SDCEP guidance for perio Flashcards
List the 4 inter-related phases that a periodontal assessment comprises of:
- DETECTION of systemic and local risk factors which could make the person more susceptible to disease/make disease control more complex
- discuss with the patient of any symptoms of disease, DH, current dental/oh habits/routines
- exam of tissues for signs of disease
- appropriate rads
When would we carry out a BPE screening on an adult?
for all NEW adult patients, and all adult patients without a diagnosis of periodontitis at each RECALL APPOINTMENT.
‘walk’ the probe around the gingival margin of each tooth in each sextant
SEXTANT MUST INCLUDE 2 TEETH, IF ONLY 1 PRESENT THEN INCLUDE IT WITHIN THE NEIGHBOURING SEXTANT.
What should the probing force be when examining perio tissues?
enough to blanch a fingernail (20-25g)
What BPE screening would we use on a child less than 18 years??
aged 7-17 years we assess 6 INDEX teeth using the SIMPLIFIED BPE
teeth examined - 16, 11, 26, 36, 31, 46
BPE codes of 0-2 are used for 7-11 year olds (mixed dentition stage)
for 12-17 year olds, full range of codes used - perm teeth have fully erupted.
who would we refer a child to with evidence of perio - 12-17 yo
specialist in paeds dentistry, restorative dentistry or specialist periodontologist
what will the recording of additional features in a pocket chart like mobility, recession and furcation involvement allow the dentist to determine?
the PROGNOSIS and case management, particularly in complex perio disease.
What is the PROBING DEPTH?
Distance from the gingival margin to the base of the pocket
how can we measure recession
from the CEJ in relation to the position of the gingival margin (can be hard when the CEJ isnt fully exposed)
How can we measure clinical attachment loss
COMBINES the measurements of pocket depths and gingival recession
this will give us an overall indication of where the perio tissues attach to the root surface!
What can plaque disclosing tablets/solutions help with
they can aid in the detection of plaque biofilm and act as a VISUAL demo of plaque levels for patients
what is a diagnosis based on?
based on the FINDINGS of the periodontal assessment, incorporating info from both the patients history and the clinical examination.
What should a diagnosis of perio disease include?
it should include:
- identification of the disease TYPE/EXTENT (is it general or local in mouth?)
- the STAGE AND GRADE of the disease
- current PERIO STATUS and a risk factor profile
if radiographs are not clinically justified, what can we used to aid in our diagnosis of perio?
use CAL or bone loss from CEJ????
where can a diagnosis of periodontal health be indicated?
this can be applied to patients where no bone loss has occurred and those where there is evidence of bone loss ONLY WHEN bone has been lost for reasons other than PERIO eg crown lengthening surgery or recession due to overbrushing.
What if a patient comes in with an obvious history of perio and it is indicated with evidence of ID recession, what can we do?
We would automatically follow the code 4 pathway, we can omit the BPE screen and proceed directly to assessment of radiographs (justified) and a full perio assessment. so we can stage and grade.
What are the 4 goals to achieve in a periodontitis patient?
- high levels of plaque CONTROL
- complete resolution of gingival bleeding
- ppds less than or equal to 4mm THROUGHOUT mouth
- absence of bop and 4mm sites
What are the 2 main modifiable systemic risk factors for periodontitis?
SMOKING AND DIABETES
What is the principal local modifiable risk factor for gingival inflammation/perio disease
PLAQUE BIOFILM
3 points
ORAL HYGIENE SHOULD:
- be INDIVIDUALLY TAILORED to suit each patient
- should assist and encourage the patient to improve their OH skills as well as their understanding of the value of good self care routines
- should be delivered in a manner that actively involves the patients skill rather than just speaking at them eg giving them the opportunity to do it infront of dental professional
Give an example of a behavioural change strategy that can be used to highlight the importance of effective plaque biofilm removal
OH TIPPS
T - talk
I - instruct
P- practice
P- plan
S- support
What are low levels of plaque associated with?
PERIODONTAL STABILITY
How often should we carry out a 6ppc for people with periodontal disease?
YEARLY
What is prognosis?
this is the prediction of the probable course, duration and outcome of the disease ie in this case the tooth.
