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BDS2 Periodontology > Non-surgical Treatment > Flashcards

Non-surgical Treatment Flashcards

1
Q

What is score 0 on a BPE?

A

Pockets <3.5mm, no calculus/overhangs, no bleeding on probing (black band entirely visible)

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2
Q

What is score 1 on a BPE?

A

Pockets <3.5mm, no calculus/overhangs, bleeding on probing (black band entirely visible)

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3
Q

What is score 2 on a BPE?

A

Pockets <3.5mm, supra or subgingival calculus/overhangs (black band entirely visible)

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4
Q

What is score 3 on a BPE?

A

Probing depth 3.5-5.5mm (black band partially visible, indicating pockets of 4-5mm)

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5
Q

What is score 4 on a BPE?

A
  • Probing depth >5.5mm (black band disappears, indicating a pocket of 6mm or more)
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6
Q

What is meant by * on a BPE?

A
  • Furcation involvement
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7
Q

What treatment should be given to a patient with a BPE sc ore of 0?

A

No need for periodontal treatment

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8
Q

What treatment should be given to a patient with a BPE score of 1?

A
  • Oral hygiene instruction
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9
Q

What treatment should be given to a patient with a BPE score of 2?

A

OHI, plus removal of plaque retentive factors, including all supra and subgingival calculus

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10
Q

What treatment should be given to a patient with a BPE score of 3?

A

OHI, Plus removal of plaque retentive factors, including all supra and subgingival calculus, PLUS RSD if required

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11
Q

What treatment should be given to a patient with a BPE score of 4?

A
  • OHI, RSD, assess the need for more complex treatment, referral to specialist may be indicated
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12
Q

What treatment should be given to a patient with a BPE score with *?

A

Treat according to BPE score (0-4), assess the need for more complex treatment, referral to a specialist may be indicated

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13
Q

What % of people you see are likely to have periodontitis?

A

50%

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14
Q

What % of people you see are likely to have gingivitis?

A
  • 80%
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15
Q

If a patient has a BPE score of 3, do you need to do a pocket chart before or after treatment?

A
  • Bottom line is it doesn’t matter
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16
Q

What is non-surgical management also known as? (2 points)

A
  • Cause-related Therapy

- Hygiene Phase therapy

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17
Q

What are the aims for periodontal therapy? (4 point)

A
  • To arrest the disease process
  • Ideally, to regenerate lost tissue
  • To maintain periodontal health long term
  • RESULT = Keep teeth
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18
Q

What is the flow chart for ‘the treatment plan’?

A

Emergency care -> Disease control -> re-evaluation -> (periosurgery - maybe) -> Reconstruction -> Supportive care

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19
Q

What happens in the disease control phase of perio treatment? (5 points)

A
  • Extraction oof hopeless teeth
  • Hygiene phase therapy
  • Caries management
  • Endodontic therapy
  • Provisional prosthesis
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20
Q

What is meant by periodontitis?

A
  • Loss of attachment & true pocket formation colonisation of the root surface
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21
Q

What is included in hygiene phase therapy? (5 points)

A
  • Dental health education
  • Oral hygiene instruction
  • Scaling anf root surface debridement
  • Removal of other plaque-retention factors
  • Re-evaluation (need to re-evaluate to make sure patient doesn’t just go back to the way they were before)
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22
Q

What should you include in dental health education? (6 points)

A
  • Evaluate patients resons for attendance, attitudes to health care, motivation etc
  • Explain the nature of disease using diagrams, photographs, models etc
  • Discuss findings of examination
  • Demonstrate health and disease in the patients mouth
  • Explain the nature and consequences of treatment
  • Use the language the patient will understand
23
Q

What should be included in oral hygiene instruction? (3 points)

A
  • Tooth brushing (bass technique)
  • Interdental cleaning (floss and tape, interdental sticks, interdental brushes)
  • Disclosing agents
24
Q

What is scaling?

A

The removal of plaque and calculus from root surface

25
Q

What is debridement?

A

The act of removing dead, contaminated or adherent tissue, or foreign material

26
Q

What does root surface debridement encompass? (2 point s)

A

Scaling and removal or supragingival calculus

27
Q

Is there a difference in plaque/calculus removal or healing response when using powered vs hand instruments?

A

No

28
Q

Is there a difference in being able to access furcation regions when using powered vs hand instruments?

A

Ultrasonic/sonic tip design may allow better access to furcations

29
Q

Are powered instruments faster and less demanding on the operator than hand instruments?

A
  • They may be in the correct hands
30
Q

Do ultrasonic/sonic instrumentation result in less unwanted tooth tissue removal?

A
  • They might in the right hands
31
Q

Do you get greater tactile sensitivity with powered or hand instruments?

A
  • Hand instruments
32
Q

Can ultrasonic instruments be used supra and subgingivally?

A
  • Yes
33
Q

What are possible problems with restorations that can cause overhangs/defective margins? (3 points)

A
  • Restoration margins (location, adaptation)
  • Restoration contour
  • Partial dentures (gingival coverage, direct trauma, uncontrolled loads)
34
Q

How is success measured in periodontal therapy? (3 points)

A
  • Inflammation (bleeding on probing)
  • Reduction in pocket depth
  • Gain in probing attachment level
35
Q

What does probing depth indicate?

A

The difficulty of treatment and the likelihood of recurrence

36
Q

What is attachment levels a measure of?

A
  • Measre of tissue destruction (pre-treatment) and the extent of repair (post-treatment)
37
Q

What can manual probing measurements be influenced by? (6 points)

A
  • The resistance of the tissues
  • Size, shape and tip diameter of the probe
  • Site and angle of probe insertion
  • Pressure applied
  • Presence of obstructions such as calculus
  • Patient discomfort
38
Q

What is the effect of supragingival plaque control alone? (4 points)

A
  • Decreased gingival inflammation
  • Limited effect on probing depth
  • No change in attachment levels
  • No alteration in subgingival microflora in deep pockets (>6mm)
39
Q

What are the effects of RSD without supragingival plaque control? (3 points)

A
  • Initial reduction in inflammation and pocket depth
  • Pockets are re-colonised by bacteria from supragingival plaque
  • Disease recurs
40
Q

What are the effects of RSD with supragingival plaque control? (4 points)

A
  • Decreased gingival inflammation
  • Reduction in probing depth
  • Gain in probing attachment level
  • Marked changes in the subgingival microbial flora
41
Q

Gain in attachment is due to long junctional epithelium formation and improved tissue tone (inflammatory infiltrate in replaced by collagen). When are the greatest changes observed and how long does it take for gradual repair and maturation of tissues?

A
  • Greatest changes = observed 4-6 weeks after therapy

- Gradual repair and maturation of tissues over 9-12 months

42
Q

What is the objective of full mouth disinfection?

A
  • Prevent treated pockets being re-colonised by intra-oral translocation of bacteria
43
Q

What should Chlorhexidine be used for in full-mouth disinfection?

A
  • Used for subgingival irrigation, tongue brushing and mouth rinsing
44
Q

What are the effects of debridement? (2 points)

A
  • Reduces microbial challenge - decreased inflammation

- Inoculation with plaque organisms - boost immune response

45
Q

When re-evaluating the periodontal therapy, what should you look for? (4 points)

A
  • Patient plaque control
  • Bleeding on probing
  • Residual probing depth (& attachment levels)
  • Tooth mobility
46
Q

What would you see if periodontal treatment had been successful? (5 points)

A
  • Good OH
  • No bleeding on probing
  • No pockets >4mm
  • No increased tooth mobility
  • A functional and comfortable dentition
47
Q

What should you do if at the re-evaluation stage the patient has poor OH anfd persistent inflammation?

A
  • Identify the reason for poor OH, then supportive care or repeat cause-related therapy
48
Q

What should you do if at the re-evaluation stage the patient has good OH and the inflammation has resolved?

A
  • Supportive care & proceed with the treatment
49
Q

What should you do if at the re-evaluation stage the patient has good OH and persistent pockets with BOP?

A
  • Surgical access or repeat RSD, then re-evaluate
50
Q

Why might periodontal treatment fail? (3 points)

A
  • Poor compliance
  • Inadequate debridement
  • Host factors (mainly smoking)
51
Q

What are the limitations of non-surgical treatment? (5 points)

A
  • Root morphology
  • Frcation involvement
  • Deep pockets
  • SKill level
  • Time
52
Q

What does supportive periodontal care involve (for maintenance)? (4 points)

A
  • MAintain periodontal health
  • Detect and treat reoccurance
  • Maintain an accepted level of disease
  • Manage tooth loss
53
Q

How often should someone on supportive periodontal care be seen?

A
  • At intervals of approx. 3 months are appropriate for most patients
  • OH must be reinforced
  • Examine for signs of recurrent disease
  • Scaling, RSD, polishing and other treatment as necessary

BDS2 Periodontology (4 decks)

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