BSP Guidance

Question 1

What is the likely diagnosis for the following patient:

• BPEs: 1
• BOP: <10%
• No interdental recession.

Answer 1

Clinical gingival health.

Question 2

What is the likely diagnosis for the following patient:

• BPEs: 0
• BOP: 10-30%
• No interdental recession.

Answer 2

Localised Gingivitis

Question 3

What is the likely diagnosis for the following patient:

• BPEs: 2
• BOP: 60%
• No interdental recession.

Answer 3

Generalised gingivitis

Question 4

What is the management for the following patient:

• BPEs: 3
• BOP: 30%
• No interdental recession.

Answer 4

Radiographic assessment

If no pockets <4mm and no evidence of bone loss continue with code 0-2 treatment.

If pockets >4mm or bone loss then perio diagnosis and tx plan.

Question 5

What is the management for the following patient:

• BPEs: 4
• BOP: 20%
• With interdental recession.

Answer 5

Radiographic assessment

Full periodontal assessment (6PPC)

Periodontal diagnosis and treatment planning.

Question 6

What is the definition of stable periodontitis?

Answer 6

Whole mouth BOP is less than 10%, probing depths of 4mm or less, with no bleeding from 4mm sites.

Question 7

What is the definition of periodontitis in remission?

Answer 7

Whole mouth BOP is greater than 10%, with probing depths of 4mm or less with no bleeding from 4mm sites.

Question 8

What is the definition of unstable periodontitis?

Answer 8

Probing pocket depths 5mm or greater, or 4mm but bleeding on probing.

Question 9

How will a successfully treated periodontitis patient present?

Answer 9

Loss of attachment

Some inflammation

<10% bop

4mm or less pocket with no BOP

Radiological bone loss

Question 10

What defines an engaging patient?

Answer 10

Sufficient OH improvement

<35% MPS
<30% MBS

OR more than a 50% improvement in both

OR other target defined by clinician.

Question 11

How should a non-engaging patient be managed?

Answer 11

Re-motivate

Reinforce prevention

Re-estabish PT agreement

Supra/subgingival

PMPR

3 month recall

Question 12

How often should an engaging periodontal disease patient be recalled?

Answer 12

6 months.

Question 13

What is involved in step I of periodontal treatment?

Answer 13

Explain disease and R/B of treatment
Explain importance of OH
Explain risk factors
Supra-gingival PMPR
Provide tailored OHI

Question 14

When do you move to step 2 treatment?

Answer 14

Periodontitis patient
Engaging
Step 1 completed

Question 15

What is involved in step 2 of periodontal treatment?

Answer 15

Reinforce OH
Risk factor control
Behaviour change
Subgingival PMPR

Question 16

When do you move to step 3 or 4 treatment?

Answer 16

If stable after three months - move to step 4

If unstable after three months - move to step 3

Question 17

What is involved in step 3 of periodontal treatment?

Answer 17

Reinforce OH
Risk factor control
Behaviour change

Re-perform sub gingival PMPR of 4-5mm pockets

Residual pockets >6mm consider differential.

Consider referral for pocket management or regenerative surgery.

Maintenance recall 3-6 months.

Question 18

What is involved in step 4 periodontal treatment?

Answer 18

Supportive care
Reinforce OH, RF, BC
Regular targeted PMPR
Maintenance recall 3-12 months.