The document discusses gingival and periodontal diseases in children. It notes key differences in the child periodontium compared to adults, such as a thicker and rounder free gingiva. Gingivitis is more common than periodontitis in children and tends to be more transient and acute. Common gingival diseases in children include pericoronitis, eruptive gingivitis, and acute necrotizing ulcerative gingivitis. Common periodontal diseases are prepubertal and early onset periodontitis. Localized and generalized early onset periodontitis are classifications. Gingivitis is characterized by inflammation, bleeding, and color/texture changes of the gingiva. Local irrit

1. Gingival and
periodontal disease
in children

2. The periodontium is a connective tissue organ
covered by epithelium that attaches the teeth to the
bones of the jaw and provides a continually
adapting apparatus for support of teeth during
function.
It comprises of,
• Gingiva
• Periodontal ligament
• Alveolar bone
• Cementum

3. Differences between the child and adult
periodontium:
• Free gingiva- thicker and rounder
• Flaccid and retractable marginal gingiva
• Attach gingiva- greater width
• Presence of interdental cleft
• Periodontal space is wider with few fibers
• Gingivitis is common than periodontitis and is more transient and
acute, compared to progressive and chronic in adults.
• Alveolar bone
• Less calcified
• More vascular
• Few but thicker trabecular
• Thin lamina dura
• Flattened interdental crests

4. Common gingival diseases:
• Acute pericoronitis
• Eruptive gingivitis
• ANUG
• Gingival Fibromatosis and hyperplasia
Common periodontal diseases:
• Prepubertal periodontitis- local and generalized
• Early onset periodontitis- juvenile periodontitis
• Associated with systemic diseases

5. Classification of periodontal diseases:
• Per-pubertal periodontitis
• Localized early onset periodontitis
• Generalized early onset periodontitis
Gingivitis:
• It is the inflammatory involvement of gingival tissue.
Microscopically it is characterized by presence of
inflammatory exudate and edema and destruction of
collagenous gingival fibers. Ulcerations of the
epithelium are also seen.

6. Clinical Feature of Gingivitis:
• Gingival bleeding: Two earliest symptoms of gingival
inflammation are:
Increased gingival fluid production rate.
Bleeding from gingival sulcus on probing.
• Change in the color of gingival:
Normal color is coral pink. Inflamed tissue is red or bluish red.
• Change in consistency of gingiva:
In chronic inflammation, both destructive (edematous) and reparative
(fibrotic) changes co-exist.
• Change in surface texture of gingiva:
 Loss of surface stippling is an early sign of gingivitis.
 Chronic inflammation- the surface is either smooth and shiny or firm and
nodular depending on whether changes are exudative or fibrotic.

7. Etiology of gingival diseases:
Local irritating factor
a)Bacterial plaque
b)Predisposing factors like: material alba, food debris, malalignment of teeth,
dental calculus etc.
Local functioning factors
a)Malocclusion
b)Habits: mouth breathing tongue thrusting
c)Eruption of teeth
Systemic factors
a)Puberty
b)Vitamin or protein deficiency
c)Drugs and chemical
d)Pregnancy
e)Hereditary
f) Metabolic disorders
g)Hematological disorder
h)Viral, bacterial and fungal infections

8. Classification of gingival diseases:
Simple gingivitis
a) Eruption gingivitis
b)Gingivitis associated with poor oral hygiene
Acute Gingival Inflammation
a) Herpes simplex virus infection
b)Recurrent apthous ulcer
c) Acute necrotizing ulcerative gingivitis
d)Acute candidiasis
e) Acute bacterial infections
Chronic non- specific gingivitis
Condition gingival enlargement:
a) Puberty gingivitis
b)Fibromatosis
c) Phenytoin-induced gingival overgrowth
 Scorbutic gingivitis