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Fast Facts: Perio Edition - Non-Dental Biofilm Induced Gingivitis - Viral Origin

Fast Facts

Fast Facts: Perio Edition Episode 41

[Andrew Johnston, RDH]
Welcome back everyone! You are listening to another episode of Fast Facts- Perio Edition brought to you by A Tale of Two Hygienists in partnership with DentistRX. And now, please welcome your host, Katrina Sanders.
[Katrina Sanders, RDH]
Hello and welcome to Fast Facts: Perio Edition. This week, we continue the conversation we started last week around looking at non dental biofilm induced gingivitis cases. Last week, we looked at hereditary gingival fibromatosis and patients that present with an inflammatory condition of bacterial origin. But remember, we are continuing the dialog specifically about patients who have gingivitis not associated with biofilm. These are patients that are going to present with an inflammatory condition due to some other extraneous circumstance. And in this week's episode, we're going to look specifically at patients that present with a gingival manifestation associated with viral origin.
Now, these are going to be patients who primarily present with some type of a herpes simplex type virus, coxsackie viruses, herpes simplex one, herpes simplex two, or varicella zoster. And we're going to look at these in sequential order, beginning with coxsackie virus. That is the etiological virus for hand, foot and mouth disease. And these are going to be clinically presented as small little vesicles, typically in our pediatric patients that will rupture and leave a little ulceration there. In addition, we can, of course, see lesions on the hands and feet of these patients, as well as sometimes a fever.
Speaking of fever, another very common viral condition that we can see in the oral cavity is primary herpetic gingivostomatitis. These are situations in which our young pediatric patients are experiencing a massive inflammatory condition, severe manifestations, painful gingiva, painful ulcerations, edema, stomatitis of the gingiva.
These are patients that typically present with lethargy and, of course, fever. Patients that present with recurrent intra oral herpes simplex are going to be patients that will experience small clusters of painful ulcers that will be notated on either the attached gingiva or the hard palate. And it's important to know that the etiology of these ulcers is herpes simplex type one and herpes simplex type two. Chicken pox or varicella is a type of virus primarily affecting our young pediatric patient population, and of course, when these young kiddos experience chicken pox, they can also experience small yellowish type vesicles that can easily rupture. These patients oftentimes experience not only that skin rash associated with chickenpox, but fever and general malaise. The latent form is a form of shingles or herpes zoster and this type of shingles observation, of course, we oftentimes see in an older patient population, oftentimes observed by a unilateral pain. We see this as well in the oral cavity. These are patients that can present, for example, with various types of vesicles in the oral cavity associated with their varicella zoster infection.
Finally, we can see changes associated with human papilloma virus. These would be relatively asymptomatic, flat lesions observed in the oral cavity associated with papilloma virus. In many of these cases, patients are being treated not only managing their pain, but also creating a type of opportunity where now we're biopsying or potentially removing the lesions, causing these challenges. That concludes our conversation this week in identifying patients that can present with an inflammatory condition in the oral cavity. However, with these types of patients, the inflammatory condition is viral in nature and not due to the presence of dental biofilm.
Stay tuned next week, as we look at patients who present with non dental biofilm induced gingivitis of fungal origin. Have a wonderful week.
This has been another episode of Fast Facts - Perio Edition with Katrina Sanders, RDH. Please feel free to reach me on Instagram @thedentalwinegenist or on my website Cheers.
[Andrew Johnston, RDH]
Thank you for listening to another episode of Fast Facts - Perio Edition, brought to you in part by DentistRX makers of the InteliSonic line of power brushes. Find out more by visiting their website at We'll see you next week for another Fast Fact!

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