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Questions and Answers
What oral condition is likely to occur during puberty due to increased hormone levels?
Which hormonal change is specifically associated with increased gingival inflammation during pregnancy?
What characterizes pregnancy-associated pyogenic granuloma?
How do elevated progesterone levels during pregnancy affect gingival tissues?
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What oral health issue can potentially arise from periodontal pathogens during pregnancy?
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What is a common oral effect of menopause in women?
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During which trimester of pregnancy is gingival inflammation known to significantly increase?
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What is the primary role of Prevotella intermedia during pregnancy in relation to periodontal health?
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What is a common oral complication associated with xerostomia?
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Which type of medication is most likely to cause gingival hyperplasia?
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Which of the following is NOT a consequence of medications that induce xerostomia?
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What oral condition should be monitored in leukemia patients?
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What is the primary cause of oral mucositis in chemotherapy patients?
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During menopause, which oral health issue is most likely to be exacerbated?
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Which type of therapy is most commonly associated with causing xerostomia?
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How can professional oral care help patients undergoing chemotherapy?
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How does chronic stress affect the immune system related to periodontal disease?
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What is one of the effects of hormonal variations on the periodontium?
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During pregnancy, which oral condition is commonly observed?
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What is a potential oral complication associated with menopause?
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How does stress specifically influence patient behavior related to oral health?
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What role does cortisol play in stress related to oral health?
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What oral health issue may be accelerated by poorly controlled diabetes during pregnancy?
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Which population is at increased risk for dental caries due to stress factors?
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Which statement about the relationship between diabetes and periodontal pathogens is true?
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What impact does increased proinflammatory cytokine production have in diabetics?
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Study Notes
Puberty
- Increased hormones cause increased blood circulation to gingival tissues
- Increased levels may cause increased sensitivity to local irritation
- Pubertal gingivitis occurs equally in males and females
Pregnancy
- Usually occurs in patients who have gingivitis before pregnancy
- Inflammation of gingiva increases in presence of small amounts of biofilm
- Inflammation increases in 2nd and 3rd trimesters
- Second trimester associated with increased levels of Prevotella intermedia
- P. intermedia utilizes estrogen as a substitute for natural growth factor
- Elevated progesterone levels enhance capillary permeability and dilation resulting in increased gingival exudate and edema
- High progesterone and estrogen levels suppress the immune response to dental biofilm
Pregnancy Gingivitis
- Gingival tissue appears edematous and dark red with bulbous interdental papillae
Pyogenic Granuloma (Pregnancy Tumor)
- A tumor-like proliferation on the interdental gingiva or gingival margin
- Noncancerous
- Usually not painful
Premature Labor and Low-Birth-Weight
- Research suggests that periodontal pathogens can enter the bloodstream affecting the developing fetus
- May lead to premature labor and low-birth-weight babies
Menopause and Postmenopause
- Decreased levels of circulating hormones in menopausal and postmenopausal women result in oral changes
Subgingival Microbiota in Diabetics
- Composition of subgingival microbiota in a diabetic patient is no different than in a non-diabetic patient
- Diabetes does not favor or influence growth of specific periodontal pathogens
Wound Healing in Diabetics
- Unfavorable treatment outcome may occur in long-term maintenance therapy in individuals with poorly controlled diabetes
- Poorer response to non-surgical and surgical periodontal therapies
- More rapid recurrence of deep pockets
Other Oral Complications of Poorly Controlled Diabetes Mellitus
- Reduced salivary flow
- Encourages the growth of Candida Albicans
- Greater formation of dental caries
- Multiple abscess formation
- Rapid destruction of alveolar bone
- Cheilosis
- Burning mouth and tongue
Altered Inflammatory Response
- Defective neutrophilic function impairs the initial immune response to infection
- Hyperresponsive monocytes/macrophages elevate production of proinflammatory cytokines
- Proinflammatory cytokines may initiate and worsen the spread to other organ systems
- May cause other systemic conditions like cardiovascular disease
Imbalanced Bone Destruction and Repair
- Rapid alveolar bone loss may result from the uncoupling of activities of osteoblasts and osteoclasts
- Prolonged osteoclastic formation and activity increases programmed cell death of osteoblasts
- Impairs bone formation following bone resorption
Stress as a Risk Factor for Periodontal Disease
- Acute stress can be immunoenhancing
- Chronic stress can impair the physiologic regulatory mechanism that governs the immune system
- Hormone Cortisol has anti-inflammatory and immunosuppressive properties
- Blood levels of cortisol become elevated in response to physical and psychological stress
Stress: Implications for the Dental Hygienist
- Prolonged or intense stress can cause suppression of the immune system
- This might tip the host-microbial interaction in favor of bacteria causing attachment loss
- Stress can alter how people look after themselves
- Make patients aware of potential effects of stress on general and oral health
Hormonal Variations
- Changes in hormone levels may have an effect on the periodontium
Oral Mucositis
- Inflammation of oral mucous membranes is caused when chemotherapy attacks and kills rapidly dividing cells of the mucous membranes
- Cells die faster than normal in 10-14 days
- Sloughing of mucosa can be localized or generalized
Xerostomia
- Occurs when salivary glands are damaged during radiation therapy
- Reduced flow of saliva encourages growth of Candida Albicans
- Causes oral candidiasis
Leukemia: Implications for the Dental Hygienist
- Look for spontaneous gingival bleeding an gingival enlargement for no apparent reason
- If oral signs seen first in the dental office, refer to a physician
- Good oral care is necessary to prevent the spread of serious infections from the oral cavity to other parts of the body
- Chemotherapy causes sore and sensitive mouth that bleeds easily
Pain Management
- Topical anesthetics have limited success
- Prophylactic use of chlorhexidine may reduce the frequency of oral mucositis and oral pathogens
Leukemia-Associated Gingivitis
Effects of Oral Medications
- A number of medications used to treat systemic conditions can cause oral complications
- Alteration of biofilm composition or pH
- Effect on salivary flow
- Effect on gingival tissues
Xerostomic Effects
- More than 400 over-the-counter and prescription drugs reduce salivary flow
- Some common medications causing xerostomia are blood pressure medicines, diuretics, and antidepressants
Xerostomic Effects (cont.)
- Patients with xerostomia suffer from an increase in
- Oral candidiasis
- Root surface caries
- Excess biofilm formation
Reduced Salivary Flow
- Drugs with xerostomic effects
- Antihypertensives
- Narcotic analgesics
- Tranquilizers
- Diuretics
- Antimetabolites
- Antihistamines
- Sedatives
Overgrowth of the Gingival Tissues
- The most dramatic medication-related change seen in the gingiva is gingival hyperplasia
- Drug-influenced gingival hyperplasia is an overgrowth of the gingiva that is a side effect associated with certain medications
Gingival Overgrowth
- Overgrowth begins in the interdental papillae area
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Description
Explore the connections between hormonal changes during puberty and pregnancy and their effects on gingival health. This quiz covers the mechanisms of gingivitis and conditions like pyogenic granuloma associated with these life stages. Test your knowledge on the physiological changes impacting periodontal health in these critical periods.
