SDCEP Prevention and Treatment of Periodontal Diseases in Primary Care

Question 1

Give a brief description of gingivitis:

Answer 1

Plaque-induced inflammation of the gingivae characterised by red, swollen tissues which bleed on brushing or probing

Question 2

Give a brief description of chronic periodontitis:

Answer 2

Destruction of the junctional epithelium and connective tissue attachment of the tooth, with bone destruction & formation of periodontal pockets
- slow progression and usually reflects age of pt

Question 3

Give a brief description of aggressive periodontitis:

Answer 3

Aggressive, severe condition usually found in younger pts.
- rapid disease progression
- severe degree of destruction of connective tissue attachment and bone
- plaque levels may be inconsistent with level of destruction seen
- usually family trait

Question 4

What are some risk factors that increase a patients risk of getting periodontal disease?

Answer 4

• smoking
• uncontrolled diabetes
• cardiovascular disease
• family history of disease
• medication (eg calcium channel blocker, phenytoin, ciclosporin)

Question 5

Why does smoking increase a patients periodontal disease risk?

Answer 5

• reduction in gingival blood flow
• impaired wound healing
• increased production of inflammation-mediating cytokines

Question 6

What probing force should be used when assessing periodontal tissues?

Answer 6

25g (enough to blanch a fingernail)

Question 7

What does absence of BOP suggest in patients who have periodontal disease?

Answer 7

EITHER
- a smoker
- their disease is stable

Question 8

What screening tool is used to assess periodontal disease in adults?

Answer 8

BPE with WHO CPITN probe

Question 9

What do the black bands on a WHO probe show?

Answer 9

first black band extends from 3.5mm to 5.5mm

second black band from 8.5mm and 11.5mm

Question 10

How many teeth must be present in a sextant for it to count on a BPE?

Answer 10

2 teeth minimum

Question 11

What BPE score would this patient receive?

Answer 11

BPE 0

Question 12

What BPE score would this patient receive?

Answer 12

BPE 1

Question 13

What BPE score would this patient receive?

Answer 13

BPE 2

Question 14

What BPE score would this patient receive?

Answer 14

BPE 3 (black band partially visible eg probing depth of between 3.5-5.5mm)

Question 15

What BPE score would this patient receive?

Answer 15

BPE 4 (black band within pocket eg pockets of 6mm or more present)

Question 16

How do you take a BPE of a child ages 7-17 y/o?

Answer 16

BPE around teeth:
- 16, 11, 26, 36, 31, 46

Codes 0-2 are used

Question 17

Where should the gingival margin lie ideally?

Answer 17

At level of the ACJ/CEJ

Question 18

What are the different furcation involvement gradings?

Answer 18

1 - less than 1/3 of tooth width

2 - >1/3 of tooth width

3 - through & through involvement

Question 19

What are the different mobility gradings of teeth?

Answer 19

0 - 0.1/0.2mm physiological tooth movement

1 - 1mm horizontal movement

2 - >1mm horizontal movement

3 - rotation and depression

Question 20

What does TIPPS stand for?

Answer 20

• talk
• instruct
• practise
• plan
• support

Question 21

How could you go about providing smoking cessation advice?

Answer 21

• ask pt if they smoke or have smoked
• ask if the pt has considered the effect smoking has on oral & general health
• give benefits associated with stopping
• ask if the pt is interesting in stopping smoking
• offer pt who are interested local smoking cessation services information

Question 21

What are some causes of gingivitis?

Answer 21

• poor OH plaque control
• pregnancy induced gingivitis
• puberty gingivitis
• drug induced gingival enlargement

Question 22

What is the optimal plaque score goal you want to get patients down to?

Answer 22

< 15%

Question 23

What is the optimal bleeding score goal you want to get patients down to?

Answer 23

< 10%

Question 24

What is the probing depth score goal you want to get patients down to?

Answer 24

< 4mm

Question 25

Give some examples of local plaque-retentive factors:

Answer 25

• malpositioned teeth
• overhanging restorations
• crowns with poor margins
• bridgework
• partial dentures

Question 26

What periodontal and endodontic signs may suggest that a patient is suffering from a perio-endo lesion?

Answer 26

PERIODONTAL:
- swelling
- pocketing attachment loss
- suppuration

ENDODONTIC:
- negative pulpal status
- fistula
- TTP