Oral hygiene instruction/BPE Flashcards
What is the etiological agent of all periodontal diseases
plaque
Define plaque induced gingivitis
inflammatory response of the gingival tissues resulting from bacterial plaque accumulation located at/below the gingival margin
Define periodontitis
inflammatory disease initiated by bacteria which in susceptible people causes severe inflammation and loss of bone around the teeth
What are the clinical signs of gingivitis
bleeding on probing
high plaque scores
high bleeding scores
gingival swelling and redness
What are the clinical signs of periodontitis
bleeding on probing
radiographic bone loss
gingival recession
probing depths of more than or equal to 4mm (clinical attachment loss)
What does the patient notice if they have gingivitis
blood in saliva
bleeding with toothbrushing and interdental cleaning
halitosis
What does the patient notice if they have periodontitis
blood in saliva bleeding with toothbrushing and interdental cleaning halitosis black triangles tooth movement
Why is there bone loss
there is bacteria on the teeth
the white blood cells want to get away from this bacteria but they can’t
so the way it responds is to move away by resorbing bone and with bone loss comes soft tissue loss
What is one difference between periodontitis and gingivitis in terms of inflammation
gingivitis is reversible inflammation of the gingival tissues
periodontitis is inflammation of the supporting structures of the teeth
Why does periodontitis have variable aggression
some patients are more susceptible to others
What systemic diseases can periodontitis be modified by
diabetes
How can diabetes modify periodontal disease
diabetes increases inflammation in the periodontal tissues
hyperglycemia can also result in the activation of pathways that increase inflammation
Why should we take a dental history
to identify the oral hygiene regime the patient uses
get an idea of motivation
What sort of questions should you ask your patient
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 mouth rinse?
do you attend the dentist regularly?
do you have your teeth cleaned by the dentist/hygienist?
What is a BPE
it is a screening tool for periodontal disease
it indicates what further assessment and periodontal treatment the patient requires
What is the mouth divided into for a BPE
sextants
What is the name of the probe used for a BPE
WHO CPITN
What are the two markings on a WHO CPITN probe
3.5 - 5.5
What does the ball at the end of the WHO CPITN probe do
catches plaque
How should the examination be conducted
probe is walked around the gingival margins of the teeth, gentle pressure
How much pressure is meant to be put on the probe during the examination
25g
What is the probing depth for a BPE score of 0
black band completely visible
What is the probing depth for a BPE score of 1
black band completely visible
What is the probing depth for a BPE score of 2
black band completely visible
What is the probing depth for a BPE score of 3
black band partially visible
What is the probing depth for a BPE score of 4
black band entirely within the pocket
What does a BPE score of (a number)* mean
furcation involvement
What is the observation for a BPE score of 0
No probing depths > 3.5mm
No calculus/overhangs
No bleeding after probing
What is the observation for a BPE score of 1
No proving depths > 3.5mm
No calculus/overhangs
Bleeding after probing
What is the observation for a BPE score of 2
No proving depths > 3.5mm
Supra/sub gingival calculus/overhangs present
What is the observation of a BPE score of 3
probing depths of 3.5-5.5mm present
What is the observation for a BPE score of 4
probing depths of 6mm or more present
What is the cochrane evidence for desensitizing toothpaste
supports use of potassium/stannous fluoride/both/calcium sodium posphosilicate and arginine containing densesitizing toothpastes
not the use of strontium containing
What is the evidence for manual vs electric toothbrushes
powered reduces plaque and gingivitis
What is the manual toothbrush technique
modified bass technique
What is the duration of brushing teeth
2 minutes
insufficient for those with periodontitis
What are the side effects of chlorhexidine mouth rinse
extrinsic staining
calculus build up
transient taste disturbance
effect son oral mucosa
What are the key points to behavior change
pick good words to use, better than a full lecture
offer assistance and seek permission to give knowledge - involve the patient. the natural response to force is resistance
What is oral hygiene TIPPS
talk instruct practise plan support
What should you talk about
the causes of dental disease and discuss any barriers to plaque removal
What should you instruct the patient
on the best ways to perform effective plaque removal
What should you practice?
ask the patient to clean his/her teeth and to use the interdental cleaning aids whilst in the dental surgery
What is the plan
Put in place a plan which specifies how the patient will incorporate oral hygiene into daily life
How should you support?
provide support to the patient by following up at subsequent visits
