3: Plaque & Bleeding Charts

Question 1

periodontal examinations are carried out for?

Answer 1

• new patients
• patients who have not had a periodontal examination for one year
• periodontal review/recall appointments
• longitudinal periodontal patients (requiring more complex treatment)

Question 2

what type of periodontal examination should be done on a new patient or one who has not had a periodontal examination for one year?

Answer 2

basic periodontal examination

- use WHO/CPITN probe

Question 3

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

Answer 3

5 point exam

- use CP12 probe

Question 4

what type of periodontal examination should be done on longitudinal patients?

Answer 4

• plaque & bleeding charts

- double periodontal pocket charts

Question 5

plaque and bleeding charts: contains what four sections?

Answer 5

• plaque chart
• bleeding chart
• mobility chart
• BPE chart

Question 6

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?

Answer 6

• 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

Question 7

why use the O’leary plaque chart?

Answer 7

• gives an indication of the patients oral hygiene level

- visual indication of the plaque distribution which allows targeted OH instruction

Question 8

O’leary plaque chart: clinical procedure?

Answer 8

• run CP12 along gingival margin and inform nurse of any surface where plaque is found
• systematic

Question 9

O’leary plaque chart: how is plaque score calculated?

- what does it indicate?

Answer 9

( sites with plaque / total no. of sites ) x 100%

• missing teeth not included
• indicates patient’s oral hygiene levels

Question 10

bleeding chart:
BOP occurs from?
BOP indicates?

Answer 10

• from base of pocket

- indicates inflammatory disease activity at that site, at that time (risk marker for periodontal disease)

Question 11

is BOP a good predictor of future periodontal disease progression? why?

Answer 11

no. only 30% of BOP sites go on to LOA, 70% do not

Question 12

bleeding chart: clinical procedure?

Answer 12

CP12 probe walked along base of pocket

* bleeding may be delayed, therefore walk probe around several teeth and check back for BOP

Question 13

how is bleeding score calculated?

Answer 13

( sites w. bleeding / total no. of sites ) x 100%

Question 14

susceptibility of a patient can be determined by comparing?

Answer 14

• patients age
• level of oral hygiene
• severity of disease

Question 15

low plaque score, high bleeding score: suggests?

Answer 15

• patient has high susceptibility

- patient has brushed teeth well prior to attending (lol)

Question 16

high plaque score, low bleeding score: suggests?

Answer 16

low susceptibility to plaque

Question 17

what index is used to measure tooth mobility?

Answer 17

miller’s index

Question 18

how does mobility affect prognosis?

Answer 18

higher mobility, generally poorer prognosis

Question 19

how to record mobility of tooth?

Answer 19

• place 2 instrument handles on both sides of tooth (mirror&probe)
• apply gentle pressure in 3 directions: bucally, lingually, vertically

Question 20

what are the 3 dental causes of mobility?

Answer 20

• periodontal disease leading to loss of support
• periradicular disease
• occlusal trauma

Question 21

what is calculus?

what are its 2 main forms?

Answer 21

• calcified plaque

- supragingival and subgingival

Question 22

why is removal of calculus an essential element of periodontal treatment?

Answer 22

calculus acts as a rough surface which encourages further plaque accumulation
- very adherent to tooth surfaces, can only be removed by scaling instruments

Question 23

where is supragingival calculus heavily present? example in oral cavity?

Answer 23

areas opposite opening of salivary ducts

• lingual lower incisors
• buccal upper molars

Question 24

describe supragingival calculus

Answer 24

• yellow-brown color
• fairly hard & brittle
• relatively easily removed by scaling instruments
• usually directly visible (visibility improved by drying)

Question 25

describe subgingival calculus

Answer 25

• attached to root surfaces
• dark green-black
• not directly visible, within periodontal pockets
• occurs throughout the mouth
• hard, difficult to remove with instruments

Question 26

when is subgingival plaque visible?

Answer 26

visible when tissue shrinkage has occured

Question 27

how to detect subgingival calculus within pocket? 2 methods.

Answer 27

• 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

Question 28

use of cross calculus probe: what finding indicates presence of subgingival calculus?

Answer 28

subgingival calculus is detected as bumps on root surface