Assessment of Periodontal Diseases Flashcards
During a periodontal health assessment what may you need to observe?
- Gingival colour
- Gingival contour
What needs to be checked during a periodontal assessment? (5)
- Oral hygiene or plaque control assessment
- Pocket depth and gingival recession
- Bleeding on probing
- Tooth mobility
- Furcation involvement
Describe the appearance of clinically healthy periodontal tissue
- Pink
- Stippled
- Non bleeding
- Little/no recession
- No mobility
- Pocket depths ≤3mm
What changes will you see in gingivae appearance during gingival inflammation? (4)
- Colour change
- Change in consistency
- Change in contour
- Plaque and calculus in contact with inflamed tissue
Name some types of non-plaque induced gingival diseases (8)
- Genetic disorders
- Specific infections
- Inflammatory and immune conditions
- Reactive processes
- Neoplasms
- Endocrine, nutritional and metabolic disorders
- Traumatic lesions
- Gingival pigmentation
How can pseudopockets arise?
- Gingival swelling
- Gingival overgrowth
- Anatomical factors (ie partially erupted teeth)
What are pseudopocktes?
False pockets where PPD is falsely greater than 3mm and there is no attachment loss
When should a Basic periodontal examination (BPE) be carried out?
Should be used as a part of all routine dental examinations in adults and children aged above seven
Describe the BPE method (4)
- Dentition is divided into sextants
- Examination is carried out with a WHO/BPE probe
- Probe gently inserted into the gingival crevice and ‘walked around’
- For each sextant only the highest score is recorded
What does a ‘X’ on a BPE examination indicate?
Signifies a sextant that is edentulous or has only 1 functioning tooth
What does a ‘*’ on a BPE examination indicate?
Signifies furcation involvement and is used as an adjective score
What would you see for a BPE score of 0;
Probing depth?
Black band visibility?
Bleeding?
Overhangs/Calculus?
- <3.5mm
- Completely visible
- No
- No
What would you see for a BPE score of 1;
Probing depth?
Black band visibility?
Bleeding?
Overhangs/Calculus?
- <3.5mm
- Completely visible
- Yes
- No
What would you see for a BPE score of 2;
Probing depth?
Black band visibility?
Bleeding?
Overhangs/Calculus?
- <3.5mm
- Completely visible
- Yes or No
- Yes
What would you see for a BPE score of 3;
Probing depth?
Black band visibility?
Bleeding?
Overhangs/Calculus?
- 3.5mm-5.5mm
- Partially visible
- Yes or No
- Yes or No
What would you see for a BPE score of 4;
Probing depth?
Black band visibility?
Bleeding?
Overhangs/Calculus?
- > 5.5mm
- Entirely within pocket
- Yes or No
- Yes or No
What treatment is needed for a BPE score of 0
No treatment
What treatment is needed for a BPE score of 1
Oral hygiene advice
What treatment is needed for a BPE score of 2 (3)
- Scaling
- Oral hygiene advice
- Elimante plaque retentive restorative margins
What treatment is needed for a BPE score of 3 (5)
- Scaling
- Root surface debridement
- Oral hygiene advice
- Elimante plaque retentive restorative margins
- Full 6 point probing chart needed of the sextant
What treatment is needed for a BPE score of 4 (5)
- Scaling
- Root surface debridement
- Oral hygiene advice
- Elimante plaque retentive restorative margins
- Full 6 point probing chart needed of the sextant
Much more complex treatment
What are the 6 reference teeth used in paediatric BPE?
UR1 UR1 UL6
LR1 LR1 LL6
What codes do you use for paediatric BPE?
When should you use full range of codes?
- Only use 0,1,2
- 12+
What are 2 advantages of BPE?
- Simple and rapid screening to identify periodontal risk
- Good indication of treatment required
What are some disadvantages of BPE? (5)
- Not designed to monitor patients
- No distinction between true and false pockets
- Lack of detail within sextant
- No detail about recession
- No detail about furcation involvement
When and why is a six point pocket chart (6PPC) used?
- When full periodontal assessment is required
- When we record BPE score 3 and 4
- Gives 6 measurements for each tooth (more detailed)
What probes are used for 6PPCs?
Williams or UNC15
What information do you get from a 6PPC that you don’t get from a BPE? (5)
- Bleeding on probe
- Recession
- Furcation defects
- Mobility
- Full mouth plaque score
Why may reading errors from probing occur? (6)
- Interference from the calculus on tooth/root
- Overhanging restorations
- Incorrect angulation of probe
- Pressure applied
- Misreading
- Shape/Size of the probe
How are clinical crown to root (C:R) ratios determined?
Amount of root remaining in bone compass with the amount of tooth above the bone level
What is horizontal bone loss?
If the level of the bone is essential equal interdentally, it is called horizontal bone loss
(measured as % bone lost)
What is vertical/angular bone loss?
When one tooth has lost more bone than the tooth next to it
In terms of bone loss what do radiographs look at? (5)
- Bone levels
- Root length and shape
- Furcation are in multi rooted teeth
- Width of PDL
- Restorative status of tooth
What can horizontal bitewings show in regards to bone loss? (2)
- Show crystal bone and are indicated if picketing is less than 5mm
- Detail of overhanging restorations or dental caries that act as plaque traps
What can vertical bitewings show in regards to bone loss?
Bone levels in moderate tp severe periodontitis around several teeth
What can periapical radiographs show in regards to bone loss? (4)
- Indicated in severe periodontitis
- Assessment of tooth morphology
- Furcation involvement
- Root shape
