peridontal disease Flashcards
why do we get issues with the peridontium?
what are the peridontal diseases?
the peridontium is under constant attack and has limited regeneration capacity
Periodontal disease:
- Gingivitis (first)
- Periodontitis (2nd)
what causes gingivitis?
A biofilm of bacteria that causes inflammation due to the host response to the toxins released by the bacteria
biofilm forms in 48 hours
- Plaque bacteria adjacent to gingiva and within the sulcus
the inflammation can’t get rid of the bacteria due to the bactria being onthe tooth and not on the gums therefore starts to damage the soft tissue
gingivitis can be reversed by removing the plaque, by tooth brushing on a daily basis
Severity score (G0-3):
- signs of inflammation
- tendency to bleed
what is peridontitis?
what is the cause?
what is involved?
how do you prevent peridontitis?
IRREVERSIBLE sequel to gingivitis
Plaque bacteria = primary factor
Inflammatory disease
Involves:
* gingiva
* periodontal ligament
* cementum
* alveolar bone
Cannot get periodontitis without gingivitis
May remain only as gingivitis - Multi-factorial disease process
predisposing disease, genetic presisposition
Can slow or arrest by effective plaque removal - BRUSHING
what are the patterns of peridontitis?
Damage patterns eg:
* pocketing
* gingival recession
Damage exacerbates problem
Extraction eventually required
What are the presidposing factors of peridontal disease?
Systemic
* Underlying disease
* Immune compromise
Local:
* Site-specific disease
* Plaque trapping
* Plaque retention
* Plaque stagnation
* Calculus
* Overcrowd
* Gingival abnormalities
* Foreign bodies
* Trauma
what are the complications of peridontal disease?
Local extension
* Adjacent teeth
* Abscess
* Osteitis
* Osteomyelitis
* Stomatitis
* Ulceration - eg contact/ ‘kissing’ ulcers
* Faucitis
Systemic extension
* Bacteraemia
* Dissemination to organs (kidneys, heart, liver)
* Pregnancy, performance etc
how can we prevent and treat peridontal disease?
remove the plaque
then ensure the owner brushes the teeth daily
Scaling:
Debulk calculus: hand scale (don’t use calculus forceps can break teeth)
Then: use and ultrasonic scaler
what are the two hand scaler instuments?
Hand scale instrumentation: scaler & curette
Scaler = Supragingival ONLY (pointy tip, picture)
Curette = Supra and subgingival (rounded tip)
what is does scaling do?
what does polishing do?
what needs to be done after scaling (and polishing)?
scaling does:
- Calculus removal
- Plaque biofilm removal
- BUT leaves rough, plaque retentive surface
polishing does:
Plaque biofilm removal
meant to be smoothing - but not really needed
Flush
- paste (inhibits healing)
- calculus
Chlorhexidine prep pre-op
what are the homecare steps of preventing dental disease?
Brushing = gold standard
- soft-medium bristle brush - DAILY
short forwad and back movements
other homecare aids:
- Mouth wash – chlorhexidine 0.12%
- Chews
- 5mins+ - saliva, exercise, eg olive wood
- Avoid damage – bones, antlers
- Dental diets
- Plaque removal
- Fibrous & size
- Powders, Gels, Tablets…?!!
