Periodontal history & examination Flashcards
What are the 6 key aspects to history taking
- Chief complaint
- History of presenting complaint
- Medical history
- Dental history
- Social history
- Family history
How do we take history
- Note details on the patient’s complaint/reason for attendance
- Record in patient’s own words
- Patient’s list of problems
How do you take a HPC (History of presenting complaint)
Note details of onset, duration, severity etc.
How do you take a PDH (Dental History)
- Past dental experience
- Past periodontal treatment
- Frequency of brushing, type of brush etc.
- Clenching/grinding
- Dental anxiety, expectations
- Dietary habits
Describe a medical history
- Medical history should be taken in full
- Identifies patients with systemic illness
- Identifies patients who may pose an infection risk control
- Identifies patients with systemic periodontal risk factors
What must you consider when taking medical history
- Medication that that may affect management in the surgery
- Does the patient’s medical history put them at risk from having periodontal examination
- Does the patient have systemic risk factors for periodontal diseases
- Does the patient pose an infection control risk to you
What must be done for patients on anticoagulants or new anticoagulants
- Need INR prior to surgery or extractions - increased bleeding risk
- Need INR on the day of visit
- Follow current guidelines in LDI for INR threshold
Describe what you must do for social history
- Note smoking habit
- Alcohol consumption
- Check availability to attend the dentist
Describe the patient appraisal examination
- Pallor
- Obesity
- Posture
- Skin rash
Describe the examination in case notes
Extraoral - Symmetry, muscles of mastication, mouth opening
Intraoral - Other soft tissues, gingiva
Soft tissues - Tongue, oral mucosa - swelling? ulcers?
Describe the examination in patient’s case notes
- Charting - cavities, restorations
- Examination of both hard and soft tissues
- Periodontal status - bleeding on poking
Describe a BPE
- Quick simple means of screening patients
- Determines who has periodontal disease
- Identifies presence of bleeding, calculus…
- Identifies which sextents are effected
What are the factors affecting probing
- Size of probe
- Angle of probe
- Contour of the root + surface
- The probing force used
- The inflammatory state of the tissues
What are the current BPE guidelines
- Radiographs for all code 3 & 4 sextants and periapicals are recommended
- Code 3 sextants should only have a 6 point pocket chart after initial therapy
- When carrying out a 6 point pocket chart, only record sites of 4mm and above
- Always record bleeding on probing with a 6 point chart
- BPE shouldn’t be used around implants
What are the different scoring codes
0 - Pockets < 3.5mm: No calculus, no bleeding on probing
1 - Pockets < 3.5mm: No calculus, bleeding on probing
2 - Pockets < 3.5mm: Supra/subgingival calculus
3 - Probing depth 3.5-5.5mm: Black band partially visible, indicating pocket of 4-5mm
4 - Probing depth > 5.5mm: Black band disappears, indicating a pocket of 6mm or more
* - Furcation involvement
