BPE, radiographs and clinical decisions Flashcards
disadvantages of BPE?
- Tend to overestimate disease as only scoring the worst site in each sextant
- No indication of which teeth are effected
- Don’t test mobility
- Don’t know bone loss
- Ball end may underestimate pockets
- Cant use to monitor disease
what is used for diagnosis of periodontal disease ?
BSP implementation guidelines
referring to the BSP implementation guidelines how is clinical gingival health diagnosed?
BPE code 0/1/2
with no obvious interdental recession
<10% BOP
referring to the BSP implementation guidelines how is localised gingivitis diagnosed?
BPE code 0/1/2
with no obvious interdental recession
10-30% BOP
referring to the BSP implementation guidelines how is generalised gingivitis diagnosed?
BPE code 0/1/2
with no obvious interdental recession
>30% BOP
using the BSP implementation guidelines what should you do if BPE score is 3 with no evidence of interdental recession?
radiographic assessment
initial periodontal therapy
review in 3 months with localised 6 point pocket chart
if no pockets >4mm and no radiographic bone loss due to periodontitis use code 0,1,2 (gingivitis)
if pockets >4mm remain and/or radiographic bone loss due to periodontitis -> continue with code 4 pathway
referring to the BSP implementation guidelines how is periodontitis molar-incisor pattern diagnosed?
BPE code 4
and/or obvious interdental recession
radiographic assessment
full perio assessment (6 point)
molar-incisor pattern
referring to the BSP implementation guidelines how is localised periodontitis diagnosed?
BPE code 4
and/or obvious interdental recession
radiographic assessment
full perio assessment (6 point)
<30% of teeth affected
referring to the BSP implementation guidelines how is generalised periodontitis diagnosed?
BPE code 4
and/or obvious interdental recession
radiographic assessment
full perio assessment (6 point)
>30% of teeth affected
what is incipient gingivitis?
very little BOP but almost localised and don’t think it will get better on its own so want to give OHI
remember this
disadvantages of radiographs
- Superimposition: bone on bone, tooth on tooth and tooth on bone
- Does not show disease activity
- No indication of timescale
- Doesn’t show periodontal pockets
- Underestimates bone loss
what are the things you need to include in your periodontitis diagnosis? refering to the BSP guidelines
extent of disease
periodontitis
stage
grade
stability
risk factors
how is the extent of periodontitis in your diagnosis worked out?
Localised: <30% teeth involved
Generalised: >30% teeth involved
Molar/incisor pattern
what does the stage of periodontitis mean?
severity of the disease and complexity of management
is it likely for a periodontitis patient to change stage?
no
how is stage I periodontitis diagnosed?
<15% bone loss
borderline between gingivitis and periodontitis
how is stage II periodontitis diagnosed?
Coronal 1/3 bone loss
established periodontitis
how is stage III periodontitis diagnosed?
Mid 1/3 bone loss
<4 teeth lost due to periodontitis
how is stage IV periodontitis diagnosed?
Apical 1/3
> 4 teeth lost due to periodontitis
what does the grade of periodontitis mean?
rate of progression and how quickly u need to get them back
how is Grade A periodontitis diagnosed?
percentage bone loss at worst site is less than half the patients age
how is grade B periodontitis diagnosed?
percentage bone loss at worst site is more than half the patients age, less than the patients age
<2mm loss over 5 yrs
how is grade C periodontitis diagnosed?
percentage bone loss is more than the patients age e.g. >40% for 40yr old
>2mm loss over 5 yrs
