3. PERIODONTIUM OF DECIDUOUS DENTITION
The gingiva is :
Pale pink and firm
Either smooth or stippled [stippling is found in
35% of children between ages 5 and 13 years]
Interdental gingiva is broad facio-lingually
and tends to be narrow mesiodistallly
Mean gingival sulcus depth for the primary
dentition is 2.1mm +/- 0.2mm
4. Width of the attached gingiva is
-- greater in the incisor area
-- decreases over the cuspids and
-- increases again over premolars
[primary molars]
Attached gingiva increases in width with age
STIPPLED GINGIVA
5. Radio graphically :
Alveolar bone in relation to the deciduous
dentition shows a prominent lamina dura
during eruption
Trabaculae of the alveolar bone are fewer
but thicker than in adult
Marrow spaces tend to be larger
Crests of the interdental septa are flat
6. PHYSIOLOGICAL GINGIVAL CHANGES
ASSOCIATED WITH
TOOTH ERUPTION
PRE-ERUPTION BULGE
Before the crown appears in the oral cavity
the gingiva presents a bulge that is firm
7. FORMATION OF THE GINGIVAL MARGIN
Marginal gingiva and sulcus develops as the
crown penetrates the oral mucosa in the course
of eruption
Gingival margin is usually edematous
rounded and slightly reddened
8. NORMAL PROMINENCE OF THE GINGIVAL MARGIN
During the period of mixed dentition it is
normal for the marginal gingiva around the
permanent teeth to be quite prominent
particularly in the maxillary anterior region
9. TYPES OF GINGIVAL DISEASE
1 CHRONIC MARGINAL GINGIVITIS
Most prevalent
A fiery red surface discoloration is often
superimposed on underlying chronic changes
Gingival color change and swelling appear
to be more common expressions of gingivitis
in children
10. etiology
A. PLAQUE
Local conditions such as materia alba and
poor oral hygiene favor its accumulation in
preschool children
Dental plaque appears to form more rapidly
in children of age 8-12yrs
11. B. CALCULUS
Uncommon in infants
Occurs in approximately
-- 9% of children ages 4-6yrs
-- 18% of those ages 7-9 yrs and
-- 33% -- 43% of those ages 10-15
12. C. ERUPTION GINGIVITIS
Tooth eruption does not cause gingivitis
The inflammation results from plaque
accumulation around erupting teeth
13. D. PARTIALLY EXFOLIATED/LOOSE DECIDUOS TEETH
The eroded margin of partially resorbed teeth
favors plaque accumulation which causes
gingival changes varying from slight
discoloration and edema to abscess formation
with suppuration
14. E. FOOD IMPACTION AND MATERIAALBA
Accumulation of food around teeth partially
destroyed by caries
Children tend to develop unilateral chewing
habits to avoid loose or carious teeth
aggravating the accumulation of plaque on
the non chewing side
15. F. MALOPOSED TEETH
Increased tendency to accumulate plaque and
materia alba
Changes include :
gingival enlargement
bluish–red discoloration
ulceration and
formation of deep pockets
BEFORE AFTER
16. G. OVERBITE AND OVERJET
H. NASAL OBSTRUCTION
I. MOUTH-BREATHING HABIT
17. PUBERTAL GINGIVITIS
Gingivitis and gingival enlargement found in
the circumpubertal period
The most frequent manifestation is significant
increase in bleeding interdental sites
18. 2 LOCALIZED GINGIVAL RECESSION
Gingival recession occurs on teeth in labial
version and on those that are tilted or
rotated so that the roots project labially
Anterior open bite increases the prevalence
of gingival recession
19. 3 ACUTE GINGIVAL INFECTIONS
A. Primary herpetic gingivo-stomatitis
-- Most common type
B. Candidiasis - mycotic infection of the oral
cavity - fungus candida albucans
C. Necrotizing ulcerative gingivitis
-- occur in children where there is
chronic malnutrition and with Down’s syndrome
20. TRAUMATIC CHANGES IN PERIODONTIUM
Excessive occlusal forces may be produced by :
-- malalignment
-- mutilation
-- loss or extraction of teeth
21. ORAL MUCOUS MEMBRANE IN CHILDHOOD DISEASES
Diseases that present specific alterations in
oral mucosa include :
-- Varicella [chicken pox]
-- Rubeola [measles]
-- Scarlatina [scarlet fever] and
-- Diphtheria
