Periodontal Disease

Question 1

What are the types of periodontal disease?

Answer 1

Gingivitis Periodontitis

Question 2

What is the difference between the two types of periodontal disease?

Answer 2

Gingivitis - Reversible condition, 0-3mm Periodontitis - Irreversible 3.5mm+

Question 3

How many types of gingivitis are they?

Answer 3

Plaque induced gingivitis Non-plaque induced gingivitis

Question 4

What does periodontal health look like?

Answer 4

Pink Firm Scalloped gingiva Knife edged papilla

Question 5

What does plaque induced gingivitis present as?

Answer 5

Red swollen gums. Bleeding gingiva. Loss on contour. No bone loss Aided via lack of saliva, tooth anatomical factors, dental restorations Systemic factors; pregnancy, diabetes, drugs 3 stages; initial, early, established

Question 6

What causes non plaque induced gingivitis?

Answer 6

Genetic/development disorders – e.g. mouth breathing Trauma Immune conditions

Question 7

What does periodontitis present as?

Answer 7

Loss of periodontal ligament connective tissue Formation of a periodontal pocket AV bone loss Caused by plaque – migrates subgingivally. Looks black/brown Systemic factors; drugs, diabetes, smoking, stress, genetic Local factors; patients habits e.g. chewing pen, mouth breathing, ill fitting restorations, incorrect use of dental equipment leaves grooves.

Question 8

Explain the process of a basic periodontal examination

Answer 8

Pocket chart on sextants. 25g Sextant is minimum of 2 teeth and is done systematically Looking for the area with the deepest pocket and that result is recorded Done with a BPE probe – 0.5mm ball end and then increments 3.5-5.5mm black band, 8.5-11.5mm.

Question 9

What is the staging in a basic periodontal examination?

Answer 9

Staging; 0 – No depth, healthy 1 – Small depth, BOP 2-SUB/Supra calculus, BOP 3-Shallow pocket 3.5mm-5.5mm 4 – Deep pocket 5.5+ no black band *Furcation involvement UR/anterior/UL LR/anterior/LL

Question 10

After doing a BPE examination what should be done after each code?

Answer 10

BPE 0,1,2 recorded at each examination, scaling, BPE 3 – initial therapy, post treatment, radiograph BPE 4 more detailed charting required, radiograph, scaling, OHI. PPD.

Question 11

What are the different stages of a treatment plan?

Answer 11

1 Emergency phase

• patients presenting complaint

2 initial therapy –

• stabilise disease,
• smoking cessation (risk factors, refer),
• OHI (modified bass and interdental,
• toothpastes(sensitivity)),
• record mobility,
• bone levels on bitewing radiograph,
• scaling (hand held e.g. universal curette, sickle scaler, gracey, ultrasonic

3 Corrective therapy

• RCT
• Surgery
• Implant

4 Supportive therapy

• starts after active therapy
• re-establish function of mouth
• want to prevent relapse
• high levels of plaque control
• reduce BPE
• ensure patient is still motivated, polishing

5 Recall