Periodontal Examination

Question 1

Clinical features of periodontitis

Answer 1

Pocket formation
Loss of attachment
Swelling 
Erythema
BOP
Alveolar bone resorption
Tooth mobility
Recession
Halitosis

Question 2

True vs false pocketing

Answer 2

True pockets - result from apical migration of junctional epithelium following loss of connective tissue attachment

False - result from gingival enlargement with no alteration in position of junctional epithelium

Question 3

Horizontal vs vertical bone loss

Answer 3

Horizontal - entire width of interdental bone resorbed

Vertical - interdental bone adjacent to root surface more rapidly resorbed

Question 4

Why does pathological mobility occur?

Answer 4

Loss of connective tissue attachment

Depends on level of bone loss, degree of inflammation and magnitude of occlusal forces

Question 5

What can occur as a result of tooth mobility?

Answer 5

Migration of teeth

Question 6

Why does halitosis occur in periodontitis?

Answer 6

G-ve, anaerobic bacteria produce production of volatile sulphur compounds

Question 7

What are 2 common intra-oral sources of halitosis?

Answer 7

Periodontal pockets and crypts on tongue - large anaerobic areas

Question 8

List 3 medical history points that can cause periodontal disease

Answer 8

Medications e.g. calcium channel blockers - gingival overgrowth

Diabetes - if glucose not controlled = risk of PD

Rheumatoid arthritis - struggle with brushing

Hormone changes - pregnancy, puberty

Question 9

What factors in social history can effect periodontal disease?

Answer 9

Smoking
Occupation (shifts - tired = less brushing)
Stress - hormones
Family history

Question 10

Is BPE a screening or diagnostic tool?

Answer 10

Screening

Question 11

What BPE score will require further investigation?

Answer 11

Codes 3 or 4

Question 12

Describe BPE probe?

Answer 12

Ball ended

Black band 3.5-5.5mm

Question 13

BPE score 0

Answer 13

No pockets <3.5mm
No calculus/overhangs
No BOP

Question 14

BPE score 1

Answer 14

No pockets <3.5mm
No calculus/overhangs
BOP

Question 15

BPE score 2

Answer 15

No pockets <3.5mm

Supra/sub-gingival calculus/overhangs

Question 16

BPE score 3

Answer 16

Probing depth 3.5-5.5mm

Question 17

BPE score 4

Answer 17

Probing depth >5.5mm

Question 18

You complete a BPE on a patient have they have 1 score of 4. What do you do?

Answer 18

Full mouth periodontal assessment

Question 19

You complete a BPE on a patient and they require 1 BPE score of 3. What do you do?

Answer 19

Initial therapy - OHI, risk control, RSI, review

Post-initial therapy - review, localised periodontal charting in affected area

Question 20

What are the 7 components of a full periodontal assessment?

Answer 20

Radiographs
Six point pocket chart (PPD)
Six point bleeding on probing assessment
Assessment of recession
Assessment of mobility
Furcation involvement
Plaque score

Question 21

If you are going to treat a patient for periodontal disease. What is a good way to measure progress?

Answer 21

Plaque score before treatment and review

Question 22

Describe how you would measure PPD

Answer 22

Probe parallel to tooth, record 6 sites per tooth

Question 23

When is furcation involvement recorded in a full periodontal examination?

Answer 23

During PPD

Question 24

What probes can be used for full periodontal examination?

Answer 24

UNC probe or Williams probe

Each have bands to show mm

Question 25

How is BOP recorded?

Answer 25

Yes or no

colour in box if yes whilst doing PPD

Question 26

How is tooth mobility assessed?

Answer 26

Graded
0 - physiological mobility
I - 0.2mm-1.0mm horizontal movement 
II - >1.0mm horizontal but no vertical
III - >2.0mm horizontal and vertical

Question 27

How is recession measured?

Answer 27

From CEJ to gingival margin using BPE probe

Question 28

What probe is used for furcation involvement?

Answer 28

Nabers probe

Question 29

How is furcation classified?

Answer 29

1 - <3mm deep
2 - >3mm deep but not through
3 - entire ridge of tooth

Question 30

How is plaque score completed?

Answer 30

Disclosing tablets

look at each sextant of tooth and colour in if plaque is there

Question 31

How do you work out clinical attachment loss?

Answer 31

From CEJ to base of pocket

PPD + recession

Question 32

When should you take radiographs for periodontal examination?

Answer 32

All BPE codes 3,4, *