Ch 19 Flashcards
1
Q
what is the evidence based approach
A
- improve treatment results by using information from the research literature
- periodontal literature better determines and evaluates the pros and cons of various treatments in the context of individual patients
- GOAL: control inflammation
2
Q
what is problem based learning
A
- develops an individualized treatment plan for each patient
- identifies problems from the patient’s history/assessment
- interpretation and/or dental hygiene diagnosis will be made from each problem
- determine prognosis: diagnosis of periodontitis, nonsurgical tx of ging and perio, surgical perio therapy
3
Q
what are the goals of periodontal therapy
A
- ideal goal is to restore the periodontium to a functional state of health
4
Q
what is arrestive therapy
A
- periodontal therapy that aims to prevent the:
- initiation
- progression
- or recurrence of periodontal disease
5
Q
what is regenerative therapy
A
- reformation of periodontal tissue lost due to disease
- requires arrestive therapy first
6
Q
how is periodontal therapy considered ongoing care
A
- different therapies for every patient
- continued reassessments
- continued periodontal maintenance care: ethical and legal responsibilities; referrals when out of scope of abilities! send early rather than late
7
Q
what is a problem list
A
- take into consideration the patient’s chief complaint or concern, signs, and symptoms
- identify the patient’s problem
- a solution must be given for each problem
- expected outcomes (result of taking care of the problem)
- prognosis (predication of recovery)
8
Q
why is a risk assessment for periodontal disease important
A
- essential for treatment planning
- identification of risk factors and risk indicators or predictors (crystal ball)
- some risk factors cannot be modified ie socioeconomic status and genetics
- some risk factors can be modifiable ie. smoking, biofilm control
9
Q
guidelines for referral to periodontist
A
- rapid progressing periodontitis
- periodontitis with systemic factors
- refractory (nonresponsive) cases
- moderate to severe periodontitis (moderate if you feel out of scope)
10
Q
what is a level 3 patient
A
- patient who should be treated by periodontitis
11
Q
what do level 3 patients present with
A
- severe periodontitis
- furcation involvement
- vertical/angular bony defects
- a periodontal abscess and other acute periodontal conditions
- significant root surface exposure and/or progressive gingival recession
- peri implant disease
- any patient with periodontal disease, regardless of severity, whom the referring dentist prefers not to treat
- rapidly progressing periodontitis
12
Q
what is a level 2 patient
A
- patients who would likely benefit from co-management by the referring dentist and the periodontitis
13
Q
what does a level 2 patient present with
A
any patient with periodontitis who demonstrates at reevaluation, or any dental examination, one or more of the following risk factors/indicators known to contribute to the progression of perio:
- early onset of perio (prior to 35)
- unresolved inflammation at any site (eg. bleeding upon probing, pus, and/or redness)
- pocket depths of 5 mm or greater
- vertical bone defects
- radiographic evidence of progressive bone loss
- progressive tooth mobility
- progressive attachment loss
- anatomic gingival deformities
- exposed root surfaces
- a deteriorating risk profile
- smoking/tobacco use
- diabetes
- osteoporosis/osteopenia (low bone density)
- drug-induced gingival conditions (eg. phenytoins, calcium channel blockers, immunosuppressants and long term systemic steroids)
- compromised immune system, either acquired or drug induced
- a deteriorating risk profile
14
Q
what is a level 1 patient
A
- patients who may benefit from comanagement by the referring dentist and the periodontist
15
Q
what do level 1 patients present with
A
any patient with periodontal inflammation/infection and the following systemic conditions: - diabetes - pregnancy - CV disease - chronic respiratory disease any patient who is a candidate for the following therapies who might be exposed to risk from periodontal infection, including but not limited to the following treatments: - cancer therapy - CV surgery - joint-replacement surgery - organ transplantation
