Periodontitis Flashcards
What is the definition of a biofilm?
A community of microorganisms that adhere to each other and a surface which are encased in an extracellular matrix
What is calculus?
A hard substance that forms as a result of calcification of microbial plaque
What to use for basic perio examination?
BPE
WHO probe
What does code 0 BPE mean?
pockets less than 3.5 mm
no calc or overhangs
no bleeding on probing
What does code 1 BPE mean?
black band intirely visible
no calc
bleeding
pockets <3.5mm
What does BPE of 2 mean?
pockets less than 3.5mm
- claculus , overhangs present
What does BPE of 3 mean?
probing depth 3.5 -5.5
black band partially visible
What does BPE 4 mean?
- black band disappears
- pockets more than 5.5mm
What does * in BPE mean?
furcation involvement
What is the pathway for a 0,1,2 BPE?
- BPE recorded at every visit
- OHI
- remove of calculus
What is management of code 3 ?
6PPC in that sextant
OHI
Supra and subgingival PMPR
RSD
What is involved in Code 4 management?
full mouth 6PPC
OHI
Supra and sub PMPR
RSD
refer to specialist
Clinical gingival health
less than 10% bleeding on probing , no evidence of interdental recession
Localised gingivitis?
10-30% bleeding on probing, no evidence of interdental recession
generalised gingivitis?
more than 30% bleeding on probing, no evidence of interdental recession
What is the code 4 pathway of treatment?
- radiographic assessment
- ## full 6PPC
What is the types of periodontitis?
molar incisor pattern
localised (less than 30% of sites bone loss)
generalised (more than 30% of sites bone loss)
What are the staging of periodontitis?
Stage 1 - mild - 15% bone loss at worst site
Stage 2 - coronal third of root
Stage 3 - mid third of root - Stage III
Stage 4 - Apical third of root - Stage IV
how to grade bone loss ?
% of bone loss at worst site / patient age
What are the grades of periodontitis?
- Grade A - less than 0.5
- Grade B - 0.5-1.0
- Grade C - more than 1
How to assess current periodontal status?
- currently stable ( less than 10% bleeding , less than 4mm pockets)
- currently in remission ( more than 10% bleeding on probing , pockets more than 4mm, no probing on bleeding at mm sites)
- currently unstable ( bleeding on probing on sites of 4mm)
What is involved in Step 1 periodontitis?
- Explain disease , risk factors
- OHI
- reduce risk factors
- Supra and subgingival PMPR of the crown
- interdental cleaning
- Oral health educator
-recall in 8 weeks - re-evaluate and if improved move to step 2
What is involved in Step 2 periodontal treatment?
- Subgingival intrumentation
- OHI
- subgingival instrumentation
- hand or powered
- use systemic antimicrobials
- re-evaluate in 3 months
What is involved in step 3
- if not stable after step 2
- managing non responding sites
- OHI
- risk factor control
- behavioural change
- pockets of 4-5mm = subgingival instrumentation
- pockets of more than 6mm = consider referral for periodontal surgery
What is involved in step 4
- if all sites are stable after step 3
- Maintenance
-supportive periodontal care - reinforce OHI
- targeted PMPR
recall every 3-12 months
What is the criteria for an engaging patient?
-Favourable improvement in OH indicated by 50% improvement in plaque and marginal bleeding
- plaque levels <20% and bleeding levels 30%
- Patient has met the targets outlined in their personal self care plan as determined by their healthcare practitioner
What is a non engaging patient?
- inssuficient improvement in OH - indicated by more than 50% improvement in plaque and marginal bleeding
- plaque levels more than 20% and bleeding more than 30%
- patient states preferance to palliative care than periodontal care
