BPE & periodontal assessment Flashcards
What is periodontal disease?
Any inherited or acquired disorder of the tissues surrounding & supporting the teeth (periodontium)
What is dental plaque biofilm?
A mass of bacteria that forms on tooth surfaces on a daily bases.
It is a sticky colourless deposit.
Which later if unremoved, forms calculus (tartar) - hard, brown or yellow in colour.
What happens to the periodontium when there is plaque-induced periodontal disease?
Inflammation at gingival margin Destruction of the junctional epithelium Destruction of the alveolar bone Formation of periodontal pockets Clinical attachment loss [cemento-enamel junction (CEJ) to base of pockets.
Clinical attachment loss =
gingival recession + pocket depth
What is the clinical appearance of periodontal health?
Periodontal health - absence of clinically detectable inflammation
COLOUR - pale pink
CONTOUR - scalloped shaped, with knife-edge margin
CONSISTENCY - no inflammation - no bleeding of probing (BOP), firm & stippled.
What is gingivitis?
Reversible inflammation of the gingiva in which the connective tissue attachment to the tooth remains at its original level.
Is there destruction of junctional epithelial attachment in gingivitis?
yes
Is there periodontal loss of attachment/breakdown of PDL (periodontal ligament) fibres or bone loss in gingivitis?
NO
What are the clinical features of gingivitis?
Change in colour - redness starting at the papillae & progressing along the gingival margin.
Surface smooth & glossy
Loss of stippling
Swelling (oedema) - tissues become softer & ‘pit’ on pressing
Rolling of gingival margin & loss of the triangular shape of the interdental papillae
BOP
Bad or metallic taste
Halitosis (bad breath)
Fibrous tissue reaction
Severe inflammation - marked redness, oedema, ulceration & tendency to bleed spontaneously
False pocketing
Name some histopathological features of gingivitis:
Vasodilation & increase in capillary permeability
Increase in GCF
More inflammatory cells
Collagen breakdown
What are the clinical features of periodontitis?
- some or all signs of gingivitis
- true pocketing - apical migration of JE beyond the CEJ & transformation of the JE to pocket epithelium.
- recession
- suppuration (pus)
- mobility above physiological levels
- drifting of teeth
- furcation involvement
- radiographic evidence of alveolar bone
What is BPE?
Basic Periodontal Examination
Screening tool to give provisional diagnosis
Indicated need for further diagnostic measure/special investigations
What does BPE assess?
Bleeding
Plaque retentive factors
Depth of periodontal pockets
When do you not carry out BPE?
Evidence of historical periodontitis
History of interproximal recession or attachment loss, radiographs
Patient review after treatment of periodontitis
Patients with implants
in these situations: carry out full periodontal assessment
How do you carry out a BPE?
divide the dentition into 6 sextants
examine all teeth except 8s (unless 6/7 missing
record the highest code for each sextant
codes 0.1.2.3.4 and *
