3: Plaque & Bleeding Charts Flashcards
periodontal examinations are carried out for?
- new patients
- patients who have not had a periodontal examination for one year
- periodontal review/recall appointments
- longitudinal periodontal patients (requiring more complex treatment)
what type of periodontal examination should be done on a new patient or one who has not had a periodontal examination for one year?
basic periodontal examination
- use WHO/CPITN probe
what type of periodontal examination should be done on a patient when it has been LESS than a year since the last periodontal examination? e.g. a three month recall patient
5 point exam
- use CP12 probe
what type of periodontal examination should be done on longitudinal patients?
- plaque & bleeding charts
- double periodontal pocket charts
plaque and bleeding charts: contains what four sections?
- plaque chart
- bleeding chart
- mobility chart
- BPE chart
plaque charts: what is the name of the chart used? how is plaque recorded?
what if plaque is found on one side of an embrasure?
- O’leary plaque chart
- dichotomous chart: plaque is present or absent
- present: plaque is recorded by colouring in the appropriate surface of tooth on the chart in BLUE
- the entire embrasure is recorded as having plaque
why use the O’leary plaque chart?
- gives an indication of the patients oral hygiene level
- visual indication of the plaque distribution which allows targeted OH instruction
O’leary plaque chart: clinical procedure?
- run CP12 along gingival margin and inform nurse of any surface where plaque is found
- systematic
O’leary plaque chart: how is plaque score calculated?
- what does it indicate?
( sites with plaque / total no. of sites ) x 100%
- missing teeth not included
- indicates patient’s oral hygiene levels
bleeding chart:
BOP occurs from?
BOP indicates?
- from base of pocket
- indicates inflammatory disease activity at that site, at that time (risk marker for periodontal disease)
is BOP a good predictor of future periodontal disease progression? why?
no. only 30% of BOP sites go on to LOA, 70% do not
bleeding chart: clinical procedure?
CP12 probe walked along base of pocket
* bleeding may be delayed, therefore walk probe around several teeth and check back for BOP
how is bleeding score calculated?
( sites w. bleeding / total no. of sites ) x 100%
susceptibility of a patient can be determined by comparing?
- patients age
- level of oral hygiene
- severity of disease
low plaque score, high bleeding score: suggests?
- patient has high susceptibility
- patient has brushed teeth well prior to attending (lol)
high plaque score, low bleeding score: suggests?
low susceptibility to plaque
what index is used to measure tooth mobility?
miller’s index
how does mobility affect prognosis?
higher mobility, generally poorer prognosis
how to record mobility of tooth?
- place 2 instrument handles on both sides of tooth (mirror&probe)
- apply gentle pressure in 3 directions: bucally, lingually, vertically
what are the 3 dental causes of mobility?
- periodontal disease leading to loss of support
- periradicular disease
- occlusal trauma
what is calculus?
what are its 2 main forms?
- calcified plaque
- supragingival and subgingival
why is removal of calculus an essential element of periodontal treatment?
calculus acts as a rough surface which encourages further plaque accumulation
- very adherent to tooth surfaces, can only be removed by scaling instruments
where is supragingival calculus heavily present? example in oral cavity?
areas opposite opening of salivary ducts
- lingual lower incisors
- buccal upper molars
describe supragingival calculus
- yellow-brown color
- fairly hard & brittle
- relatively easily removed by scaling instruments
- usually directly visible (visibility improved by drying)
describe subgingival calculus
- attached to root surfaces
- dark green-black
- not directly visible, within periodontal pockets
- occurs throughout the mouth
- hard, difficult to remove with instruments
when is subgingival plaque visible?
visible when tissue shrinkage has occured
how to detect subgingival calculus within pocket? 2 methods.
- gently blow 3 in 1 air into pocket, allowing direct vision of calculus on root surfaces
- only possible in areas such as lower anterior teeth
- cross calculus probe can be used to detect subgingival calculus on root surfaces
use of cross calculus probe: what finding indicates presence of subgingival calculus?
subgingival calculus is detected as bumps on root surface
