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paediatrics > periodontal care > Flashcards

periodontal care Flashcards

1
Q

What are the classifications for periodontal conditions as of the 2017 guidelines?

Please Give George Nine Percy Pigs Straight Past Meal Time Tonight.

A
  • periodontal health
  • Gingivitis
  • Gingival diseases and conditions (non dental biofilm induced)
  • Necrotising periodontal diseases
  • Periodontitis
  • Periodontitis as a manifestation of systemic disease
  • Systemic diseases or conditions affecting the periodontal supporting tissues
  • Periodontal abscesses
  • Mucogingival deformities
  • Traumatic occlusal forces
  • Tooth and prosthesis related factors
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2
Q

What does staging periodontitis entail?

A
  • Recording interproximal bone loss at the worst site of bone loss
  • Stage 1, stage 2, stage 3, stage 4.
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3
Q

What does grading periodontitis entail?

A
  • calculates rate of progression
  • %bone loss/age
  • Grade A, Grade B, Grade C
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4
Q

what does assessing periodontal status entail?

A

*Is it stable, in remission, or currently unstable?

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5
Q

Describe a healthy periodontium

A
  • Gingival margin several millimetres coronal to the CEJ
  • Gingival sulcus 0.5-3mm deep
  • Alveolar crest 0.4-1.9mm apical to the CEJ in teenagers
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6
Q

what is the biological width of the tooth?

A

distance from cemento-enamel junction to alveolar bone crest

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7
Q

To diagnose clinical “periodontal health” you would expect to see what?

A

BPE screening showing bleeding on probing with intact or 10% reduced periodontium

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8
Q

what constitutes as gingivitis?

A
  • gum inflammation
  • Presence of plaque
  • Is it biofilm induced - local/generalised?
  • Is it non biofilm induced ?
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9
Q

describe the mechanisms of biofilm induced gingivitis

A

supragingival plaque accumulates on teeth, inflammatory cell infiltrate develops in gingival connective tissue. junction epithelium becomes disrupted. allows plaque to migrate apically and increases sulcus depth. creates false pocket.

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10
Q

When doing a BPE how would you diagnose gingivitis?

A
  • 10-30% BOP = localised gingivitis
  • > 30% BOP =Generalised gingivitis
  • Presence of plaque retentive factors
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11
Q

necrotising ulcerative gingivitis is caused by what type of bacteria?

A
  • fusiform

* Spirochete

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12
Q

how does pubertal gingivitis come about?

A

Increased inflammatory response to plaque mediated by hormonal changes. In teenagers can progress to periodontitis.

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13
Q

what are some non biofilm induced causes of gingivitis?

A
  • Trauma
  • Genetics
  • Infection
  • drug induced
  • Systemic disease
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14
Q

What kind of drugs can cause gingivitis?

A
  • cyclosporin

* Phenytoin

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15
Q

what systemic diseases can cause gingivitis?

A
  • Haematological - Agranulocytosis
  • cyclic neutropenia
  • Granulomatous inflammations
  • crohns
  • sarcoidosis
  • granulomatosis
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16
Q

what is the best approved method of treating gingivitis

A
  • Rigourous oral hygiene/home care
  • frequent scaling
  • Surgery (especially in drug induced cases)
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17
Q

what are the 4 main distinguishing features of periodontitis?

A
  • Apical migration of junctional epithelium beyond CEJ
  • Loss of attachment of periodontal tissues to cementum
  • Transformation of junctional epithelium to pocket epithelium
  • Alveolar bone loss
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18
Q

How much attachment loss counts as periodontitis?

A

> 1mm

19
Q

describe stage 1 periodontitis

A

<15% interproximal bone loss or <2mm

20
Q

describe stage 2 periodontitis

A

interproximal bone loss around coronal 3rd of root

21
Q

describe stage 3 periodontitis

A

interproximal bone loss around mid 3rd of root

22
Q

describe stage 4 periodontitis

A

interproximal bone loss around apical 3rd of root

23
Q

how do you describe the “extent” of periodontitis?

A

Localised up to 30% of teeth

Generalised if more than 30% (molar/incisor pattern)

24
Q

describe grade A periodontitis

A

<0.5 when %bone loss/age (slow)

25
Q

describe grade B periodontitis

A

0.5-1.0 when %bone loss/age (Moderate)

26
Q

describe grade C periodontitis

A

> 1.0 when %bone loss/age (Rapid)

27
Q

When recording and diagnosing during a periodontal screening what features of the gingival condition should be noted?

A
  • gingival colour
  • Contour
  • swelling
  • recession
  • suppuration
  • inflammation
28
Q

When recording and diagnosing during a periodontal screening what features of the oral hygiene status should be noted?

A
  • description of plaque status
  • Describe surfaces covered in plaque
  • presence of calculus
29
Q

When recording and diagnosing during a periodontal screening what local risk factors should be noted?

A
  • plaque retentive factors
  • low frenal attachments
  • malocclusion
  • incompetent lip seal
  • Mouth breathing
30
Q

What is a simplified BPE?

A

Screening tool that has been simplified for 7-11 year olds. Performed with a WHO CPITN probe.

31
Q

how much force should you apply to a CPITN probe when carrying out a simplified BPE?

A

20-25g - same as adults

32
Q

What are the advantages of the simplified BPE technique?

A
  • quick
  • easy
  • well tolerated
  • Avoids false pocketing
33
Q

what teeth are assessed in a simplified BPE?

A

UR6, UR1, UL6

LR6, LL1, LL6

34
Q

What does a score of 0 mean in a simplified BPE?

A

Healthy

35
Q

what does a score of 1 mean in simplified BPE?

A

Bleeding on gentle probing

36
Q

what does a score of 2 mean in simplified BPE?

A

calculus or plaque retention factor

37
Q

what does a score of 3 mean in BPE?

A

pocketing 4mm-5mm (black band visible but partially obscured)

38
Q

what does a score of 4 mean in BPE?

A

pocketing of 6mm or greater (black band no longer visible)

39
Q

what does a score of * mean in BPE?

A

Furcation involvement

40
Q

How should gingivitis and periodontitis be treated in children and adolescents?

A
  • Good toothbrushing
  • Emphasise need to clean all surfaces
  • Tooth brushing advice and fluoride advice
  • Supervised/assisted brushing up to 7 years old
  • Disclosing tablets
  • fluoride mouthwash for patients undergoing fixed appliance therapy
41
Q

Someone who gets a simplified BPE score of 1 should get what treatment and seen how regularly?

A
  • OHI and prevention

* 6 months

42
Q

Someone who gets a simplified BPE score of 2 should get what treatment and seen how regularly?

A
  • OHI, prevention, scaling, removal of plaque retention factors
  • 6 months
43
Q

Someone who gets a simplified BPE score of 3 or 4 should get what treatment and seen how regularly?

A
  • Full perio assessment, radiographs, scaling, RSD, OHI + prevention
  • If they score 4 or * then refer to specialised periodontologist or paediatric dentist.
  • Treat & review after 3 months

paediatrics (8 decks)

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