Gingival inflammation and aggressive periodontitis in a child with a specific antibody deficiency

Gingival inflammation can occur in very young children prior to the eruption of the permanent teeth, however, for the same exposure to plaque, gingivitis is not as intense as that found in older children and adolescents.¹ Periodontitis is extremely rare in childhood and the term prepubertal periodontitis was introduced by Page et al² to describe localized or generalized periodontal destruction in children. In a more recent classification, this condition has been renamed aggressive periodontitis.³ Functional defects in inflammatory or immune responses are often associated with periodontal problems, such as aggressive periodontitis in childhood.⁴ Since possible defects in the host response often underpin such conditions, it is important to refer affected children to appropriate specialists for investigations to establish a diagnosis. This case describes the occurrence of persistent gingival inflammation with evidence of periodontal destruction in a 5-year-old girl. Further investigations identified an underlying defect in the immune system which had significant implications for the general health of the affected girl. The case highlights the need for the integrated care of such cases to ensure that they receive appropriate and timely treatment to maintain good general health.