Periodontics · single question
Which procedure should be AVOIDED in a patient with desquamative gingivitis due to pemphigus vulgaris?
Show answer and explanation
Correct answer: D. Air polishing (prophy jet)
Air polishing uses high-pressure abrasive particles that traumatize the fragile desmosome-deficient epithelium of pemphigus, causing blistering (Nikolsky's sign positive).
- A. Topical corticosteroids (clobetasol, fluocinonide) are actually the FIRST-LINE treatment for pemphigus vulgaris oral lesions.
- B. Gentle supragingival debridement with appropriate modifications is acceptable and part of supportive periodontal care.
- C. Ultrasonic scaling can be used carefully with appropriate precautions — trauma should be minimized but it is not absolutely contraindicated.
- D. CORRECT. Prophy jet/air polishing should be AVOIDED in pemphigus vulgaris. The abrasive particles and pressure can traumatize the fragile epithelium, causing new blistering (Nikolsky's sign) and worsening the condition.