PART 11 — TEETH & GUMS

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Study use: Rapid revision of dental anatomy, caries and pulpal disease, periodontal disease, gingival enlargement, developmental dental abnormalities, odontogenic infection, third-molar complications, and dental trauma. Emergency and drug-management points are intentionally concise and should be interpreted with age, immune status, pregnancy, trauma pattern, systemic involvement, restorability, and dental assessment.

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Priority Guide: 🔴 Core / Must Know | 🟠 Important | 🟡 Additional

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🎯 High-Yield Overview

• Primary teeth = 20; permanent teeth = 32; first permanent molar ≈ 6 years; tooth in socket = gomphosis.
• Dental caries has a classic Streptococcus mutans association, but the disease is biofilm-mediated, sugar-driven, and multifactorial.
• Gingivitis = inflammation without attachment/bone loss; periodontitis = attachment loss + alveolar bone loss.
• Necrotizing gingivitis / ANUG → painful bleeding gums + halitosis + punched-out interdental papillae + gray slough.
• Phenytoin, cyclosporine, and calcium-channel blockers such as nifedipine → gingival enlargement.
• Gingival enlargement + bleeding + blasts/cytopenias/systemic features → consider AML with monocytic differentiation.
• Spongy bleeding gums + corkscrew hairs + poor healing → vitamin C deficiency / scurvy.
• Excess fluoride during enamel formation → dental fluorosis; Hutchinson incisors + mulberry molars → late congenital syphilis.
• Third-molar surgery can injure the lingual nerve; pericoronitis surrounds a partially erupted third molar; dry socket gives severe pain several days after extraction.
• Avulsed permanent tooth → urgent replantation/preservation when feasible; avulsed primary tooth → do not replant.

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RED FLAGS: Rapidly increasing facial/submandibular/floor-of-mouth swelling, dysphagia, drooling, voice change, severe trismus, systemic toxicity, or breathing difficulty after dental infection → urgent assessment for deep-space spread and airway compromise. Permanent-tooth avulsion is also time-critical.

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1. DENTAL ANATOMY, TOOTH TISSUES & DENTITION

2. DENTAL CARIES, PULPITIS & PERIAPICAL ABSCESS

3. GINGIVITIS, PERIODONTITIS & NECROTIZING GINGIVITIS

4. GINGIVAL ENLARGEMENT, BLEEDING & SYSTEMIC CLUES

5. FLUOROSIS, CONGENITAL SYPHILIS & DEVELOPMENTAL TOOTH DEFECTS