Periodontal Referral

Question 1

What guidelines should be followed regarding referal for periodontal treatment?

Answer 1

British socierty of periodontology and implant dentistry guidelines.

Question 2

How are the BSP referal guidelines set out?

Answer 2

Level 1 complexity - seen in practice
Level 2 complextiy - seen in both
Level 3 complexity - specialist referal required
Modifying factors - factors which make it more likely to refer

Question 3

What is Level 1 complexity under the BSP guidelines?

Answer 3

• Assessment, diagnosis and inital periodontal treatment.
• Assessment for periodontal referal
• Communication of nature of disease
• Evaluation and monitoring of patient outcomes
• On going motivation and risk factor management
• Periodontal care and maintanence
• All patients with uncomplicated treatment

Question 4

What is Level 2 complexity under the BSP guidelines?

Answer 4

• Patients with stage II, III, or IV perio, and have residual pockets of above 6mm.
• When determined to have grade C perio, furcationd efects, or complex root morphologies
• Instances of nercotising disease
• Perio-implant mucositis

Question 5

What is Level 3 complexity under BSP guidelines?

Answer 5

• Patients with grade C or Stage IV periodontitis, with pocketing of 6mm or more.
• Requiring periodontal surgery
• Furcation defects not suitible for management
• Patients requiring multi-disciplinary care
• Complexity 2 patients not responding to care
• Non plaque induced gingival diseases

Question 6

What modifying factors may influence your decision to refer a periodontal patient?

Answer 6

Co-ordinated MDT
Regular tobacco smoking and tobacco free alternatives
Concurrent muco-gingival disease (LP)
Patients with a significant medical history