Perio Flashcards
What are the signs of periodontal disease?
Bleeding gums
Swollen and tender gums
Bad breath
Recession-lengthening of teeth
Tooth loss
Tooth mobility
Gum abscesses
What are the risk factors for perio?
Age
Smoking
Diabetes
HIV
Stress
Medications
Malnutrition
Anatomical
What are the risks of periodontal treatment?
Recession - sensitivity, lengthening of teeth, susceptibility to root decay
Temporary increase in mobility
Should not be carried out in 1st trimester of pregnancy
What are the treatment options for recession?
Monitoring
Use of desensitising agents
Composite restorations
Prosthetic crowns
Removable pink gingival veneers
Periodontal surgery
How do you calculate clinical attachment loss?
Pocket depth + gingival margin height
What are the reasons for failure of perio treatment?
Smoking
Patient not compliant- OH is poor
Inability for patient to practice OH effectively
Systemic factors- stress, diabetes, pregnancy, malnutrition, poor diet
What are the stages of periodontal disease?
1- <15% of bone loss
2- Coronal third of root
3- middle third of root
4- apical third of root
What is the grading of periodontal disease?
% bone loss/age (worst site)
A= <0.5
B= 0.5-1
C= >1
What is currently stable in periodontal disease?
Currently stable
BOP <10%
PPD less than or equal to 4mm (with no BOP at 4mm sites)
What is currently in remission in periodontal disease?
BOP greater than or equal to 10%
PPD less than or equal to 4mm (No BOP at 4mm sites)
What is currently unstable in periodontal disease?
PPD greater than or equal to 5mm
PPD greater than or equal to 4mm with BOP
What is occlusal trauma?
Injury resulting in tissue changes in the attachment apparatus due to excessive occlusal force
What are the factors causing increased mobility?
Short roots
Widened PDL
Shorter PDL
Inflammation
What are the signs and symptoms of occlusal trauma?
Widening of PDL
Tooth mobility
Fremitus
Wear facets
Fracture
Migration
Root resorption
What is the treatment of a perio abscess?
Subgingival PMPR- short base of pocket
Incision and dilation if pus
Analgesia
CHX 0.2%
When free of pain recall for PMPR
What are the signs and symptoms of a perio abscess?
Swelling
Pain
TTP
Bleeding
Suppuration
Lymphadenopathy
Fever
What are the guidelines for perio treatment?
BSP S3 treatment guidelines
What is an engaging patient?
BOP less than or equal to 30%
Plaque scores less than or equal to 20%
OR 50% reduction
What is in Step 1 of perio treatment?
Education
OHI
Reduce risk factors
PMPR- supra
What is in step 2 of perio treatment?
Subgingival PMPR
Reinforce OHI
Reevaluate after 3 months
What is step 3 of perio treatment?
Reinforce OHI
Repeated subgingival PMPR of residual pockets
What is step 4 of perio treatment?
Supportive care
Reinforce OHI
Regular targeted PMPR
