Treatment for Gingival and Periodontal Disease Flashcards
what are the characteristics of a healthy gingiva
- knife edge, scalloped gingival margin
- stippling
- pink
- absence of bleeding on probing
- no erythema or oedema
- no attachment or bone loss
- no patient symptoms
how often does healthy gingiva have stippling
30%
how do physiological bone levels range from the apex to the cemento enamel junction in a healthy individual
1-3mm
what is gingival health defined as
less than 10% bleeding sites with probing depths less than or equal to 3mm, with no loss of attachment, no bone loss and no interdental recession
describe the characteristics of plaque induced gingivitis
- no radiological bone loss
- no interdental recession
- bleeding on probing in more han 10% of cases
- inflamed gums
how can puberty modify plaque induced gingivitis
gums are red
is there probing attachment loss in healthy gingiva
no
is there probing attachment loss in gingivitis
no
what is the probing pocket depth for healthy gingiva
less than or equal to 3mm
what is the probing pocket death for gingivitis
less than or equal to 3mm
how much bleeding on probing is there in healthy gingiva
less than 10%
how much bleeding on probing is there in gingivitis
more than 10%
is there radiological bone loss in healthy gingiva
no
is there radiological bone loss in gingivitis
no
what are teeth with gingivitis more likely to do
- show loss of attachment
- be lost
- progress to periodontitis
what are the characteristics of periodontitis
inflammation and loss of periodontal attachment
- spacing between teeth and loss of interproximal gingival attachment
what is the clinical difference between health and periodontitis
- subgingival plaque biofilm
- attachment loss
- deep pockets
- bone loss
- gingival inflammation
is loss of attachment reversible
no
alongside loss of attachment, what else may periodontitis patients have
- increased probing depth pockets of greater than 3mm
- increased bleeding on probing
- gingival recession
- tooth mobility
- halitosis
- bad taste
- tooth sensitivity to hot or cold
- abscesses
describe the characteristics of a site with unstable periodontitis
- probing pocket depth of greater than 4mm, with or without bleeding
- loss of attachment
- suppuration on probing
what is the difference between true and false pockets
in false pockets there is gingival swelling that increases the pocket depth without actually losing attachment
in true pockets there is genuine loss of attachment
what is the sequence of the periodontitis treatment plan
- immediate/emergency care
- initial disease control
- reevaluation
- reconstructive
- maintenance/supportive care
what is involved in the steps for periodontal treatment
- basis of therapy, and then four steps
what is the basis of therapy for periodontal treatment
- examination
- assessment of risk factors
- diagnosis
what is step one of periodontal treatment
this is control of local and systemic factors
professional mechanical plaque removal
what is step two of periodontal tretment
subgingival instrumentation with adjunctive measures
what is step three of periodontal treatment
repeated subgingival instrumentation
periodontal surgery
access flap
what is step four of periodontal treatment
supportive periodontal therapy with risk adaptive intervals
continuous monitoring of local and systemic factors
which step of periodontal treatment is reconstructive
step three
which step of periodontal treatment involves reevaluation
step one and step two
which steps of periodontal treatment are in the intial disease control phase
basis of therapy, 1 and 2
which step of periodontal treatment is maintenance and supportive care
step four
which step of periodontal treatment is the immediate emergency care
the basis of therapy
what can affect treatment outcomes
- early diagnosis, prevention and prompt intervention
- screening using BPE
what is BPE
basic periodontal examination
what is BPE
this is a screening tool that performs by walking the probe around each tooth and recording only the worst score
how is dentition divided for periodontal screening
six sextants
are all teeth in the sextants examined
yes, with the exception of third molars unless the first and second molars are missing
how many teeth should be in each sextant to qualify for recording
two
describe the BPE probe
- 15mm long
- markings at each mm with colour coding at 5, 10 and 15mm
describe BPE score 0
no need for periodontal treatment
describe BPE score 1
oral hygience instruction
describe BPE score 2
oral hygiene instruction
removal of plaque retentive factors including all calculus
describe BPE score 3
root surface debridement
describe BPE score four
assess the need for more complex treatment
why is the use of BPE screening good
- it assists in reaching a diagnosis of gingivitis or periodontitis for the patient
- formulation of a treatment plan or decision to refer to a specialist
- determine whether detailed charting is indicated or if special tests like radiographs are required
if you are good at treating periodontitis, two thirds of sites with what characteristics can be treated
those with increased pocket depths of more than 4mm can be treated to make the pocket 4 or less and does not bleed on probing
how many grams of force on the BPE should be applied
25g
what is the probing pocket depth of active periodontitis
greater than 4mm
what is CAL
clinical attachment level
what are some plaque retention factors
restorations
calculus
retainer
