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BDS2 Periodontology > Oral hygiene instruction and BPE presentation > Flashcards

Oral hygiene instruction and BPE presentation Flashcards

1
Q

what is the aetiological agent for gingivitis and periodontitis

A

plaque

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2
Q

define plaque induced ginigvitis

A

an inflammatory response of the ginigival tissues resulting from bacterial plaque accumulation located at and below the gingival margin

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3
Q

what are the clinical signs of plaque induced gingivitis

A
  • bleeding on probing
  • high plaque score
  • high bleeding scores
  • gingival swelling and redness
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4
Q

what does the patient notice with plaque induced gingivitis

A
  • blood in saliva
  • bleeding with toothbrushing and interdental cleaning
  • bad breath
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5
Q

key points to know about plaque induced gingivitis

A
  • reversible inflammation of the gingival tissues
  • swelling and bleeding at the gingival margins
  • risk factor for periodontitis
  • probing depths ≤3mm
  • no attachment loss
  • no radiographic bone loss
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6
Q

define periodontitis

A

an inflammatory disease initiated by bacteria which, in susceptible people, cause severe inflammation and loss of bone around the teeth

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7
Q

clinical signs of periodontitis

A
  • bleeding on probing
  • radiographic bone loss
  • gingival recession
  • probing depths ≤4mm (clinical attachment loss)
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8
Q

what the patient notices with periodontitis

A
  • blood in saliva
  • bleeding with toothbrushing and interdental cleaning
  • bad breath
  • black triangles
  • tooth movement
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9
Q

key points to know for periodontitis

A
  • inflammation of the supporting structures of the teeth
  • bleeding on probing in active disease
  • probing depths ≤4mm
  • radiographic bone loss
  • susceptible patients most at risk for tooth loss
  • can be modified by systemic disease
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10
Q

What 3 booklets do i need to read

A
  • the good practitioner’s guide to periodontology
  • guidelines for effective prevention of periodontal diseases
  • SDCEP prevention and treatment of periodontal diseases in primary care
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11
Q

What questions do you ask in a dental history

A
  • how often do you brush your teeth
  • do you use a manual or powered toothbrush
  • what toothpaste do you use
  • do you clean in between your teeth with floss or interdental brushes
  • do you use any mouthrinse?
  • do you attend the dentist regularly
  • do you have your teeth cleaned by the dentist/ hygienist?
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12
Q

How do you screen for periodontal disease

A

the basic periodontal examination (BPE)

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13
Q

How is the mouth divided in a BPE exam

A

into sextants

UR7-UR4, UR3-UL3, UL4-UL7, LR7-LR4, LR3,LL3, LL4-LL7

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14
Q

What do you record in a BPE

A

the highest score recorded in each sextant

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15
Q

What tool do you use for a BPE

A

WHO CPITN probe is walked around the gingival margin of the teeth

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16
Q

What does a BPE score of 0 indicate

A

Probing depth: black band completely visible

Observation: no probing depths >3.5mm, no calculus/overhangs, no bleeding after probing

17
Q

What does a BPE score of 1 indicate

A

Probing depth: black band completely visible

Observation: no probing depths >3.5mm, no calculus/overhangs, but bleeding after probing

18
Q

What does a BPE score of 2 indicate

A

Probing depth: black band completely visible

Observation: no probing depths >3.5mm, but supre- or sub-gingival calculus/overhangs present

19
Q

What does a BPE score of 3 indicate

A

Probing depth: black band partially visible

Observation: probing depth(s) of 3.5-5.5mm present

20
Q

What does a BPE score of 4 indicate

A

Probing depth: black band entirely within the pocket

Observation: probing depth(s) of 6mm or more present

21
Q

What does a BPE score of * indicate

A

furcation involvement

22
Q

What things do you check when asking about their personalised oral hygiene regime

A
  • toothpaste
  • toothbrush
  • method
  • duration
  • frequency
  • interdental cleaning
  • mouthrinse
  • denture hygiene
23
Q

What acryonm is used for giving oral hygiene advice and what does it stand for?
(KNOW THIS)

A

TIPPS

T - talk
about the causes of dental disease and discuss any barriers to effective plaque removal

I - instruct
the patient on the best ways to perform effective plaque removal

P - practise
ask the patient to clean his/her teeth and to use the interdental cleaning aids whilst in the dental surgery

P - plan
put in place a plan which specifies how the patient will incorporate OH into daily life

S - support
provide support to the patient by following up at subsequent visits

24
Q

What tooth paste should someone use

A

fluoride (1400ppm for adults)

25
Q

What ingredients are good for desensitising toothpastes

A

potassium-,stannous fluoride, potassium and stannous fluoride, calcium sodium phosphosilicate, and arginine containing desensitizing toothpastes (not strontium containing desenstizing toothpastes)

26
Q

powered or manual toothbrush

A

powered meant to be a little better

27
Q

what type of powered toothbrush?

A

rotation oscillation meant to be better at reducing plaque than side to side

28
Q

what toothbrushing technique should you use

A

Modified bass

29
Q

how long should you brush for

A

twice a day for at least 2 mins

n.b. for periodontitis 2 mins is insufficient (need for additional inter-dental cleaning)

30
Q

what interdental cleaning to do

A

yes to doing interdental cleaning

interdental brushes may be more effective than floss

limited evidence for tooth cleaning sticks and oral irrigators

31
Q

what mouth rinse to use?

A

daily use = fluorigard (if high caries risk)

severe gingivitis = corsodyl (not daily use)

32
Q

Key points to remember about changing a patients behaviour?

A
  • learning a skill is fast but changing a habit takes weeks/months
  • instruction is meaningless and easily forgotten without understanding the context in which it fits
  • a few appropriately selected and delivered words are more effective than a full lecture delivered with the hope the patient will grasp the relevant details
  • repeating instructions multiple times will not increase motivation (may decrease)
  • offering assistance, and seeking permission to give knowledge or teach skills facilitates patient ownership of the task. Natural response to force is resistance
  • motivation is not static but can vary as an individual is affected by other life related factors and stresses

BDS2 Periodontology (9 decks)

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