Supportive Periodontal Care Flashcards
What are the aims of supportive periodontal therapy?
- prevent or minimise disease recurrence or progression
- prevent or reduce incidence of tooth loos
- increase likelihood of detecting and treating other oral conditions
In the Loe et al. 1986 study, what factors constitute as rapid progression of periodontitis ?
- loss of attachment 9mm at 35 years old
- loss of attachment 13mm at 45 years old
- tooth loss starts at 20 with all teeth lost at 45
In the Loe et al. 1986 study, what factors constitute as moderate progression of periodontitis ?
- loss of attachment of 4mm at 35 years old
- loss of attachment of 7mm at 45 years old
- tooth loss starts at 30 with 7 teeth lost at 45
In the Loe et al. 1986 study, what factors constitute no progression of periodontitis?
- no progression beyong gingivitis
- loss of attachment was 1mm at 35 with no tooth loss in study
What was the conclusion of the study conducted by Loe et al in 1986?
- small group showed no progression of disease beyond gingivitis suggesting a possible genetic component influencing susceptibility
- for most people, disease will progress if left untreated resulting in tooth loss
Briefly outline the treatment plan for supportive periodontal treatment
assessment –> diagnosis –> treatment –> review –> maintenance
Where does supportive periodontal therapy fall in the treatment plan for periodontal treatment?
falls into the maintenance stage/phase of the treatment plan
The maintenance phase of the periodontal treatment plan is now commonly referred to as ..
supportive therapy- phase is vital to ensure stability
The supportive phase of periodontal therapy is achieved by implementing …
- regular clincal assessment
- re-treatment of certain sites
- patient motivatoon
What does the supportive phase of periodontal treatment look like for patients who are most likely going to lose teeth?
- regular clinical assessment
- retreatment at certain sites
- motivation
- modify factors affecting succes e.g. smoking
- discuss progression
- manage symptoms
- if patient is compliant look for other possible reasons why disease is progressing/no respisne to treatment
What are the factors that contribute to effective supportive periodontal treatment?
- good oral hygiene
- healthy looking gingivae
- shallow pockets
- stable attachment levels
- intact dentition - no tooth loss or increased mobility
- removal of deposits
What are the factors that contribute to ineffective supportive periodontal therapy?
- marked gingivitis
- deepening pocket depths
- loss of attachment
- tooth loss
- evidence of ineffective debridement
What are the stages of supportive therapy?
- review history- MH, DH, SH
- review oral hygien regim
- clinical assessment and periodontal review
- radiograph assessment
- diagnosis
- discuss findings
- tratment
- reinforce advice
- arrange recall/review
What are the stages of supportive therapy?
- review history- MH, DH, SH
- review oral hygien regim
- clinical assessment and periodontal review
- radiograph assessment
- diagnosis
- discuss findings
- tratment
- reinforce advice
- arrange recall/review
What are the components of an effective history review?
MH:
* new conditions
* worsening conditions
* change in smoking status
DH:
* issues since last appt- pain, swelling
SH:
* lifestyle changes- stress
* reasons for lapses- bereavment
What should be reviewed in the in the patients oral hygiene regime ?
- TB habits- ETB, MTB, how often
- ID cleaning- what aids?
- other aids- mouth washing
What must be included in your clinical assessment in your periodontal review?
- PPD
- bleeding scores
- plaque scores
- recession
- suppuration
- mobility
- furcation involvment
- CAL
The frequency of radiographs for periodontal assessments is often determined by…
clinical judgement
What are a potential justifications for radiation exposure in a periodontal review?
- deepening pockets
- increased attachment loss, mobility furcation involvement
- suppuration or abscess
A diagnosis of periodontal disease is for life. True or false
true
When discussing your findings following the clinical assessment of the periodontal review, what should you include?
- current condition
- any non responsive sites
- reasons why non responsive sites are present (if known)
- any sites being missed for plaque control
- recommended options (risks and benefits)
Non-responding sites in periodontal disease may be present due to…
- incorrect diagnosis
- inadequate plaque control
- inadequate sub-ginvival debridement
- smoking
- other - systemic, bacterial
Give some potential reasons for non compliance in periodontitis patients
- time
- cost
- social issues
- treatment complexity
- personal view of disease
- treatment dissatisfaction e.g. taking too long
- breakdown in professional relationship
What constitutes stable periodontal disease?
<10% BoP
PPD </= 4mm
no BoP at 4 mm sites
