Clinical Assessment of Periodontal Diseases Flashcards
What is gingivitis?
Gingivitis is inflammation of the gums (gingivae). It is mostly caused by the bacteria in
dental plaque causing inflammation and it does not affect support for the teeth.
What is periodontitis?
Periodontitis is a chronic inflammation involving the supporting tissues around the
teeth with largely irreversible tissue damage. It is usually slowly progressive. The
gingiva detaches from the tooth neck, the periodontal ligament and alveolar bone are
damaged, and an abnormal gap (pocket) develops between the tooth and gum.
What is another word for gums?
gingivae
What is the common reason for gingivitis?
bacteria in dental plaque
Does gingivitis affect the support of teeth?
no
Does periodontitis effect the support of teeth?
yes
Is periodontitis slow of fast with its progression?
slow
Describe periodontists symptoms
The
gingiva detaches from the tooth neck, the periodontal ligament and alveolar bone are
damaged, and an abnormal gap (pocket) develops between the tooth and gum
Compare and contrast periodontists and gingivitis
Gingivitis causes swollen and bleeding gums. On the other hand, periodontitis is characterized by severely receding gums and deep pockets between teeth. Gingivitis is reversible, but periodontitis is so advanced that it may lead to tooth loss
Is periodontitis reversible?
no, it may be so severe it will result in tooth loss
What does BPE stand for?
BASIC PERIODONTAL EXAMINATION
What is the role of a BPE?
a simple and rapid screening tool that is used to indicate the level of further examination needed and provide basic guidance on treatment needed.
It indicates if further periodontal examination is needed
What does a BPE not do?
- It IS NOT a diagnostic tooth.
- It CANNOT be used for assessment of periodontal disease progression.
What instrument is used to carry out a BPE?
The BPE probe
What are the marking on the BPE probe?
markings at 3.5, 5.5, 8.5 and 11.5 mm
What is the diameter of the ball-end of a BPE probe?
0.5 mm
How long is the probe part of the BPE probe?
16 mm long working end
What do you call the probing end of a BPE probe?
working end
What is the BPE probe used for?
advocated for use in epidemiology and routine periodontal screening
How many sections should you split the mouth into for a BPE?
SECTANTS - 6 SITES
What are the sextants for a BPE?
lower left molars and premolars as one sextant, lower anteriors as another and lower right molars and premolars as a third sextant.
AND THE SAME FO RTHE UPPER SET
What numbers are the upper right site?
17-14
What numbers are the upper central site?
13-23
What numbers are the upper left teeth?
24-27
What number are the lower right teeth?
47-44
What number are the lower central teeth?
43-33
What numbers are the lower left teeth?>
34-37
What pressure should you use with a WHO PBE probe?
20-25g
What section of the mouth is A and B referring to?
A = upper
B=lower
What section of the mouth is circled?
upper right
molars and premolars
What section of teeth is circled?
Upper central
incisors and canines
What section of teeth is circled?
The upper left
molars x3
premolars x2
What number do the upper right teeth start with?
1
11-18
What number do the upper left teeth start with?
2
21-28
What number do the lower right teeth start with?
4
41-48
What number do the lower left teeth start with?
3
31-38
What are wizzies?
wisdom teeth
What do you have to consider when carrying out a BPE?
gaps and wizzies
What happens if there is only 1 natural standing tooth in a sextant?
For example LR
e.g. Patient has 1 natural standing tooth in
the LR sextant.
Add LR4 score to the LC
What do you score a sextant if the there is only 1 natural standing tooth?
e.g. LR4
X
add natural tooth onto neighbouring sextant
Can you score a sextant if 2/5 teeth are natural standing?
And what would you score the missing teeth?
e.g. LR4 and LR8
YES
score LR5/6/7 an 8
What pocket depth is rated a 0-2?
0-3.5mm
What pocket depth is rated a 3?
3.5-5.5mm
What pocket depth is rated a 4?
> 5.5mm
What does a ‘*’ mean?
furcation involvement
What is furcation involvement?
the area where the roots divide and branch into multiple teeth at a time
What BPE score would you give this?
0
What BPE score would you give this?
1
What BPE score would you give this?
2
What BPE score would you give this?
3
black band partially visible
What BPE score would you give this?
4
What does this tooth show?
furcation involvement
What is the first step in the assessment flowchart for BPE?
History examination and screening for periodontal disease
When would you score a section 0/1/2?
no obvious evidence of interdental recession
What does <10% bleeding on probe mean?
clinical gingival health
What does 10-30% bleeding on probing mean?
localised gingivitis
What does >30% bleeding on probing mean?
generalised gingivitis
What else should you include in a score of 2 when diagnosing during a BPE assessment?
diagnosis should also include a comment on plaque factors where BPE code 2 is present
What steps should you follow of a tooth/teeth area score of 3 during a BPE assessment?
- appropriate radiographic assessment
- initial periodontal therapy and review in 3 months with localised 6-point pocket chart in involved sextant
If score of 3, how long should you wait to review the pat8ient again?
3 months
When a patient that was a band 3 at initial appointment returns for a review, what 2 options are you assessing for?
- no pockets (2-4mm) and no radiographic evidence of bone loss due to periodontitis - continue with 0/1/2 pathway
- pockets above or equal to 3mm remain and/or radiographic evidence of bone loss due to periodontitis - continue with 4 pathway
When you are reviewing a patient after 3 months, what is a probe depth which rules out periodontitis?
2-4mm
What steps do you follow if a patients have a score of 4?
- radiographic assessment
- full periodontal assessment (and detailed 6-point pocket chart)
What are the 3 levels of periodontitis of a score of 4?
- molar-incisor patter - periodontitis (molar-incisor pattern)
- <30% of teeth - localised periodontitis
- over or equal to 30% of teeth - generalised periodontitis