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Spring 2020 Perio > Clinical Assessment of Periodontal Disease > Flashcards

Clinical Assessment of Periodontal Disease Flashcards

1
Q

Describe the dental hygiene process of care.

A

ADPIE

Assessment 
Dental Hygiene Diagnosis 
Planning
Implementation
Evaluation
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2
Q

Discuss the elements that make up the “assessment”

phase.

A
  • Med hx —
  • Social hx —
  • Family hx —
  • Dental hx —
  • Chief Complaint (CC) —
  • EO/IO —
  • Dental Examination —
  • Periodontal Examination
  • Must use open ended questions and have follow up questions that address “yes” Answers
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3
Q

Explain how different items on med hx, social hx,
dental hx, CC, and examinations can affect
periodontal disease

A

Med Hx: Uncontrolled diseases, diabeties
Social Hx: What their habits are? Drinking/Smoking/Vaping
Dental Hx: Frequeny of snacking, brushing/flossing, careis risks
CC: CC can give us an idea of what is going on.. such as sensitivity of pain

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4
Q

EO/IO

  • Lymphadenopathy what does this tell us
  • How might this relate to perio?
  • Gingival Discription- what does this tell us?
  • How might he medical hx or social hx affect what we might see
A
  • Infection of the lymph nodes
  • The Mandible or maxilla nodes may be swollen from infection from perio
  • The gingival description tells us weather the gingiva is healthy or not
  • Medical history.. certain diseases to show signs in the mouth and social history of smoking may show loss of color in gingiva
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5
Q

Dental Evaluation

What might we see that would affect perio?

A
  • Teeth —
  • Attrition, abfraction, erosion — -Malpositioning —
  • Restorations —
  • Decay —
  • Stain —
  • Appliances —
  • Hypersensitivity

These can contribute to perio due to overhangs, recurrent decay, appliances hard to clean.

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6
Q

Dental Evaluation

What might we see that would affect perio?

A
  • Teeth —
  • Attrition, abfraction, erosion — -Malpositioning —
  • Restorations —
  • Decay —
  • Stain —
  • Appliances —
  • Hypersensitivity

These can contribute to perio due to overhangs, recurrent decay, appliances hard to clean.

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7
Q

Gingival Description
- Anything from the med hx or social history that may come into play here… picture not shown but it was gingival hyperplasia from medicatios

A
  • Color
  • Consistency
  • Contour
  • Size
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8
Q

Periodontal assessment provides the ____ for __-term monitoring of periodontal disease activity

Outcomes evaluation to measure success after periodontal therapy

A

baseline long-term

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9
Q

Periodontal Examination is completed typically ___- ____ times a year

A

1-4

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10
Q

For periodontal maintenance patients: Complete periodontal charting at every appointment- This may vary form office to office

For healthy patients: complete periodontal charting at least __ yearly

At other visits ___ screening may be used to determine if complete charting is needed- if a __ or above is scored, then complete charting is indicated

Research has shown that usually screening and documentation is ___ **

A

1
3
PSR
** INADEQUATE

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11
Q

THE PSR is a periodontal assessment used to determine the periodontal health status of a patient and determine if a more ____ examination is indicated

A

complete

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12
Q

THE PSR exam take __-__ mins

Uses the __ probe ( has a __ tip and a colored band that marks __ - ___ mm

Mouth divided into __

All sites are probed on each tooth, but only the __ probing depth is scored and recorded

A 
2-3minutes
PSR
ball tip 3.5-5.5mm
sextants
deepest
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13
Q

Colored band is completely visible; no bleeding; no calculus; no roughness

A

Code 0

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14
Q

Colored band is completely visible; bleeding; no calculus or roughness

A

Code 1

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15
Q

Colored band is completely visible; bleeding; calculus and/or roughness

A

Code 2

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16
Q

Colored band is partially visible (3.5-5.5 mm PD)

A

Code 3

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17
Q

Colored band is not visible (5.5mm or greater PD)

A

Code 4

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18
Q

PSR * next to score

A

Furcation, mobility, mucogingival involement or recession

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19
Q

When scoring a __ or __ then a comprehensive charting is indicated

A

3 or 4

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20
Q

current or ongoing loss
of soft tissue attachment, specifically destruction of
gingival fibers and apical migration of JE, with
subsequent bone loss

A

Periodontal Disease Activity

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21
Q

Disease activity is typically seen in periods of ____ followed by periods of quiescence (inactivity)

A

exacerbation (worsening)

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22
Q

most commonly used physical
screening method for measuring the depth of the
gingival sulcus and the clinical attachment level

A

Periodontal Probing

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23
Q

Distance from the gingival margin to the base of the sulcus

A

Probing Depth

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24
Q

***In healthy gingiva, the marginal gingiva is approx.__ - __mm coronal to the CEJ

A

.5-2

25
Q

distance from CEJ

to the base of the sulcus (JE)

A

Clinical Attachment Level

26
Q

Even in a healthy state, the probe tip can penetrate the ___ (coronal to middle portion)

In gingiva that is inflammed, it goes even deeper into the LP, and sometiems all the way to the alveolar crest

A

JE

27
Q

2 examples of Controlled Force Probes

A

Florida Probe

Interprobe

28
Q

Controlled Force Probes provide a fixed __ - ___ g probing force in order to reduce examiner error

A

20-25g

29
Q

Connected to a computer for recording and storing data

A

controlled force probes

30
Q

Factors that Affect Probing

A
  • Probe angulation —
  • Variation in placement
  • Site of probing —
  • Probe size, type of probe —
  • Tooth anatomy —
  • Presence of calculus — -Visibility —
  • Patient discomfort
31
Q

Probe is ___. Spot probing is not sufficient. Most errors occur on ____ readings

A

walked

interproximal

32
Q

Probing:
Posterior: probe is angled into the _
Anterior probe is parallel to the long axis of tooth
Facial and lingual surfaces probe is paraellel to the long axis

*** it will need to be angled just a hair to get into the sulcus

A

col

33
Q

Clinical Attachment LEVELS

A

Need to know

  • Probe depth
  • Distance from CEJ to gingival margin
CAL= PD+Recession
CAL= PD-Amount of gingival overgrowth
34
Q

**A patient has clinical attachment loss when there is periodontitis with __ migration of the __

A

apical

junctional epithelium

35
Q

Determination of attachment loss is part of __

A

Clinical attachement level

36
Q

a shift in the position of the
gingival margin apical to the CEJ à root is now
exposed

A

Gingival recession

37
Q

Causes of Gingival Recession

A

trauma, orthodontic
movement, dental procedures, crown margins, clasps
from RPDs, periodontal disease, periodontal
therapy, oral habits (nail biting, aggressive
brushing), anatomic variations (frenum pull)

38
Q

a discrepancy in
the relationship between the mucogingival junction
and the free gingival margin — Usually, there is no attached gingiva remaining

A

Mucogingival involvement (defect)

39
Q

Determining the amount of attached gingiva:

A
  1. Measure the amount of keratinized gingiva (FGM
    to MGJ)– now known as Keratinized Tissue Width
    (KTW)
  2. Subtract the probing depth from this measurement
  3. The result is the amount of attached gingiva
40
Q

Determining the amount of attached gingiva:

/mucogingival involvement

A
  1. Measure the amount of keratinized gingiva (FGM
    to MGJ)– now known as Keratinized Tissue Width
    (KTW)
  2. Subtract the probing depth from this measurement
  3. The result is the amount of attached gingiva
41
Q

4 parts for consideration in treatment-oriented classification of gingival biotype and recession:

and which are collectively, gingival biotype or phenotype

A
  • Recession Depth
  • (Gingival Thickness)
  • (Keratinized Tissue Width)
  • Root Surface Condition
42
Q

Gingival Phenotype Explained: Gingival thickness and keratinized tissue width

Thin KTW: roughly < mm
Thick KTW: roughly >mm

Thin gingiva <1mm thick is associated with an increased risk of
Thick gingiva >1mm is at less risk

A

5mm
5mm

gingival recession

43
Q

What is the trick to figuring out gingival thickness

A

If the probe is visible through the tissue yes thin biotype

if no thick biotype

44
Q

**What is the trick to figuring out gingival thickness

A

If the probe is visible through the tissue yes thin biotype

if no thick biotype

45
Q

Recession Classification

***Attachment loss is measured from the CEJ to base of sulcus

A

Recession Type 1
Type 2
Type 3

46
Q

gingival recession with no loss of
interproximal attachment; IP CEJ is not detectable at both mesial
and distal aspects

A

RT1

47
Q

gingival recession associated with loss of IP
attachment; IP attachment loss is less than or equal to the buccal
attachment loss

A

RT2

48
Q

Gingival recession associated with loss of IP
attachment; IP attachment loss is greater than buccal attachment
loss

A

RT3

49
Q

Root Surface Classification:
- Root concavity (ex. abfraction) = “step” cervical step >equal to _mm +

CLASS A: CEJ is detecable
CLASS B: CEJ is undetecteble

REFER TO CHART

A

.5mm

50
Q

Tooth can be moved up to 1mm in any

direction

A

CLASS 1 MOBILITY

51
Q

Tooth can be moved more than 1mm in

any direction but is not depressible in the socket

A

Class II MOBILITY

52
Q

Tooth can be moved in a buccolingual

direction and is depressible in the socket

A

CLASS III

53
Q

**MOBILITY SHOULD BE ASSESSED WITH

A

2 INSTRUMENTS

54
Q 
FURCATION INVOLEMENT:
THE ABILITY TO ASSESS FURCATION WITH AN EXPLORER OR \_\_
- MAXILLARY MOLARS: 
- MANDIBULAR MOLARS:
- MAXILLARY FIRST PREMOALRS :
A

PROBE

TRIFURCATED
BIFURCATED
BIFURCATED

55
Q

The concavity just above the furcation entrance can be felt with the probe tip and this area may pose a challenge for patient cleaning; the probe can enter the furcation up to 3mm

A

GRADE 1 FURACATION

56
Q

The probe or explorer can enter the

furcation more than 3mm, but cannot pass all the way through

A

GRADE 2 FURACATION

57
Q

Probe passes all the way through.

A

GRADE 3 FURCATION

58
Q

Visible through and through.

A

GRADE 4 FURCATION

Spring 2020 Perio (12 decks)

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