Perio Flashcards
Which drugs can cause gingival hyperplasia?
Calcium channel blockers used in the treatment of hypertension
Cyclosporine an anti rejection drug
Phenyltoin used in epilepsy
What is necrotising gingivitis/periodontitis?
Painful ulceration of the papillae, with grey necrotic tissue visible on the surface.
Associated with halitosis and submandibular lymph nodes
What is the prevalence of aggressive perio?
1/1000
0.1%
Why is smoking the most important risk factor for perio?
Reduction in blood flow
Impaired white cell function
Impaired wound healing
Increased production of inflammatory cytokines, which cause tissue breakdown
Can periodontal treatment improve diabetes?
Yes! It can help to control the condition.
Beyond what depth can perio no longer be controlled by oral hygiene alone?
3mm
These sites should be considered for active treatment
Why do we use periapicals rather than dpts?
Give more accurate and detailed assessment of bony defects
Less radiation.
What comments should be made on perio radiographs?
Degree of bone loss %
Type of bone loss
Other features - perio/endo lesions, widened pdl space, calculus, restoration over hangs
What is more effective, hand scaling or ultrasonics?
Neither one has been proven to be more effective, but ultrasonics are quicker to reach the same end point
Less cementum removed with ultrasonic
What side effects can a patient expect from scaling?
Gingival recession
Increased sensitivity
Food packing
Does subgingival irrigation with chlorhexidine work?
Doesn’t appear to have a clinical benifit
When would we recommend chlorhexidine?
To manage acute periods when cleaning is difficult.
Not routine
How much more likely is it that a smoker will get perio compared to a non smoker?
6 times more likely
How long after smoking cessation can we expect the periodontium to be back to normal, in terms to its response to treatment?
3 years
When would we use systemic antibiotics for perio?
Possibly In aggressive perio alongside debridement, following failed initial treatment of debridement alone.
Necrotising peridontal disease
Systemic involvement and facial swelling due to periodontal abscess
Which systemic antibiotics would
You use in aggressive perio?
Amoxicillin 250mg TDS with mmetranidazole 200mg TDS
7-10 days
What does the black band on a bpe probe represent?
3.5-5.5 mm
What is a bpe of 0?
No pockets greater than 3.5mm
No calculus or overhangs
No bleeding on probing
What is a bpe 1?
No pockets greater than 3.5mm
No calculus or over hands
Bleeding on probing
What is a bpe 2?
No pockets greater than 3.5mm
Calculus or overhangs present
What is a bpe 3?
Probing depth between 3.5-5.5
What is a bpe 4?
Probing depth greater than 5.5
What is a bpe *?
Furcarion involvement
What charting should we do following a bpe 3?
Full perio charting in that sextant only
What charting should we do following bpe 4?
Full charting in all areas
What should we do clinically following a bpe 3?
Ohi
Rsd
What radiographs do we need?
Periapicals in areas where bpe scores of 3 or 4 are found
What distance describes recession?
The distance from the acj To the gingival margin
What is the probing pocket depth?
The distance from the gingival margin to the bottom of the pocket
What is the probing/clinical attachment level?
The distance from the acj to the botto of the pocket
Recession + pocket depth
How often should you change a manual toothbrush?
2-3 months
What brushing technique do we recommend for children?
Fones
Teeth in occlusion, large circles on buccal surfaces
Scrub remaining surfaces
Modify to smaller circles at the gingival margin as permanent teeth erupt
At what age do we stop supervising children’s brushing?
7
How often should you change the head of an electric toothbrush?
Oscillating 2-3 months
Sonic 6 months
What is the correct name for the plaque index we use?
Turesky modification of quigley and hein
What is a tureksy 3?
Plaque wider than 1mm but covering less than 1/3 of the crown
What temperature changes do ultrasonics cause in the pulp?
8degree with coolant
35degree without coolant
What are the disadvantages of ultra sonics?
Contaminated aerosols Aspiration required Expensive Noisy Burnished tooth surface Increase in dentine hypersensitivity Reduced tactile feeling on root
What are the contraindications of ultrasonics?
Tuberculosis Compromised immune system Respiratory problems Swallowing problems Primary teeth Newly erupted teeth Decalcified enamel Pacemakers? Metal tips used with implants
Why do we no longer carry out routine polishes?
Home care can achieve the same thing Fluoride in the surface enamel can be removed Doesn't improve fluoride uptake Creation of aerosol and splatter Can cause bacteraemia Possible iatrogenic damage
Why is a full perio exam necessary?
Site specific nature of the disease Extent and severity of the disease Treatment planning Monitor disease and hygiene therapy Predict likely treatment out come
What is a mobility score of 0?
No mobility
Less than 0.2mm
What is a mobility score of 1?
Less than 1mm movement
What does fremitus mean?
A palpable or visible movement of a tooth when subjected to functional occlusal forces
What is localised aggressive perio?
1st molar and incisor teeth
Not involving more than two teeth which aren’t the above
