Clinical session 1 Flashcards
What does TIPPS stand for
TALK with the patient about the causes of periodontal disease and discuss any barriers to effective plaque removal
INSTRUCT the patient on the best ways to perform effective plaque removal
Ask the patient to PRACTISE cleaning his/her teeth and to use the interdental cleaning aids whilst in the dental surgery
Put in place a PLAN which specifies how the patient will incorporate oral hygiene into daily life
Provide SUPPORT to the patient by following up at subsequent visits
BPE score 0
Black band completely visible
No probing depths >3.5mm, no calculus/overhangs, no bleeding after probing
BPE score 1
Black band completely visible
No probing depths >3.5mm, no calculus/overhangs, but bleeding after probing
BPE score 2
Black band completely visible
No probing depths >3.5mm, but supra or sub gingival calculus/overhangs present
BPE score 3
Black band partially visible Probing depths(s) of 3.5-5.5mm present
BPE score 4
Black band entirely within the pocket Probing depth(s) of 6mm or more present
BPE score *
furcation involvement
BPE score 0 treatment plan
no need for periodontal treatment
BPE score 1 treatment plan
Oral hygiene instruction (OHI)
BPE score 2 treatment plan
OHI, removal of plaque retentive factors, including all supra- and subgingival calculus
BPE score 3 treatment plan
OHI, root surface debridement (RSD)
BPE score 4 treatment plan
OHI, root surface debridement (RSD), assess the need for more complex treatment; referral to a specialist may be indicated
BPE score * treatment plan
OHI, root surface debridement (RSD), assess the need for more complex treatment; referral to a specialist may be indicated
What BPE scores should radiographs be taken for and why
- to assess alveolar bone levels
- where BPE codes 3 or 4
What is the BPE for this patient:
- interproximal plaque
- spaced teeth
- bleeding on probing
- probing depths are 3.5-5.5mm in the upper and lower anterior sextants, >5.5 in all posterior sextants
4 3 4
4 3 4
Describe the mini-sickle
A double-ended point scaler with two cutting edges on each blade for buccal and lingual embrasure surfaces supra-gingivally and within the pocket orifice
Describe the Columbia curette 4R-4L
A double-ended universal curette with 2 cutting edges on each blade for subgingival scaling and root planing anywhere in the mouth but with limited access to deep pockets
Describe your seating position when scaling
- forearms parallel to floor
- weight evenly balanced
- thighs parallel to floor
- hip angle 90 degrees
- seat height positioned so that you are able to rest the heels of your feet on the floor
- 11o’clock, 9 o’clock or 7o’clock
What teeth surfaces should you scale in the 11 o’clock position
upper anterior buccal all upper palatal upper left buccal lower right posterior lingual lower left posterior buccal
What teeth surfaces should you scale in the 9 o’clock position
upper right posterior buccal
lower right posterior buccal
lower left posterior lingual
What teeth surfaces should you scale in the 7 o’clock position
lower anterior palatal
lower anterior buccal
How do you grip the curette
‘modified pen grasp’
- index and thumb on the instrument
- middle finger rests lightly on the shank
- ring finger on oral structures, often a tooth surface
- little finger near ring finger, held in a natural, relaxed manner
what is the function of the index and thumb finger when holding a curette
holds the instrument
what is the function of the middle finger when holding a curette
- helps to guide the working-end
- feels vibrations transmitted from the working-end to the shank
what is the function of the ring finger when holding a curette
stabilizes the hand for control and strength
what is the shape of the cross-section of the minisickle
triangle
what is the shape of the cross-section of the columbia/universal curette
rounded
how should the lower terminal shank be positioned when scaling with either a columbia or minisickle curette
parallel to the long axis of the tooth
What is a BPE used for
- screening tool for periodontal disease
- provide guidance as to further investigations needed, and may
inform treatment planning.
Can BPE be used for diagnosis
no
How do we manage patients with a BPE score of 3 at glasgow dental school
The SDCEP guidelines suggest full periodontal
pocket chart for sextants with BPE=3 before treatment, AND at re-evaluation.
The British Society for Periodontology Guidelines suggest full periodontal
pocket chart for sextants scoring a BPE of 3 after initial treatment. At Glasgow
Dental School, we carry out full periodontal chart for sextants initially scoring 3
after initial treatment*. Either approach is correct.
*initial treatment includes dental health education, oral hygiene instruction, and
removal of all accessible (both supra and subgingival) plaque and calculus.
This should take no more than 2 appointments.
What are the limitations of BPE
- it relies on pocket depth and this can be misleading
- it fails to indicate the extent of disease
What probe is used to do a BPE
CPITN/WHO/BPE probe
