Good practioner's guide BSP

Question 1

what are systemic risk factors?

Answer 1

• tobacco use
• diabetes
• stress
• medication
• socioeconomica status
• cardiovascular disease
• poor nutrition

Question 2

how does diabetes affect perio?

Answer 2

• poorly controlled = affected wound healing
• undiagnosed diabetes = present with multiple, lateral perio abscesses, liase with patient’s gp

Question 3

what must patient diabetes control be

Answer 3

• maintain levels HbA1c pf 6.5% (48mmol/mol) or lower
• important indicator of long-term glyciemic control because reflects lifespan of haemoglobin 3 months

Question 4

why does smoking affect perio health?

Answer 4

• reduction in gingival blood flow
• impaired white cell function
• impaired wound healing
• increased production of inflammatory cytokines enhancing tissue breakdown

Question 5

what is link to Cardiovascular disease and perio?

Answer 5

not nature of relationship not full understoon but some potential risks are
- inflammation - both share chronic inflammation
- shared risk factors
- some bacteria from periodontitis can enter bloodstream and travel down to heart and contribute or make worse heart disease

Question 6

how do record bpe for children?

Answer 6

6 index teeth
- 16, 11, 26, 36, 31, 46

7-11 years
- codes used 0-2

12-17 years
- 0, 1, 2, 3, 4 , *

when under 12 kids can have false pockets which would give false 3’s

Question 7

implants and bpe

Answer 7

• don’t bpe implants not reliable
• have to do detailed probing (4 or 6 points) around implant and bleeding and suppuration measured

Question 8

what are indications for referring a child to specialist?

Answer 8

• Diagnosis of aggressive periodontitis
• Systemic medical condition associated with periodontal destruction
• Medical history that significantly affects periodontal treatment or requiring multi-disciplinary care
• Genetic conditions predisposing to periodontal destruction
• Non-plaque induced conditions requiring complex or specialist care
• Drug-induced gingival overgrowth
• Cases requiring evaluation for periodontal surgery

Question 9

what should radiographs be asses for with regards to perio?

Answer 9

• Degree of bone loss
• pattern or type of bone loss
• presence of furcation defects
• presence of subginigval calculus
• Other features: e.g. endo- perio lesions; widened periodontal ligament spaces; abnormal root
  length or root morphology; overhanging restorations.

Question 10

what is gingivitis?

Answer 10

Gingivitis is a reversible plaque-induced inflammation of the gingivae. It is recognised by erythema, oedema and bleeding
on brushing or probing.

Question 11

what is this caused by?

Answer 11

gingivitis aggravated by mouth breathing

Question 12

what is this caused by?

Answer 12

Pregnancy gingivitis with pregnancy epulis
buccal to UR2/3 area.

Question 13

what medicines can cause gingival overgrowth?

Answer 13

• calcium channel blockers treatment of hypertension examples include amlodipine and nifedipine
• ciclosporin
• phenytoin used to control epilepsy

Question 14

what is chronic periodontitis?

Answer 14

Characterised by the destruction of the junctional epithelium and connective tissue attachment of the tooth, together with bone destruction and formation of periodontal pockets

Question 15

what is aggressive perio?

Answer 15

Aggressive periodontitis is diagnosed from
its rapid rate of progress or as a result of severe disease in individuals usually under 35 years of age who are otherwise
medically healthy

Question 16

what is necrotising ulcerative gingivitis?

Answer 16

Painful ulceration of the tips of the interdental papillae. Grey necrotic tissue is visible and there is an associated halitosis

Question 17

what is periodontal abscess?

Answer 17

Infection in a periodontal pocket which can be acute or chronic and asymptomatic if freely draining

Question 18

what is endo-perio lesion?

Answer 18

Lesions may be independent or coalescing and the bacterial source originates either in the periodontium or the root canal system

Question 19

what is diff between marginal and bleeding on probing?

Answer 19

Bleeding from the gingival margin is an indicator of gingivitis and will respond quickly to improvements in daily plaque removal.
Bleeding from the base of the pocket represents periodontitis and is more reflective of the response to periodontal treatment such as root
debridement

Question 20

what is oral hygiene strategy

Answer 20

oral hygiene TIPPS
talk instruct practice plan support

Question 21

what are side effects and management of non surgical therapy?

Answer 21

• increased gingival recession
• longer-looking teeth (especially if there are deep pockets anteriorly)
• increasing gaps between the teeth (black triangles),
• increased sensitivity
• soreness
• food packing
• 0.2% chloroxedine gluconate mouthrinse used for acute periods when cleaning difficult only licensed for 30 days of use

Question 22

what are principle aims of periodontal surgery?

Answer 22

• Access for debridement
• regenerative surgery (form a long junctional epithelium)
• crown lengthening (increase for aesthetic reasoms or provide adequate tissue for restoration)
• management of recession (called mucogingival surgery) (for aesthetics)

Question 23

what are recession classes?

Answer 23