Perio - Classification

Question 1

What are the stages of perio broken down into?

Answer 1

Stage 1 - less than 2mm of bone loss
2 - bone loss in the coronal 1/3
3 - Bone loss in the middle 1/3
4 - Bone loss in the apical 1/3

Question 2

What are the grades for periodontal disease broken down into?

Answer 2

A - Less than 0.5
B - Between 0.5-1
C - Greater than 1

Question 3

How are the grades of periodontal disease worked out?

Answer 3

You take the percentage of bone loss and divide it by the age of the patient.
For example, if the patient had 80% bone loss and was 40 years of age. That would give a score of 2 and that patient would be a grade C (severe).

Question 4

How do you categories stable and unstable perio?

Answer 4

Stable perio with only 10% B.O.P, All pockets are less than or equal to 4mm, and any pockets of 4mm having no BOP.

Unstable is pocket depths of 5mm or more and 4mm have BOP.

Question 5

What makes periodontal disease localised or generalised?

Answer 5

It will be localized if less than 30% of the teeth are affected.
Can also get a molar incisor pattern but that mainly effects younger people

Question 6

What are some risk factors for perio?

Answer 6

Smoking and diabetes (MAIN)
Stress
obesity
Down syndrome

Question 7

How can bone loss be measured?

Answer 7

By taking radiographs (bitewings) and measuring from the CEJ

Question 8

For this classification is it an average score given or is the score given as a reflection from the greatest area of bone loss?

Answer 8

The greatest area of bone loss.

If the patient has lost a tooth due to periodontal disease then they will be stage 4

Question 9

What does the grade of a patient tell you about their periodontal health?

Answer 9

It is a measure of progression and tells you how fast the disease is progressing

Question 10

Is periodontal disease completely reversible?

Answer 10

No, you will always have periodontal disease but you can control it and stabilise it.

Question 11

For a BPE of 3 what guidelines does the GDH follow and what are they?

Answer 11

BSP guidelines
Carry out a 6 point pocket chart only in that sextant. (after initial treatment)
But if any other sextant scores a 4 then a full 6PPC is indicated.

Question 12

What is a BPE used as?

Answer 12

A screening tool.

Further appropriate diagnostic measures are then needed to formulate a diagnosis and treatment plan.

Question 13

Define gingival health?

Answer 13

An intact periodontium with no BOP, erythema, edema, and patient symptoms. Physiological bone levels vary from 1-3mm apically from CEJ

Question 14

What is pregnancy epulis?

Answer 14

It is a severe gingival swelling that happens in pregnant women. As a result of dental plaque. It usually resolves after the birth but can need to be surgically removed.

Question 15

What is a common type of drug which can induce gingival enlargement?

Answer 15

Calcium channel blockers

Question 16

For gingival diseases which are not plaque-induced, what should you do?

Answer 16

Seek specialist help

Question 17

What is lichen planus and why must you monitor it carefully?

Answer 17

It is an autoimmune disorder that causes white patches to form in the mouth on swollen tissue.
It must be monitored cause can develop into oral cancer

Question 18

3 Types of gingival recession?

Answer 18

Recession type 1 - the recession is only on the labial aspect and there is no visible recession on the interproximal surfaces (Mesial or distal)
Recession type 2 - the recession interproximal is less than or equal to the recession on the labial/buccal aspect of the tooth.
Recession type 3 - the recession in the interproximal area is greater than or equal to the labial/buccal area.