Chronic Periodontitis

Question 1

a bacterial infection affects what parts of the periodontium

Answer 1

1. gingiva
2. cementum
3. PDL
4. alveolar bone

Question 2

what is the host-bacterial interaction theory

Answer 2

bacteria + host response = disease

Question 3

what bacteria are in the red complex?

Answer 3

PG, TF, and TD

Question 4

what type of perio is most common?

Answer 4

chronic

Question 5

how fast does chronic progress?

Answer 5

progresses at a slow to moderate rate with short periods of rapid disease progression

Question 6

in chronic perio, tissue destruction is consistent with what?

Answer 6

presence of local etiologic factors

Question 7

what does refactory mean?

Answer 7

disease always progresses no matter what we do

Question 8

what kind of deposits are present in chronic perio

Answer 8

bacterial plaque and subgingival calculus deposits

Question 9

what was chronic perio previously known as?

Answer 9

adult periodontitis

Question 10

what are some warning signs of chronic perio?

Answer 10

red swollen gingiva, bleeding during brushing, bad taste in mouth, persistent bad breath, sensitive or loose teeth, and pus around teeth

Question 11

is pain a symptom? what does this lead to?

Answer 11

no which leads to patients not seeking treatment early in the disease or not following through with treatment after the disease is diagnosed

Question 12

T/F: clinical appearance is a reliable indicator of the disease

Answer 12

False it is not

Question 13

what types of changes might we see in chronic perio?

Answer 13

may exhibit pronounced changes in appearance or may exhibit minimal changes in appearance

Question 14

what kind of adjunct would you use for a patient who has had gingival recession?

Answer 14

proxa brush, end tuft, pipe cleaner, acrylic yarn, and sulcus brush

Question 15

what causes teeth flaring in the anteriors?

Answer 15

1. tongue thrusting

2. bone loss

Question 16

T/F: bleeding does not mean bone loss

Answer 16

True

Question 17

what does pus represent?

Answer 17

dead white blood cells and can occur in any infection

Question 18

define etiology

Answer 18

bacteria alone are not sufficient for progression to chronic periodontitis

Question 19

what is the onset and severity of perio determined by?

Answer 19

interaction between the host immune response and bacteria

Question 20

what is extent?

Answer 20

amount of destruction characterized by number of sites that have experienced destruction

Question 21

what is severity?

Answer 21

seriousness of the disease determined by rate of disease progression over time and response of tissues to treatment

Question 22

what are characteristics of slight to moderate tissue destruction?

Answer 22

1. loss of 1/3 of perio structures
2. probe depths 4-6 mm
3. CAL up to 4 mm
4. Class 1 or 2 furcation

Question 23

what are characteristics of advanced tissue destruction

Answer 23

1. loss of more than 1/3 of perio structures
2. probe depths 7 mm or more
3. CAL of 5 mm or more
4. Class 3 furcation

Question 24

what is progression?

Answer 24

change or advancement of periodontal destruction

Question 25

characteristics of localized chronic perio progression

Answer 25

less than 30% of sites in mouth have attachment and bone loss ( or 2 sextants)

Question 26

characteristics of generalized chronic perio progression

Answer 26

more than 30% of sites in mouth have attachment and bone loss (more than 2 sextants)

Question 27

the rate of disease progression in chronic periodontitis appears to be _____

Answer 27

slow to moderate

Question 28

what are treatment considerations for initial therapy

Answer 28

1. consult with physican if systemic risk factors are present
2. evaluation of plaque control skills
3. smoking cessation
4. whole mouth debridement
5. individualized oral hygiene instructions

Question 29

what are treatment considerations for re-evaluation?

Answer 29

1. re-examine inital therapy’s outcome after allowing time for tissue repair

Question 30

what are treatment goals? also known as?

Answer 30

also known as long-term goals

1. arrest disease progression
2. eliminate risk factors
3. prevent re-occurrence
4. control plaque level

Question 31

what are desired outcomes?

Answer 31

1. decrease SBI
2. decrease PCR
3. decrease probe depths
4. maintain patient comfort
5. prevent further attachment loss

Question 32

what does long term outcome depend on?

Answer 32

depends on patient compliance with self-care and recall appointments at appropriate intervals

Question 33

do all site respond equally to therapy?

Answer 33

no

Question 34

what is recurrent perio?

Answer 34

-NEW signs of destructive perio that reappear after therapy

Question 35

why does recurrent perio occur?

Answer 35

1. disease was not adequately treated

2. patient did not practice adequate self-care

Question 36

what is refractory disease?

Answer 36

determined over time that there is continuing attachment loss at one or more sites

Question 37

when can refractory disease be applied?

Answer 37

it can be applied to all types of periodontal diseases that do not respond to treatment