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Periodontics > Assessment of the Periodontal Patient > Flashcards

Assessment of the Periodontal Patient Flashcards

1
Q

Describe a new patient assessment

A
  • Presenting Complaint
  • History of Presenting Complaint
  • Extra Oral Examination
  • Intra Oral Examination
  • Radiographic Assessment
  • Diagnosis
  • Treatment plan
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2
Q

What are 5 common presenting complaints with regards to periodontics?

A
  1. No issues
  2. Gingival bleeding on brushing
  3. Spacing or drifting of teeth
  4. Tooth mobility
  5. Gingival recession and sensitivity
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3
Q

Describe 3 components of a history-taking not related to the patient’s complaint

A
  1. Past Medical History - Medication or systemic diseases
  2. Social History - Smoking / Alcohol, Work Environment
  3. Past Dental History
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4
Q

How do you take a smoking history?

A
  • Do you smoke?
    • “Yes” > How many? / How long? > Current smoker
    • “No” > Have you ever smoked?
      • “Yes” > When did you stop / How many for how long > Ex-smoker
      • “No” > Never smoker
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5
Q

Describe 5 components of a previous dental history

A
  1. Attendance with GDP
  2. Frequency of brushing
  3. Use of inter-dental cleaning aids or mouthwash
  4. Anxiety regarding dental treatment
  5. Denture wearer
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6
Q

What are 2 things to look out for during an extra-oral examination?

A
  1. Lymphadenopathy

2. TMJ disorders

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7
Q

Describe 4 components of an intra-oral clinical examination

A
  1. Soft tissue assessment
  2. Overall assessment of dentition
  3. Assess occlusion
  4. Inspection of periodontal tissues
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8
Q

Describe 6 components of a periodontal examination

A
  1. Plaque Index
  2. Periodontal Pocket Depths
  3. Bleeding on Probing
  4. Mobility
  5. Gingival Recession
  6. Presence of Furcation Defects
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9
Q

What plaque index is used during a periodontal examination?

A

O’Leary Plaque Index

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10
Q

Describe the O’Leary Plaque Index

A
  • Method of recording plaque on individual tooth surfaces
  • Mesial, distal, buccal and lingual surfaces assessed
  • Plaque Score = (Number of Surfaces Exhibiting Plaques / Number of Surfaces Available x 100)
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11
Q

Name 2 periodontal probes which can be used to determine pocket depths

A
  1. Michigan-O probe with William’s markings

2. WHO-621 Periodontal Probe

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12
Q

What is probing pocket depth?

A

Distance from gingival margin to base of periodontal pocket

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13
Q

What is clinical attachment loss?

A

Distance from CEJ to base of the periodontal pocket

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14
Q

In terms of clinical attachment loss and probing pocket depth, how is gingival recession determined?

A

If CAL is greater than PPD then gingival recession is present

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15
Q

In terms of clinical attachment loss and probing pocket depth, how is gingival swelling determined?

A

If periodontal pocket depth is greater than clinical attachment loss, gingival swelling is present

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16
Q

Name 2 uses of bleeding on probing

A
  1. Sign of inflammation in tissues

2. Use as a marker of stability

17
Q

What 2 reasons may a pocket bleed on probing?

A
  1. Ulcerated pocket epithelium

2. Increased vascularisation of connective tissues

17
Q

What 2 reasons may a pocket bleed on probing?

A
  1. Ulcerated pocket epithelium

2. Increased vascularisation of connective tissues

18
Q

What 2 reasons may a pocket bleed on probing?

A
  1. Ulcerated pocket epithelium

2. Increased vascularisation of connective tissues

19
Q

How can bleeding on probing be used as a marker of stability of periodontal disease?

A

Presence of BOP is a marker of unstable periodontal diseases whereas absence of bleeding is a better indicator of stability

20
Q

Describe Miller’s Index with regards to mobility of a tooth

A

0 - No movement of tooth
1 - Buccal-Lingual movement of <1mm
2 - Buccal-Lingual movement >1mm
3 - Buccal-Lingual movement >1mm and vertical movement

21
Q

What causes mobility of teeth?

A

Alveolar bone loss

22
Q

What is the function of carrying out radiographic assessment in periodontics?

A

Determine any alveolar bone loss and other pathology present in the oral cavity

23
Q

What are 3 most common radiographic views in periodontics?

A
  1. OPT
  2. Bite-wings
  3. IOPAs
24
Q

Describe an OPT with regards to periodontics

A
  • Provides overview of all teeth, jaws and sinuses
  • Poor quality anteriorly due to superimposition of cervical spine
  • Good screening radiographs
  • Increased radiations vs bitewings and IOPAs
24
Q

Describe an OPT with regards to periodontics

A
  • Provides overview of all teeth, jaws and sinuses
  • Poor quality anteriorly due to superimposition of cervical spine
  • Good screening radiographs
  • Increased radiations vs bitewings and IOPAs
25
Q

Describe a bitewing with regards to periodontics

A
  • Excellent quality
  • Posterior teeth only
  • Does not show apices of roots so may not show full extent of bone loss
26
Q

Describe an IOPA as a periodontal radiograph

A
  • Excellent quality
  • Gold standard
  • Shows all tooth and root and periapical bone
27
Q

What mnemonic is used to decide on choice of radiographs?

A

ALARP - As Low As Reasonably Practicable

28
Q

What radiographs are likely to be taken for generalised moderate to advanced periodontal disease?

A

OPT plus anterior IOPAs

29
Q

What radiographs are likely to be taken for generalised mild periodontal disease?

A

Bitewings and anterior IOPAs

30
Q

What radiographs are likely to be taken for localised advanced periodontal disease?

A

Additional IOPAs of areas affected

31
Q

Name 9 things to look for on a radiographic examination

A
  • Bone Loss (severity and pattern)
  • Presence of sub-gingival calculus
  • Caries
  • Restoration margins
  • Peri-apical radiolucencies
  • Presence of furcation lesions
  • Widening of PDL
  • Root form
  • Any associated pathology

Periodontics (8 decks)

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