Gum Disease 101 Diagnosis and Treatment

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Gum Disease 101Diagnosis and Treatment

• By
• LT SHELLBACK
• 2007

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Gingivitis - Marginal

• THE SYMPTOMS
• A. my gums are sore or swollen
• B. the gums bleed
• THE SIGNS
• A. painful reaction to gingival bleeding
• B. red swollen gingiva with loss of stippling
• C. Heavy plaque and calculus

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Treatment of Marginal Gingivitis

• Oral hygiene instruction
• Warm saline rinse
• Scale teeth to remove debris

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Necrotizing Ulcerative Gingivitis

• Symptoms
• A. Same as marginal gingivitis
• B. bad taste in mouth
• C. Pain when eating/brushing
• D. Excessive bleeding
• Signs
• A. Same as marginal gingivitis
• B. Ulceration of interdental papilla
• C. Gray membrane covering gingiva
• D. Foul breath or Fetid odor
• E. Pus from the gingiva or gingival recession
• F. Elevated Temperature

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Treatment

• If temperature over 101 degrees refer immediately
  to dentist (so he has to smell the patients
  breath)
• IF non-febrile treat the same as marginal
  gingivitis

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Periodontitis

• Symptoms
• A. Gnawing pain
• B. Itching gums
• C. Hot or Cold sensitivity or both
• D. Gums bleed
• E. Food sticks between teeth
• F. Loose or long teeth
• G. Teeth ache or uneven bite
• H. Increased spacing of anterior teeth

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Signs

• Heavy plaque and calculus
• Gingival inflammation bleeding
• Mobile Teeth
• Cratered papilla

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Treatment of Periodontitis

• Rinse and remove debris
• Return the second day
• Refer to the dentist

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Periodontal Abscess

• Symptoms
• - A. Throbbing Pain
• - B. Pain to chewing lying down
• - C. Bad Taste (means pus)
• - D. Gumboil or bump
• - E. Tooth feels longer
• - F. Malaise Tender lymph nodes

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Signs

• Pain to pressure
• Gumboil
• Facial Swelling
• Mobile Tooth
• Febrile (elevated temp)
• Enlarged Lymph nodes

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Treatment

1.Establish Drainage with a Scaler or explorer 2.
Warm Saline Rinse
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Periocornitis

• Symptoms
• - A. Pain when chewing
• - B. Bad Taste
• - C. Difficulty opening mouth (Trismus)
• - D. Swelling in the neck
• - E. Fever

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Signs

• Partially erupted
• Red inflamed tissue
• Painful with pressure
• Swelling in the cheek
• Elevated Temp

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Tx of PeCor

• Irrigate with saline
• Use ultrasonic
• Rinse with salt water every 2 hours
• Refer to dentist if febrile

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Post Surgical Complications and Trauma

• Are you bored yet????
• Does the LT need to shut up???

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Post Extraction Hemorrhage

• Symptoms
• A. bleeding that wont stop after EXT
• B. Weakness in conjunction with blood loss
• C. Blood on pillow
• Signs
• A. Blood oozing in the mouth

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Treatment of Post OP Hemorrhage

• Contact Dentist
• Check Vital Signs
• Pack moistened sterile gauze and have patient
  bite down

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POST Extraction Alveolar Osteitis (aka Dry
socket)

• Symptoms
• A. Severe Constant pain/ache
• B. Loss of clot
• Signs
• A. Absence of blood clot
• B. Food in socket site
• C. Alveolar bone is visible
• D. Foul Odor
• E. Febrile

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Treatment of Alveolar Osteitis

• Rinse with warm saline
• Loosely pack with iodoform gauze
• Patient RTC the next day to remove dressing

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Avulsed Teeth

• If dentist instructs you to
• Need radiographs (not on test)
• Time is imperative to re-implantation

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FX Mandible or Maxilla

• Symptoms
• 1. difficulty breathing
• 2. pain when moved
• 3. inability to open
• 4. bleeding gums
• 5. teeth dont touch
• 6. lower lip is number

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Signs of FX

• 1. Facial Swelling
• 2. Abnormal Occlusion
• 3. FX bone (x-ray)
• 4. Abnormal movement

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Treatment - palliative

• Call the dentist
• Immobilize with bandage
• Apply Ice