NSPT Flashcards
What is the screening tool for periodontal disease?
BPE- basic periodontal exam
What does a BPE score of 1 indicate?
bleeding on probing
pocket <3.5mm
black band completely visible
What does a BPE score of 2 indicate?
Plaque retentive factors
supra/subgingival calculus or overhangs
black band entirely visible
What does a BPE score of 3 indicate?
black band partially visible
indicating a pocket of 4-5mm
What does a BPE score of 4 indicate?
black band completely disappears
indicates a pocket of 6mm or more
What does a BPE score of * indicate?
furcation involvement
What treatment is indicated for a BPE 0?
no need for periodontal treatment
encourage OHI
What treatment is indicated for a BPE 1?
OHI
What treatment is indicated for a BPE 2?
OHI
removal of plaque retentive factors
What treatment is indicated for a BPE 3?
OHI
PMPR
RSD if needed
What treatment is indicated for a BPE 4?
OHI
RSD
referral to specialist may be indicated
What treatment is indicated for a BPE *?
OHI
PMPR
RSD
assess the need for more complex treatment, referal to specialist may be indicated
List diseases associated with an implant
- peri-implant mucosititis- absence of continunin marginal bone loss
- peri-implantitis
- peri-implant soft and hard tissue deficiencies
If periodontitis is not plaque related then what is usually present?
a systemic element
systemic disease
systemic impairment
Plaque related periodontal diseases usually fall into …
Periodontal health
Gingivitis
Periodontitis
<10% of bleeding on marginal probing is an indication of …
periodontal health
10-30% bleeding on marginal probing is an indicative of …
localised gingivitis
> 30% of bleeding on marginal probing is indicative of…
generalised gingivitis
> 30% of bleeding on marginal probing is indicative of…
generalised gingivitis
Gingivitis may be present with a reduced periodontum (bone loss not due to periodontitis). What can lead to bone loss in these cases?
- surgical crown lengthening
- trauma
- cushings disease/syndrome- increased bone resorption?
What assessment and treatments should be provided following a BPE score 3?
radiographic assessment with PA or OPT (if not clinically indicate or if only bitewings available then CAL or bone loss from CEJ)
interproximal bone loss assessment
Following initial periodontal therapy, what should you do for a patient with a BPE score 3?
3 month review
with a 6PPC in sextants involved
What assessments should be provided following a BPE code 4?
Radiographic assessment
full periodontal assessment- detailed 6PPC
A molar-incisor pattern of bone loss/CAL is indicative of …
Periodontitis Molar incisor pattern
Bone loss/CAL in <30% of teeth is indicative of…
localised periodontitis
Bone loss/CAL in >30% of teeth is indicative of …
generalised periodontitis
Why is bone loss in maxillary and mandibular anteriors more of a concern?
this is because they have the shortest roots and therefore are at an increased risk of mobility
What clinical measurement is used to determine the stage of periodontal disease ?
Interproximal bone loss
Staging is indicative of the _______ of the disease
severity
Grading is indicative of the _________ of the disease
rate of progression of the disease
What is stage I periodontitis ?
early/mild
15% bone loss
or <2mm attachment loss from CEJ
What is stage II periodontitis?
bone loss ending at the coronal third of the root
moderate
What is stage III periodontitis?
bone loss ending at the mid third of the root
severe
What is stage IV periodontitis?
bone loss ending at the apical third of the root
very severe
How is the grade of periodontal disease arrived at?
%bone loss / age
(%bone loss determined from the PA radiograph)
What is grade A periodontal disease?
slowly progressing
<0.5
What is grade B periodontal disease?
moderately progressing disease
0.5-1.0
What is grade C periodontal disease?
rapidly progressing disease
>1.0
Staging and grading of periodontal disease both require…
radiographs
using the worst site of bone loss to determine the periodontitis
What does a baseline periodontal chart include?
- 6PPC
- recession
- attachment loss
- mobility scoring
- furcation scoring
- plaque scores
- bleeding scores
- suppuration
What probes can be used to undertake a pocket chart?
UNC 15 (5, 10, 15)
Williams probe (1,2,3,5,7,8,9,10)- 4 and 6 missing
Describe how a pocket chart should be undertaken
Walk the probe
record deepest pocket
record bleeding/suppuration if present
6PPC are required to …
monitor the disease
Describe the correct probing technique that should be used for the 6PPC
- probing should done parallel to the long axis of the tooth
- must be in the correct adaptation- the probe tip should always be in contact with the tooth surface
What area is especially important for probing?
the interproximal area; below the contact point - most difficult areas to clean
How many instruments are used to assess mobility?
2 - usually the handle end
What are the grades of mobility and what they indicate?
- grade 0- normal movement 0.2mm
- grade 1- <1mm movement horizontally
- grade 2- >1mm movement horizontally
- grade 3- horizontal and vertical movement
How are furcations measured?
using a nabers probe
What is a grade I furcation?
- probe can enter <1/3 of the furcation width
What is a grade II furcation?
nabers probe can enter >1/3 of the furcation width but not through and through
What is a grade III furcation?
nabers probe can enter through and through
Plaque scores are often taken following …
plaque disclosure
What plaque scoring system is used on SOEL?
O’Leary
In a plaque and bleeding score, what kind of bleeding is recorded?
marginal bleeding- moving probe swiftyly along the gingival margin
What is the difference between bleeding on marginal probing and bleeding on probing?
marginal bleeding- moving probe swiftly along the margin
BoP- probe is put into the sulcus depth and bleeding recorded
Give examples of risk factors that can be included in risk factor assessments
Suboptimally controlled diabetes
suboptimal oral hygiene
smoking
(other systemic health disease?)
What is the most effective tooth brushing technique?
Modified bass technique
What is the correct technique for interdental cleaning?
- select correct size (snug)
- insert under contact point
- move back and forth
- should be brushing gums and teeth
What may happen to sizing of TePes with reduced inflammation?
TePe sizing may increase
When should you advise patients to ID clean? What is the rational behind this?
Before they brush
After they brush, motivation to use TePes diminishes
What additional cleaning aid is beneficial for patients with bridge work or patients with retainers and tight gaps?
Superfloss
What is the aim of PMPR?
- reduction in bacterial load
- removal of plaque retentive factors
Why must sub gingival instrumentation be under LA?
- ensure effective clean- operator is able to go to a deeper depth to clear calculus whilst maintaining patient comfort
How many visits should PMPR take?
As many as required to get a good clean
What way can you split up appointments for PMPR?
2 visits- half mouth, half mouth
4 visits- quadrant by quadrant
