Periodontal Screening and management of periodontal conditions Flashcards
What are the aims of the 2012 guidelines
early recognition of gingival and periodontal conditions
a practical guide for primary care
appropriate treatment or early referral to pediatric or periodontal specialist services
early OHI to encourage good dental habits for life
What is an mnemonic for classification 2017
please give greg nine mercy pigs straight past meal time tonight
What is the staging
inter proximal bone loss at worst site of bone loss
stage 1,2,3,4
What is grading
rate of progression
%bone loss/age
grade A,B,C
How do we assess current periodontal status
currently stable
currently in remission
currently unstable
Where is the GM often seen in a healthy periodontium
several mm coronal to CEJ
How deep can the gingival sulcus be in a healthy periodontium
0.5-3mm deep
Where is the alveolar crest usually seen in a healthy periodontium
0.4-1.9mm apical to CEJ (teens)
What is the aim BOP
<10%
What are the statistics on the prevalence of gingivitis in children
2/3 of 8-12 year olds
1/3 of 5 YO
half of 15 YO
What are the types of gingivitis
dental biofilm induced (localized, generalized)
gingival diseases and conditions: non dental-biofilm induced
What happens in gingivitis
supra gingival plaque accumulates on teeth
inflammatory cell infiltrate develops on gingival connective tissue
JE becomes disrupted
allows apical migration of plaque and an increase in gingival sulcus depth
results in false pocket
What is the appearance of necrotising ulcerative gingivitis
blunted papilla
malodour
painful gingival
no attachment loss
What is the etiology of NUG
fusiform and spirochete
What are px risk factors for NUG
smoking, stress, immunosuppression, poor diet
HIV status or other underlying condition
What is puberty gingivitis
increased inflammatory response to plaque that is mediated by hormonal changes
in teens gingivitis can progress to early periodontitis
local and systemic factors can influence progression
What are causes of gingival diseases that are non-dental biofilm induced
trauma genetic infective drug induced manifestations of systemic disease
Give examples of aetiologies of non-dental biofilm induced gingival disease
cyclosporin
phenytoin
OFG: full thickness
gingivitis in leukemia
Give examples of haematological conditions that lead to gingivitis
agranulocytosis
cyclic neutropenia
Give examples of granulomatous inflammations that lead to gingivitis
crohn’s disease
sarcoidosis
granulomatosis
What can gingival overgrowth beyond biofilm induction relate to
systemic and metabolic disease genetic factors, local factors side effects of some emdications cyclosporin, nifedipine, phenytoin greater incidence seen in puberty
What is the treatment of gingivitis
rigorous OH/home care
frequent scaling
surgery may be necessary esp with drug induced
What are the 4 key features of periodontitis
apical migration of junctional epithelium beyond CEJ
loss of attachment of periodontal tissues to cementum
transformation of junctional epithelium to pocket epithelium (often thin and ulcerated)
alveolar bone loss
What are the early clinical signs of periodontitis in teenagers
> 1mm loss of attachment of cementum to PDL
What are the pathogens seen in periodontitis in teens
similar to adults
p. gingivalis
prevotella intermedia
AA
How do we assess the gingival condition
colour contour swelling recession suppuration inflammation consider use of marginal bleeding free chart
How do we assess OH status
description of plaque status
describe surfaces covered by plaque
How do we assess the calculus present
chart location
How do we assess local risk factors
plaque retention factors low renal attachments malocclusion incompetent lip seal mouth breathing
What is the effect of an incompetent lip seal
reduced upper lip coverage - labial and palatal gingivitis
increased lip separation
What is the effect of mouth breathing
palatal gingivitis due to drying
What age is normal BPE used
12-17
Who is simplified BPE used on
all cooperative children aged 7-11
What teeth are looked at for simplified BPE
UR6 UR1 UL6 LR6 LL1 LL6
What are the BPE codes for simplified BPE
0,1,2
What are the SDCEP plaque level scores
out of 10 anterior and posterior teeth 4/10 6/10 8/10 10/10
What is a 4/10 plaque score
middle 1/3rd of crown covered
What is a 6/10 plaque score
cervical 1/3rd of crown covered
What is 8/10 plaque score
line of plaque around cervical margin
What is 10/10 plaque score
perfectly clean tooth
Who should fluoride mouthwash 225ppm be prescribed for
px undergoing fixed appliance therapy
When do we screen a code 0 again
within 1 year
When do we screen a code 1,2 again
6 months
When do we screen a code3,4 again
3 months
