Gingival and Periodontal Problems in Children

Abstract

This review will concentrate on the gingival and periodontal problems which the pediatrician may see as part of his care of the child patient. The age period covered is from the time of first tooth erruption to the middle teens. In considering specific conditions, the clinical appearance will be described, together with etiology and recommended management. Although the majority of gingival and periodontal problems are chronic in nature, a section is included on acute conditions. The periodontium is the investing and supporting structure of the tooth. It comprises the gingiva, periodontal ligament, alveolar bone and cementum. The tooth is suspended in the alveolar bone socket through the periodontal ligament fibers which are embedded at one end in the cementum covering the root surface and in the alveolar bone at the other end. The gingiva is that portion of the oral masticatory mucosa which surrounds the teeth and is attached to the alveolar process of the jaws. In order to recognize pathological changes in the gingiva it is necessary to know how the normal appears (Fig. 1). The gingival tissues which extend into and fill the interdental or interproximal area form the gingival papillae. The gingiva has a thin edge where it meets and surrounds the tooth in a collar-like fashion. There is a potential space between the tooth and the marginal gingiva into which a blunt probe may be passed to a depth of 1 to 2 mm. The gingiva in health is pale pink and firm, and does not bleed on probing, brushing, mastication or spontaneously.