PERIO - referral policy Flashcards
list some factors affecting referral of periodontal patients from primary to secondary care?
stage and grade of periodontitis and complexity of tx required
patients desire to see a specialist
knowledge, experience, and training of dentist
presence of genetic and lifestyle/ behavioural risk factors
what is the suggested management for patients at a level 1 complexity?
treatment normally undertaken in general dental practice
what is the suggested management for patients of level 2 complexity?
tx either performed by GDP or referred to a specialist
periodontal/ peri-implant tx may need to be delivered by a specialist
what is the suggested management for a level 3 complexity pt?
usually referred following initial modifiable risk factor management and NSPT in general practice
when would we use abx in perio?
necrotising periodontal diseases or acute abscess with systemic complications
recommended by specialist as part of a comprehensive care plan
what is another term for ‘palliative’ periodontal care?
supportive periodontal care (SPC)
supportive periodontal therapy (SPT)
what is the criteria for level 2 complexity?
following primary care therapy - stage II, III, or IV periodontitis + residual true pocketing 6mm or more
grade C periodontitis
furcation defects and complex root morphology when strategically important
non-surgical management of gingival enlargement in collaboration with medical colleagues
management of non-plaque induced perio under specialist guidance
peri-implantitis mucositis
what is the criteria for level 3 complexity?
grade C or stage IV periodontitis
true pocketing >6mm
requires perio surgery
furcation defects/ complex root
non-plaque induced perio not suitable for delegation to a practitioner with enhanced skills
multi-disciplinary specialist care
level 2 complexity who dont respond to tx
non-plaque induced: manifestations of systemic disease
peri-implantitis
what are some modifying factors that are relevant to perio tx?
- tobacco smoking
- concurrent mucogingival disease (erosive lichen planus)
- history of H+N radiotherapy
- history of intravenous bisphosphonate therapy
- immunocompromised/ suppressed
- significant bleeding dyscrasia/ disorder
- drug interactions
what document provides high level summary guidance on the principles of periodontal implant care provison?
BSP guidance on the parameters of care (2020) remit
what is the responsibility of the oral healthcare professional in regards to implants?
regularly screen patients for the presence of periodontal and peri-implant diseases
- risk assess
- clinical investigations to aid diagnosis
- tx plan with well defined therapeutic outcomes
