Periodontal Monitoring and Indices Flashcards
what is monitoring
it is a follow up on a patients disease progression AFTER treatment and establishing the baseline investigation
what is meant by periodontal indices
a way in which we can collect information/ quantification of PDs
list 7 ways in which periodontal indices may be used
screening
establishing grade/ level of disease
help to reach diagnosis
to monitor response to treatment
to determine if we need further treatment post therapy research tool (clinical trials, epidemiology, public health)
clinical management of patients
what are specifically PLAQUE indices
evaluate the extent of plaque formation
important because plaque is a key factor in —> aetiology of gingivitis, periodontitis, success/ failure of periodontal treatment
list the ways in which plaque indices may be used for
to give quantify distribution of plaque in mouth
identify areas of difficulty for patients OH
clinician can show patient the areas of plaque
allows tailor made OH
motivational tool
gives examples of the 4 plaque indices and highlight which is used in LDI
6 point plaque index
o’leary plaque index —> used in LDI
tooth cleanliness index
plaque index- silness and loe
O leary plaque index can also be called the..
plaque FREE score
describe how you would caryr out an O’leary plaque index/ plaque free score
- disclose teeth (apply petroleum jelly on cotton bud on lips, ask patient to chew on disclosing tablet/ paint teeth with disclosing solution, swish on the tablet for 30 SECONDS, spit, rinse once
- inspect the GINGIVAL MARGINS –> all 6 surfaces of one tooth (mesio buccal, mid buccal, disto buccal, mesio palatal/lingual, mid palatal/ lingual, disto palatal/ lingual)
- record on PLAQUE CHART –> determine the % of surfaces plaque free
what is the difference between a plaque score and a plaque FREE score
plaque score gives a low mark for clean teeth and a high mark when teeth covered in plaque
plaque free score gives a high mark for clean teeth and a low mark for plaque
when would you carry out a plaque index
at the start of treatment= baseline
then will do the plaque free score PERIODICALLY DURING TREATMENT FOR ALL PATIENTS
give examples of the 3 gingival indices and which is used in LDI
gingival index -silness and loe
papillary bleeding index
6 point marginal gingival bleeding index –> LDI
describe how you would carry out a 6 point marginal gingival bleeding index
- insert a PCP10 probe into the gingival sulcus mid-buccally
- rub the probe towards the mesial papilla
- insert the probe mid-buccally again
- run the probe towards the distal papilla
- rub the probe similarly on the palatal/ lingual surface
you are observing for bleeding at the 6 points (3 for each side of tooth ) —-> mid, mesio and disto buccal and mid, mesio, disto lingual/ palatal
when would you carry out marginal bleeding index
done ONCE FOR PATIENTS WITH A BPE SCORE 1+ 2 at the START OF TREATMENT = baseline
then would do as required
it is useful also to assess compliance over long periods
give examples of periodontal indices
- suppuration
- furcation indices
- mobility index
- attachment levels
- probing pocket depths
- bleeding on probing
NB. BOP and probing pocket depth are only useful when done together
when would you carry out periodontal indices
at the START of treatment = baseline
then
6-8 weeks AFTER TREATMENT = monitoring
on sexants with BPE CODE 3/4/*
describe how you would do BOP index for periodontitis
- insert the PCP10 probe into the BASE OF POCKET
- will be a positive BOP if bleeding occurs with probing OR shortly after probing
- examine for all 6 sites of tooth (3 buccal/3 lingual or palatal)
- record on BOP chart
it is very difficult to distinguish between gingival marginal bleeding and BOP. where should bleeding come from if marginal/ BOP respectively
marginal bleeding= bleeding of gingival margins. gingivitis
BOP= bleeding from THE BASE OF POCKET. periodontitis.
describe how you would do a probing pocket depth chart index for periodontitis
- insert PCP10 to the FULL POCKET DEPTH
- read off the pocket depth in mm, do for all 6 sites of tooth. you will measure from base of pocket–> gingival margin
- record on pocket depth chart
the BPE probe (such as PCP10) is not always accurate, why not
we dont know when we are truly at the BASE of the pocket for many reasons
- gingival inflammation
- true probe tip position
- calculus and PRFs
- angulation of probe
- probing pressure (25g)
to measure attachment, we need a fixed reference point. this is usually the
CEJ
we measure attachment loss from the reference point to the …
CEJ (reference point) to the BASE OF POCKET
the attachment level between these 2 points will be different in different stages of periodontitis.
what is disadvantage of having CEJ as reference point
can be difficult to find because often sub-gingival
describe what you are measuring when carrying out recession index for periodontitis
measure from the gingival margin to the CEJ
- where the gingival margin is apical to CEJ
mobility index for periodontitis has 3 grades which are
grade 1= 1 mm, horizontal movement
grade 2= >1mm, horizontal movement
grade 3= vertical movement
what is furcation
the BONE LOSS BETWEEN MULTIROOTED TEETH
in a furcation index a probe is used to determine the EXTENT of bone loss
furcation index for periodontitis has 3 grades which are
grade 1= horizontal bone loss of LESS than 1/3 width of root
grade 2= horizontal bone loss of MORE than 1/3 width of root but NOT through and through
grade 3= horizontal THROUGH AND THROUGH involvement (also less commonly used vertical classification)
suppuration index involves
recording the present of pus when probing to the BASE OF POCKET
record the +ve sites
