SDCEP Prevention and Treatment of Periodontal Diseases in Primary Care Flashcards
Give a brief description of gingivitis:
Plaque-induced inflammation of the gingivae characterised by red, swollen tissues which bleed on brushing or probing
Give a brief description of chronic periodontitis:
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
Give a brief description of aggressive periodontitis:
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
What are some risk factors that increase a patients risk of getting periodontal disease?
- smoking
- uncontrolled diabetes
- cardiovascular disease
- family history of disease
- medication (eg calcium channel blocker, phenytoin, ciclosporin)
Why does smoking increase a patients periodontal disease risk?
- reduction in gingival blood flow
- impaired wound healing
- increased production of inflammation-mediating cytokines
What probing force should be used when assessing periodontal tissues?
25g (enough to blanch a fingernail)
What does absence of BOP suggest in patients who have periodontal disease?
EITHER
- a smoker
- their disease is stable
What screening tool is used to assess periodontal disease in adults?
BPE with WHO CPITN probe
What do the black bands on a WHO probe show?
first black band extends from 3.5mm to 5.5mm
second black band from 8.5mm and 11.5mm
How many teeth must be present in a sextant for it to count on a BPE?
2 teeth minimum
What BPE score would this patient receive?
BPE 0
What BPE score would this patient receive?
BPE 1
What BPE score would this patient receive?
BPE 2
What BPE score would this patient receive?
BPE 3 (black band partially visible eg probing depth of between 3.5-5.5mm)
What BPE score would this patient receive?
BPE 4 (black band within pocket eg pockets of 6mm or more present)
How do you take a BPE of a child ages 7-17 y/o?
BPE around teeth:
- 16, 11, 26, 36, 31, 46
Codes 0-2 are used
Where should the gingival margin lie ideally?
At level of the ACJ/CEJ
What are the different furcation involvement gradings?
1 - less than 1/3 of tooth width
2 - >1/3 of tooth width
3 - through & through involvement
What are the different mobility gradings of teeth?
0 - 0.1/0.2mm physiological tooth movement
1 - 1mm horizontal movement
2 - >1mm horizontal movement
3 - rotation and depression
What does TIPPS stand for?
- talk
- instruct
- practise
- plan
- support
How could you go about providing smoking cessation advice?
- 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
What are some causes of gingivitis?
- poor OH plaque control
- pregnancy induced gingivitis
- puberty gingivitis
- drug induced gingival enlargement
What is the optimal plaque score goal you want to get patients down to?
< 15%
What is the optimal bleeding score goal you want to get patients down to?
< 10%
What is the probing depth score goal you want to get patients down to?
< 4mm
Give some examples of local plaque-retentive factors:
- malpositioned teeth
- overhanging restorations
- crowns with poor margins
- bridgework
- partial dentures
What periodontal and endodontic signs may suggest that a patient is suffering from a perio-endo lesion?
PERIODONTAL:
- swelling
- pocketing attachment loss
- suppuration
ENDODONTIC:
- negative pulpal status
- fistula
- TTP
