by the physician), substitution of drug of different class, use of folic acid therapy, metronidazole or azithromycin, and or gingivectomy & gingivoplasty

Back 9

Drug-Related Gingival Hyperplasia