- Angles Class III malocclusions with crowding;
- Lack of an anterior lip seal;
- Anterior open bites.
General risk factors for periodontal disease are mainly centred on leucocyte defects
and may include:
- Defects of polymorphonuclear leucocyte function (chemotaxis, killing, and
phagocytosis); - Reduced T-cell activity.
11.13 SUMMARY
- Anatomical variation, which occurs during tooth eruption, and the maturation of the
periodontal tissues can mimic signs of gingivitis, recession, and bone loss. - Herpetic gingivostomatitis is most frequently seen in children under 5 years of age,
whereas necrotizing ulcerative gingivitis is more prevalent in young adults. - Although the prevalence of dental caries has declined in the UK and other
European countries, the prevalence of plaque-induced gingivitis in children has not
reduced over the last 20 years. - Chronic gingivitis in children appears to be a relatively stable lesion, which does
not necessarily progress to periodontal destruction. - Gingival changes can also occur in children who are prescribed drugs to control
epilepsy or following transplant surgery, during orthodontic therapy, as well as at sites
of self-inflicted trauma. - Early signs of chronic periodontitis are sometimes seen during adolescence, and
targeting this age group with a primary prevention strategy may help to reduce tooth
loss in later life. - Extreme vigilance is necessary to diagnose aggressive periodontal diseases and
those periodontal conditions that may be associated with systemic disease. Bleeding
after gentle probing in the presence of apparently healthy gingiva indicates the need
for further investigation.
11.14 FURTHER READING
Armitage, G. C. (1999). Development of a classification system for periodontal
diseases and conditions. 646HAnnals of Periodontology, 4 , 1-6.
Heanue, M., Deacon, S. A., Deery, C., Robinson, P. G., Walmsley, A. D.,
Worthington, H. V., and Shaw, W. C. (2003). Manual versus powered toothbrushing
for oral health. In The Cochrane Library (Issue 1). Oxford.
O'Brien, M. (1993). Children's Dental Health in the UK, 1993. Office of Population
Censuses and Surveys, HMSO, London.