Growth and Development Considerations in the Diagnosis of Gingivitis and Periodontitis in Children

Resident: Adam J. Bottrill
Date: 16APR10
Region: Providence
Article title:
Author(s): Enrique Bimstein and Lars Matsson
Journal: Pediatric Dentistry
Page #s: 186-191
Year: 21:3, 1999
Major topic: Periodontitis and gingivitis in children
Minor topic(s): NA
Type of Article: Topic Summary

Main Purpose: This topic summary is intended to point out certain areas of the clinical exam where the pediatric dentist should practice extra vigilance in order to differentiate between pathologic processes (periodontisis and gingivitis) and normal periodontal growth and development.

Overview of method of research: Summary of articles.

Key points in the article discussion:

I. Overview
The relative lack of information regarding periodontal pathosis in children, some pediatric dentists may be forced to rely on data that has been gathered from adult studies. It is becoming more obvious that this may provide inadequate data regarding this topic.

II. Conclusions:

A. Gingivitis:
-There is an age related tendancy to develop gingivitis (same amount of gingival plaque resulting in different degrees of gingivitis.

B. Bacterial composition of dental plaque:
-Different bacteria present in the gingival plaque of children vs. adults

C. Inflammatory cell response:
-Research supports the fact that age may actually have more of an influence then severity of the disease on serum AB levels.

D. Puberty:
-There is hormonal influence on the gingival inflammatory process concomitant to puberty.

E. Primary vs. permanent teeth:
-Junctional epithelium of primary teeth thicker than permanent teeth (less permiable).

F. Tooth eruption and exfoliation:
-It is possible that during eruption, the junctional epithelium may be compromised and more susceptible to bacterial infiltration.

G. Periodontitis:
-Localized prepubertal periodontitis has been studied mostly in syndromic patients or those with systemic disease. There are not many studies available for otherwise healthy children.

H. Apical migration of junctional epithelium:
-Apical migration is considered “normal” as there are many studies that support its existance through the growth and development of children.

I. Summary:
-Pediatric dentists should be aware of the age-dependant existence of periodontal changes in children. Considering these variables, we must be able to properly distinguish between periodontal pathosis and normal growth and development.

Assessment of article: Not bad Mr. Bimstein. Useful and informative. Organized well. NO shenanigans here.