Paeds Perio

Question 1

In a healthy periodontium, how deep should the gingival sulcus be?

Answer 1

0.5-3mm deep on fully erupted tooth

Question 2

What is a false pocket?

Answer 2

Apical migration of plaque and increase in the gingival sulcus depth (exaggerated by inflammation).
Junctional epithelium still at CEJ with no periodontal loss of attachment.
Reversible.

This is very common in mixed and young permanent dentition

Question 3

What are some features of necrotising gingivitis?

Answer 3

Pain
Necrosis of interdental papilla
Lymphadenopathy

Question 4

What are the key features of periodontitis?

Answer 4

Loss of attachment
Apical migration of Junctional epithelium with formation of a true pocket
Alveolar bone loss

Question 5

What is a simplified BPE and when should this be carried out?

Answer 5

Should be carried out on 6 index teeth (16, 11, 26, 36, 31, 46) using WHO 621 probe with light probing force (20-25g)
From age 7 and prior to commencing ortho treatment

7-11 only examine bleeding, calculus and/ or overhangs (BPE 1 and 2)
12-17 use full range BPE codes

Question 6

What is special test is indicated by sBPE 3/4

Answer 6

Alveolar bone levels should be checked = bitewings/ periapicals of anterior.

Question 7

What is indicated by sBPE 1

Answer 7

Bleeding on probing (no calculus/ overhangs)
OHI
Treat and screen again at recall/ 6 months

Question 8

What is indicated by sBPE 2

Answer 8

Calculus or plaque retention factor, no pocketing
OHI, PMPR, remove plaque retentive factors
Treat and screen again at recall/ 6 months

Question 9

What is indicated by sBPE 3

Answer 9

Probing depth 3.5-5.5mm

OHI, PMPR (emphasis on subgingival)

Undertake initial perio therapy including other affected teeth in the involved sextant(s). Full perio assessment after 3 months (6PPC on index tooth/ teeth in sextant)

Question 10

What is indicated by sBPE 4

Answer 10

Probing depth >5.5mm

On any tooth- do full perio assessment including 6 point probing depth throughout entire dentition, consider referral.
Then treatment.

Question 11

Where is the normal healthy bony crest in relation to CEJ in permanent teeth?

Answer 11

0.4-1.9mm from CEJ

Question 12

What special investigation does sBPE 1 indicate

Answer 12

Full assessment of marginal gingival bleeding (in conjunction with plaque biofilm score).

High percentage of bleeding on probing in relation to a low plaque index may warrant further investigation.