Juvenile periodontitis

What is Juvenile Periodontitis?

Juvenile periodontitis is an uncommon condition characterized by severe loss of attachment and destruction of alveolar bone around one or more permanent teeth in otherwise healthy adolescent.
This happens often in the absence of overt gingival inflammation.

Epidemiology

  • Prevalence rate of this case is 1:1000; occurrence in male is equivalent to that of female gender
  • Onset at puberty or earlier

Symptoms and clinical features of Juvenile Periodontitis

  • This affects the first permanent molar and incisors
  • Actinobacillus, Actinomycetes comitans has been isolated from the affected sites
  • Juvenile periodontitis results in drifting and loss of the first permanent molar and incisors

Investigation

  • Radiology may reveal marked bone loss interdentally, inter-radicularly and apically

Complications

The following are the complications of Juvenile periodontitis

  1. Tooth loss
  2. Malocclusion
  3. Temporo-Mandibular Joint (TMJ) dysfunction syndrome.

Treatment for Juvenile Periodontitis

Non-drug treatment

  1. Control of plaque bacteria by use of antiseptic solution
  2. Establishing a healthy gingival and periodontal attachment
  3. Oral hygiene instruction and motivation
  4. Regular scaling and polishing
  5. Root planning
  6. Splinting of mobile tooth
  7. Bone regenerative techniques e.g. using Polytetrafluoroethylene (PTFE) membranes, Periodontal surgery
  8. Bio-Oss, Bio-membrane

Drug treatment

Metronidazole
Adult: 200 mg orally every 8 hours for 5 days.
Child

  • 1-3 years: 50mg orally every 8 hours;
  • 3 -7 years: 100 mg every 12 hours;
  • 7 – 10 years: 100 mg every 8 hours;
  • 10 -18 years: 200 mg every 8 hours

Plus:

Tetracycline:
Adult: 250 mg orally daily for up to 21 days
Children: contraindicated
Note:

For children under 12 years of age, replace tetracycline with amoxicillin (or erythromycin for those
sensitive to penicillin as Tetracycline is contraindicated)

Precaution

Tetracyclines should not be given to children under 12 years