Preventive Procedures - Outcome 3 Flashcards
Complete Review of Medical and Dental History
It’s crucial to thoroughly review and update both the medical and dental history of a patient at every visit. This ensures that any new findings or changes are noted and considered.
Medical History and Dental Probing
Before performing any oral examination involving periodontal probing, it is essential to review the patient’s medical history. This is because probing involves manipulating the soft tissues around the teeth, and it may not be safe until it is determined if antibiotic premedication is necessary.
Premedication Considerations
Transient Bacteremia: During dental probing, temporary bacteria in the bloodstream can occur. For patients with certain heart conditions, joint replacements, or weakened immune systems, this can be risky.
Consultation: It may be necessary to consult with the supervising dentist and dental hygienist to assess the risk and decide if premedication is required.
Importance of Medical History
Pre-medication Needs: Alert the dental team if a patient requires antibiotics before treatment.
Treatment Complications: Identifies any medical conditions or medications that might complicate or affect dental treatment.
Medical Emergencies: Helps in planning for potential medical emergencies.
Special Needs: Highlights any special treatment requirements.
Systemic Diseases and Periodontal Health
The medical history helps evaluate if any systemic diseases could impact periodontal health. Conversely, periodontal disease can sometimes indicate underlying systemic conditions.
Can Dental Assistants perform dental probing?
In Alberta, dental probing is a restricted activity for dental assistants under the Health Professions Act. Only dental assistants who have completed their PDM module and work under the supervision of an authorized dentist, dental hygienist, or denturist can perform probing
Periodontal Attachment System
This system is a group of structures (the periodontium) that work together to attach the teeth to the skull. These structures include:
Epithelial Attachment (Junctional Epithelium)
Periodontal Ligament Fibers
Gingiva
Sulcus
Cementum
Alveolar Bone
Healthy Periodontium
In a healthy periodontium, the tooth is surrounded by the gingival sulcus. The junctional epithelium (JE) attaches to the tooth near the cemento-enamel junction (CEJ) and forms the base of the sulcus. The depth of a healthy sulcus ranges from 1–3 mm.
Periodontal Pocket
A periodontal pocket occurs when the gingival sulcus deepens due to periodontal disease. In this case, the junctional epithelium attaches to the tooth root below the CEJ, resulting from the destruction of the alveolar bone and periodontal ligament fibers that support the tooth.
Measuring Pockets
A pocket is essentially a diseased sulcus. To assess and measure sulcus and pocket depths, a calibrated periodontal probe is used. The measurement is taken from the base of the pocket (or diseased sulcus) to the gingival margin.
Complete Measurement
Since the pocket or sulcus extends around the entire circumference of the tooth, measurements must be taken all around the tooth. Probing depths can vary between different areas of the same tooth
What are Dental Probes?
Dental probes are thin, slender instruments with a calibrated tip that allows for precise measurement. They often have a series of markings or bands along their length to measure the depth of the gum pockets around the teeth.
Why are Dental Probes used?
Measuring Pocket Depths:
-Purpose: To measure the depth of the space (sulcus or pocket) between the gum and the tooth.
-Importance: Helps determine if there is gum disease, as deeper pockets can indicate periodontal issues.
Assessing Gum Health:
-Purpose: To evaluate the health of the gums and detect signs of inflammation or infection.
-Importance: Early detection of gum disease can prevent further damage and tooth loss.
Identifying Periodontal Disease:
-Purpose: To help diagnose periodontal disease by measuring changes in gum tissue and bone levels.
-Importance: Accurate diagnosis allows for appropriate treatment planning.
Monitoring Treatment Progress:
-Purpose: To track the effectiveness of periodontal treatments and observe improvements or worsening conditions.
-Importance: Ensures that treatments are working and adjusts care plans as needed.
Detecting Gum Recession:
-Purpose: To measure the amount of gum recession from the tooth’s surface.
-Importance: Helps in understanding the extent of gum damage and planning corrective treatments.
Probe Depth
A probe depth measures how deep a gingival sulcus or periodontal pocket is. To find this, use a calibrated periodontal probe to measure the distance from the gingival margin (where the gum meets the tooth) to the base of the sulcus or pocket.
Measurement sites for Probe Depth
Six Sites per Tooth: Measure probing depths at six specific sites around each tooth
Mesio-facial: The front part of the tooth closest to the middle of the mouth.
Mid-facial: The middle part of the tooth facing the cheek.
Disto-facial: The back part of the tooth facing the cheek.
Mesio-lingual: The front part of the tooth closest to the tongue.
Mid-lingual: The middle part of the tooth facing the tongue.
Disto-lingual: The back part of the tooth facing the tongue.
One Reading per site - for probe depth
Record only one depth measurement per site. If there are variations in depth within a site, use the deepest measurement.
Full Millimeter Measurements
Record measurements to the nearest full millimeter. For instance, if you measure 3.5 mm, record it as 4 mm.
How to read the probe
Measure from the gingival margin to the base of the pocket. Count the millimeters visible on the probe above the gingival margin. Subtract this number from the total millimeters marked on the probe.
If the gingival margin is between two probe markings, use the higher mark for your reading.
