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BDS2 - periodontitis > BPE > Flashcards

BPE Flashcards

1
Q

what is the aetiological agent of gingivitis and periodontitis

A

plaque

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2
Q

what is gingivitis

A

Plaque induced gingivitis is an inflammatory response of the gingival tissues resulting from bacterial plaque accumulation located at and below the gingival margin

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3
Q

what are the clinical signs of gingivitis

A

○ Bleeding on probing
○ High plaque score
○ High bleeding scores
○ Gingival swelling and redness

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4
Q

what will the patient notice in gingivitis

A

○ Blood in saliva
○ Bleeding with toothbrushing and interdental cleaning
○ Bad breath (halitosis)

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5
Q

what are key points to gingivitis

A

○ Reversible inflammation of the gingival tissues
○ Swelling and bleeding at the gingival margins
○ Risk factor for periodontitis
○ Probing depths < 3mm
○ No attachment loss
○ No radiographic bone loss

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6
Q

define periodontitis

A

Periodontitis is an inflammatory disease initiated by bacteria which, in susceptible people, can cause severe inflammation and loss of bone around the teeth

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7
Q

what are the clinical signs of periodontitis

A

○ Bleeding on probing
○ Radiographic bone loss
○ Gingival recession
○ Probing depths >4mm (clinical attachment loss)

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8
Q

what does the patient notice in periodontitis

A 
○ Blood in saliva
○ Bleeding with tooth brushing and interdental cleaning
○ Bad breath (halitosis)
○ Black triangles (spaces between teeth)
○ Tooth movement
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9
Q

what are the key points of periodontitis

A 
○ Inflammation of the supporting structures of the teeth
○ Bleeding on probing in active disease
○ Probing depths > 4mm
○ Radiographic bone loss
○ Susceptible patients most at risk for bone loss
	§ Some are more susceptible than others
○ Can be modified by systemic disease
○ More aggressive in younger patients
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10
Q

what questions should you ask to identify the oral hygiene regime that the patient uses

A
  • How often do you brush your teeth?
  • Do you use a manual or powered toothbrush?
  • What toothpaste do you use?
  • Do you clean in between your teeth with floss or interdental brushes?
  • Do you use any mouth rinse?
  • Do you attend the dentist regularly?
  • Do you have your teeth cleaned by the dentist / hygienist?
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11
Q

what does BPE stand for

A

basic periodontal examination

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12
Q

what is the BPE

A
  • Screening tool for periodontal disease to quickly assess someone to see if they have gum disease or not
  • mouth is divided into sextants
  • WHO CPITN probe walked around the gingival margin of the teeth
  • indicates what further assessment and periodontal treatment the patient requires
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13
Q

how is the mouth divided into sextants

A
  • upper right (17 to 14)
  • upper anterior (13 to 23)
  • upper left (24 to 27)
  • lower right (47 to 44)
  • lower anterior (43 to 33)
  • lower left (34 to 37)
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14
Q

what does a BPE score of 0 mean

A

black band completely visible

No probing depth > 3.5mm
No calculus / overhangs
No bleeding after probing

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15
Q

what does a BPE score of 1 mean

A

black band completely visible

No probing depth > 3.5mm
No calculus / overhangs
Bleeding after probing

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16
Q

what does a BPE score of 2 mean

A

black band completely visible

No probing depth > 3.5mm
Supra- and sub- gingival calculus / overhangs present

17
Q

what does a BPE score of 3 mean

A

black band partially visible

Probing depths of 3.5-5.5mm present

18
Q

what does a BPE score of 4 mean

A

black band entirely within the pocket

Probing depths of 6mm or more present

19
Q

what does * represent on a BPE score

A

furcation involvement
= disease between the roots of the teeth
can only happen in posterior sextants where there is more than one root present

20
Q

what would the treatment be for a patient with a BPE score of 2

A

remove calculus / overhang

give oral hygiene instruction

21
Q

what is included in a personalised hygiene regime

A
  • Toothpaste
  • Toothbrush
  • Method
  • Duration
  • Frequency
  • Interdental cleaning
  • Mouth rinse
  • Denture hygiene
22
Q

what can chlorhexidine mouth rinse do

A

reduce gingivitis and plaque build up

23
Q

what ppm of fluoride should adults with permanent dentition use

A

1000/1100 ppm

24
Q

what does sensitive toothpaste for dentine hypersensitivity include

A 
§ potassium-
§ stannous fluoride-
§ potassium and stannous fluoride-
§ calcium sodium phosphosillicate-
§ arginine-
containing desensitizing toothpastes
25
Q

what type of desensitising toothpaste shows no evidence for working

A

strontium containing desensitising toothpaste

26
Q

what technique should be used for manual brushing

A

modified bass technique

27
Q

what does powered toothbrush show that it is better than a manual toothbrush

A

reduction in plaque and gingivitis after use

28
Q

how long should you brush your teeth

A

2 mins

longer if you have periodontitis (especially when considering need for interdental cleaning devices)

29
Q

how does frequency of brushing impact periodontal disease

A

• Relatively few studies evaluating the association between tooth brushing frequency and periodontitis
A clear effect was observed, indicating that infrequent tooth burhsing was associated with severe forms of periodontal disease

30
Q

how does interdental cleaning affect periodontal disease

A

• Using floss or interdental brushes in addition to toothbrushing may reduce gingivitis or plaque or both, more than toothbrushing alone
Interdental brushes may be more effective than floss

31
Q

what does corsodyl do as a mouth rinse

A

○ Reduce gingivitis and plaque build up
○ Masks how well patient cleans teeth
§ Like weed killer for teeth as it kills all bacteria
○ Rinsing with chlorhexidine mouth rinse for 4 weeks or longer causes extrinsic tooth staining
○ Other adverse effects such as calculus building up, transient taste disturbance and effects on the oral mucosa were reported in the included studies
○ Not recommended for routine every day use

32
Q

what does Fluoride mouth rinse do

A

○ Large reduction in tooth decay in children’s permanent teeth
○ Little information on potential adverse effects and acceptability
○ Recommended for routine daily use if high caries risk
○ Use when not brushing
○ Gives an extra dose of fluoride on exposed dentine surfaces

33
Q

what should plaque scores be for treatment to work well

A

less than 20%

34
Q

what can be said about patient behaviour change

A
  • Learning a skill can take minutes or hours but changing a habit takes weeks or months
  • Instruction is meaningless and easily forgotten without understanding the context in which it fits
  • A few appropriately selected and delivered words are more effective than a full lecture delivered with the hole that the patient will grasp the relevant details
  • Repeating instructions multiple times will not increase motivation, in fact, it may offend and decrease motivation
  • Offering assistance, and seeking permission to give knowledge or teach skills facilitates patient ownership of the task
    ○ Remember the natural response to force is resistance
  • Motivation is not static but can vary as an individual is affected by other life related factors and stresses
35
Q

what helps to guide what is important in oral hygiene instruction

A

TIPPS

36
Q

What is TIPPS

A

• Talk
○ About the causes of dental disease and discuss any barriers to effective plaque removal
• Instruct
○ The patient on the best ways to perform effective plaque removal
• Practise
○ Ask the patient to clean his / her teeth and to use the interdental cleaning aids whilst in the dental surgery
• Plan
○ Put in place a plan which specifies how the patient will incorporate oral hygiene into daily life
• Support
○ Provide support to the patient by following up at subsequent visits

BDS2 - periodontitis (4 decks)

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