Periodontal Assessment Flashcards
What factors influence pathogenic microorganisms’ capacity to affect periodontitis?
Oral hygiene
Plaque retentive niches/factors
Diet
What are the stages of periodontal care in general practice?
Assessment and diagnosis
Changing patient behaviour
Providing (periodontal therapy) (non surgical and surgical therapy)
Reassessment
Long term maintenance
Referral
What should be done in periodontal assessment?
Assess the patient prior to the initial therapy (Plaque and inflammation). Ask about perio risk factors (history and work (stress))
Assess the overall attitude to dental treatment
Plan further treatment/advanced treatment
Plan replacement of missing teeth/teeth with poor prognosis
What should be done initially for initial therapy following assessment?
Oral hygiene instructions
Root surface debridement/scaling
What symptoms should be looked for on the assessment?
Bleeding
Sensitivity
Pain
OH status
Smoking cessation
How can patient attitude be made better regarding the assessment stage?
Make the assessment interactive with the patient / relatable to the patient’s symptoms
Give it value
Explain why you do what you need to do.
What should be looked for in the assessment stage?
Plaque build up (localised, generalised, interproximal, buccal, lingual, palatal, etc)
Inflammation
Full perio charting
Calculus build up / overhangs, caries
What special tests should be done during the assessment stage?
Radiographs (Periapical) of sites with persisting periodontal pockets
Vitality testing
Occlusion
How should findings of periodontal assessment be explained to the patient?
Involve the patient and explain the findings
Explain aims of periodontal therapy in terms of BOP (disease sites) and pocket depths.
What should dentist be aware of with regards to patient assessment?
Good record keeping
Referral guidelines
Resto/endo/pros/perio interface
Medicolegal issues
What is the order that should be used for case presentation/treatment planning slides?
Patient’s presenting complaint/history of presenting complaints
Medical history
Social history - work/stress/smoking
Past dental history/history of dental treatment
Oral hygiene habits
Extraoral examination / intraoral examination
Periodontal analysis
Diagnosis/diagnoses
Prognosis of teeth
Treatment plan:
Phase 1 - behaviour modification
Phase 2 - debridement
Reassessment - review
Phase 3 - Surgical intervention / further debridement / maintenance
What should be included in the medical history?
Current and past illnesses
Diabetes / family history of diabetes / ask about last glucose reading.
Medication list to get to know what they are and what impacts they have on oral health.
What should be included in social history?
Smoking - number of cigs a day and years smoking
Vaping
Recreational drugs
Work
Stress
Alcohol
What should be included in dental history?
Attitude towards dental health
Past dental treatments
Last dental hygiene / check up appointment
Dental hygiene carried out with or without LA?
What should be included in oral hygiene?
Oral hygiene habits:: brushing, electrical vs manual brush
Time allocated for brushing and frequency
Toothbrush type, brand, and size
Interdental cleaning aids, floss, interdental brushes, size/colours/brands
Toothpaste used
Frequency in changing toothbrushes
