AHG

• PHG aetiology?

  • primary herpatic gingivitis
  • aka acute herpatic gingivostomatitis
  • first exposure to Herpes simplex virus
• prevalence?

  • preschool children
  • mistaken for teething
  • varied symptoms - subclinical and asymptomatic
• clinical features:

  • prodomal 10-14 days, 1-2 weeks in duration
  • crops of vesicles, red halo on oral mucosa, gingivae and tongue
  • ulcers form rupture, coalesce, fibrinous coating
  • gingival margins fiery red and odema
  • painful gingivostomatits
  • halitosis
  • fever/malaise/lymphadenopathy
  • loss of appetites
  • hypersalivation
  • CONTAGIOUS
• complitations:

  • spread by saliva
  • ocular or digital lesions
  • sucking fingers/unexposed team member - herpetic whitlow formation
  • herpetic eczema
• ulceration from PHG

  
• fiery red gingival margin and odema

  
• coalesce of ruptured ulcers

  
• herpatic whitlow of unexposed team member

  
• herpetic whitlow of childs finger from sucking

  
• herpetic eczema

  
• Treatment?

  • self limiting
  • burnout in 10-12 days
  • no scarring
  • reassurance
• diet advise?

  • soft diet
  • cold food
  • adequate fluid intake - prevent dehydration
• supportive therapy?

  • chx 0.2% mw/swab
  • analgesic/anti-pyretic elixir
  • promethazine elixir
  • lignocaine mw 5%
  • acyclovir 200mg 5 x day for 5 days
• secondary herpetic lesion?

  • herpes labial
  • 20-40%
  • latent in gasserian ganglion
  • vermillion borders of lip/nose
• triggers of secondary herpetic lesions?

  • trauma from uv light
  • run down
  • immunosupressed
  • fever
  • trauma
• treatment for secondary herpetic lesions?

  topical acyclovir
• secondary herpetic lesion

  
• cause of traumatic gingivitis?

  • toothbrush
  • gingivitis artefacta
  • flossing
• traumatic gingivitis toothbrushing

  
• gingivitis artefacta

  
• what might cause chemical gingivitis?

  • aspirin burns
  • tooth tincture
• chemical gingivitis caused by aspirin burns

  
• fungal gingivitis?

  • candidosis, candidiasis caused by candida albicans
  • immunocompromised and debilated patient
  • denture related
  • broad spectrum antibiotic therapy
• how does fungal gingivitis present?

  • red gingivae
  • white flecks
  • raw bleeding surface
• tx of fungal gingivitis?

  • improve denture hygiene
  • find underlying cause?
  • antifungal eg nystatin/miconazole
• what is sequestrum?

  dead bone/tooth tissue penetrating oral mucosa, causing gingivitis, removal required

  
• what conditions may also lead to acute gingivitis?

  • acute leukaemia
  • agranulocytosis
  • uncontrolled diabetes
  • vit def (B and C)

  resistance to infection is lowered due to the conditions