Breaking Bad News - Chronic Perio

Question 1

What do the different codes 0-4 mean in BPE?

Answer 1

0 - No pockets >3.5 mm, no calculus/overhangs, no bleeding after probing
1 - No pockets >3.5 mm, no calculus/overhangs, but bleeding after probing
2 - No pockets >3.5 mm, but supra- or subgingival calculus/overhangs
3 - Probing depth 3.5-5.5 mm (black band partially visible, indicating pocket of 4-5 mm)
4 - Probing depth >5.5 mm (black band entirely within the pocket, indicating pocket of 6 mm or more)
* furcation involvement

Question 2

How would you explain chronic periodontitis to a patient?

Answer 2

i. A disease that has progressed slowly, over time
ii. It is important that patients realise that periodontitis cannot be cured, only controlled, and they must play an active part in controlling it on a day-to-day basis.
iii. The rate of progression in each individual depends upon local and systemic risk factors.
iv. In this case this is shown by presence of subgingival and supragingival calculus
v. It cannot be reversed, but it can be controlled

Question 3

What are the benefits and risks of having treatment?

Answer 3

• controlling the disease and stabilise

* leaving it can lead to further progression of disease/loss of teeth

Question 4

What kinds of treatment will be involved?

Answer 4

OHI, PMPR, cleaning the roots and removing calculus