Prevention/Control of Perio disease Flashcards
ideal oral hygiene care protocol
daily brushing - 2x
interdental cleaning
chemical products in addition to mechanical cleaning
we recommend these 3 things to every patient
the extent in which intervention does more good than harm UNDER IDEAL CIRCUMSTANCES
Efficacy - under ideal conditions - generally doesn’t have in biological systems
Major outcome clinically is trying to reduce gingival inflammation
Eliminate the plaque to eliminate the inflammation
how to prevent periodontitis?
need to start with prevention of _
also important to prevent disease reoccurrence (prevention of recurrent periodontitis)
start with prevention of gingivitis
prevention of gingivitis is through the control of plaque accumulation and gingival inflammation
Periodontitis - bacterial induced chronic disease
Have recurrent episodes - it comes back
Recurrent patients have a harder time clearing the disease the second/third time around
Plaque biofilm reduction
_ intrumentation is necessary to accomplish baseline health
at-home plaque control is necessary to keep up
outcomes should be evaluated with routine office visits, how often?
*efficacy of oral hygiene instructions
supragingival and subgingival(if indicated)
Only sub G if indicated
Try to emphasis home care oral hygiene
We change care on patients needs
Routine visits - depends on patient
This is personalized medicine, specific risk factor and risk indicator
risk factors - smoking and diabetes
true/false
no single toothbrush is better in plaque removal
true
no sig fig on tooth brush design
no longterm studies
~up to 6months we see a nice response though
does traumatic toothbrushing cause gingival recession?
_ factors plaqying a role in gingival recession occurrence
local factors and patient based factors do (so brushing could)
Dentin - sub G instrumentation may cause sensitivity (especially to _)
Dentin is exposed - how to Tx?
cold
First make a differential Dx - then toothpaste with 5% potassium nitrate
problems with interdental flossing?
technique sensitive
some evidence that it helps reduce gingivitis “as an adjunct to toothbrushing”
low compliance
only 49% of Americans floss once per day and 10% are never flossers
we do we still recommend it
helps control gingival inflammation and bristles can’t get in the space
True/False
interdental brushes remove plaque better than floss
true
BUT no difference between interdental brushes and flosses for gingival inflammation
_ (drug in mouthwashes) may cause staining, allergic reactions, alcohol is solution and cause dryness
CHX
do we need to rinse to control plaque accumulation
depends on the case
Peri-implantitis
Might put CHX in the water pick
Have to show _% decrease in gingival inflammation from baseline to get ADA seal
20%
can we treat halitosis with mouthrinses
Can’t tx halitosis with mouth rinses
Mainly deal with intra-oral
Brushing helps
Brushing tongue helps
Tools to measure it bad breath
anti-inflammatory agents to control gingivitis?
topical and systemic application of NSAIDS
Are some evidence that it will work for gingival inflammation
Related to periodontitis and risk assessment: Specifically, Diabetes and Smoking are classified as RISK _ for periodontal diseases (since we have sufficient, longterm evidence to call them as risk _). The order (based on current scientific evidence from strongest evidence to significant scientific evidence lacking longterm data to clinical evidence) is risk _, risk _ and risk _
FACTORS
FACTORS, risk INDICATORS and risk PREDICTORS
