supportive periodontal therapy

Question 1

SPT

Answer 1

1) D4910
2) periodic recall for maintenance and care of perio disease
3) extension of the active perio treatment phase

Question 2

SPT prevents

Answer 2

1) increased probing depth
2) BOP
3) continued attachment loss
3) bone and tooth loss

Question 3

rationale

Answer 3

1) subgingival scaling reduces pathogenic bacteria
2) recall anywhere from 2-4 months
3) positive microbial change can be sustained at regular intervals

Question 4

treatment planning codes

Answer 4

1) at a periodontal recall appt or interval, tp a D0120 if >1 year, or D0120P if < 1 year
2) if a new FMX is required, TP a perio baseline exam D0110 ???
3) be sure to use PERCA for D0120 and PEBASE for D0110

Question 5

part one

Answer 5

1) med and dent hx review

2) radiographic review (update prn)
3) extraoral and intraoral exam
- soft tissue, dental exam, perio exam
4) plaque biofilm control/evaluation

Question 6

dental exam

Answer 6

1) tooth mobility., fremitus, occlusal factors
2) caries assess
3) Restorative, pros
4) other tooth related problems

Question 7

perio exam

Answer 7

1) gingival changes
2) plaque calculus
3) probing
4) recession
5) furcation
6) exudate/suppuration
7) mucogingival involvement
8) occlusal changes
9) other signs and symptoms
10) microbial testing

Question 8

plaque/biofilm control eval

Answer 8

1) use disclosing solution
2) perform whole mouth plaque score

Question 9

o leary

Answer 9

1) on PEBASE form
2) have patient rinse, apply disclosing solution to all teeth with 1-2 cotton swaps, swish, and rinse again
3) divide teeth into mesial, facial, distal, and lingual
4) enter 0 if no plaque, or 1 if plaque at dentalgingival junction (L and F are the same)
5) enter 1 if present on M or D surface
6) # of plaque surfaces / # avail surfaces
= aim for 20% or lower

Question 10

occlusal considerations

Answer 10

1) ROSCCL?

Question 11

part 2

Answer 11

1) OHI
2) periodontal debridement
- scaling
- localized RP (use anesthesia: infiltration)
3) occlusal adjustment prn
4) coronal polishing and flossing
5) chemotherapeutic agent

Question 12

chemotherapeutic agents

Answer 12

1) fluoride
2) anti gingivitis
3) antisensitivity
4) antimicrobial

Question 13

part three

Answer 13

1) establish maintenance interval
2) discuss compliance with appropriate recall
3) discuss control of risk factors
4) schedule next recall visit
5) schedule or refer for perio or restorative treatment

Question 14

appointment interval

Answer 14

1) visits at 3 month intervals sufficient
2) length of time between recall visits determined by level of disease control accomplished by the patient between recalls

Question 15

first year

Answer 15

1) routine therapy with uneventful healing
- > 3 mo or 1-2 mo

Question 16

class A

Answer 16

1) interval 6-12 mo if they are well maintained for >= 1 year

Question 17

class B

Answer 17

1) 3-4 months

Question 18

class C

Answer 18

1) 1-2 months
- bad OH, smoking, systemic disease, occlusal problems, complicated prosthesis, recurrent caries, refused periodontal therapy