INITIAL PERIODONTAL THERAPY Flashcards
What is the treatment plan dependent on?
It is dependent on the correct diagnosis
What are the 3 stages of periodontal therapy?
- Initial cause related therapy
- Corrective therapy
- Supportive therapy
How should you explain the treatment plan to the patient?
- Be specific, use simple language, avoid medical /dental jargons
- Do not use a patronising tone
- Avoid vague statement
- Begin your discussion on a positive note
- Present the entire treatment plan as a unit
What is the aim of the initial cause related therapy step in periodontal therapy?
To eliminate all the infectious and inflammatory processes that cause periodontal and other oral problems that may hinder the patients general health
This should bring back the oral cavity to a state of health
What procedures can the initial therapy include?
- Periodontal procedures
2. Other dental therapy (E.g. endodontics /addressing oral lesion/extraction of hopeless teeth)
How can we Control or eliminate plaque infections when carrying out the initial therapy?
- Give instructions on oral hygiene techniques
- Give smoking cessation counselling
- Do scaling and root surface debridement and elimination of plaque retention factors
- Make sure the extractions/ endodontics/ restorations/ dentures are arranged properly
- baseline indices of periodontal status
What should we carry out when doing our initial therapy?
- Give Diet advice, luoride advice /OHI
- Give Preventive advice like looking at Lifestyle factors: stress reduction advice /alcohol moderation advice/regular exercise/smoking cessation advice/liaise with GP if necessary
- Remove calculus and root surface debridement
- Correct restorative and prosthetic irritational factors
- Excavate caries and restoration
- Can do Antimicrobial therapy (local or systemic)
- Can do Occlusal therapy
- Can look into Provisional splinting and prosthesis
What phases and steps must be pass before we can move onto corrective therapy?
- Emergency phase
- Initial therapy
- Recall and review
If review unsuccessful go back to initial therapy
If review is successful continue with treatment plan
What Is the relationship between periodontal therapy and dental therapy ?
Periodontal therapy is an inseparable part of dental therapy
What indices can we record to come to a diagnosis ?
- BPE
- Probing pocket depth
- Bleeding on probing
- Suppuration
- Furcation
- Recession
When should we record indices?
Before the initial therapy so that we can come to a diagnosis
If a patient has a BPE of 1 or 2 what should we do?
- record marginal bleeding free scores first
- then record plaque free scores
- repeat indices during initial therapy as needed
If a patient has a BPE of 3 or 4 what should we do?
- Record plaque free scores
- May be useful to record marginal bleeding free scores also
- Record probing pocket depth and bleeding on probing
- Record suppuration, furcation, recession & mobility
- Record bone levels, loss on any radiographs
What are the 3 grades we can give when testing mobility?
Grade I < 1mm horizontally
Grade II > 1 mm horizontally
Grade III > 1 mm horizontally + vertical
What is furcation?
Bone loss between roots of multicoated teeth
What are the 3 grades we can give when testing furcation involvement?
F1 < 3mm horizontally
F2 > 3mm horizontally but not right thro’
F3 through and through