Treatment Planning of Gingival and Periodontal Diseases Flashcards

1
Q

Describe the appearance of the gingivae in health

A

Pink stippled gingivae with good tone and absence of bleeding on brushing or probing

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2
Q

Describe the appearance of the gingivae in gingivitis

A

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

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3
Q

Define “plaque induced gingivitis”

A

An inflammatory response of the gingival tissues resulting from bacterial plaque accumulation located in or below the gingival margin

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4
Q

What are the clinical signs of gingivitis?

A
  • Bleeding on probing
  • High plaque scores
  • High bleeding scores
  • Gingival swelling and redness
  • Probing depths <3mm
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5
Q

Describe the appearance of the teeth and supporting structures in periodontitis

A

Inflammation of the supporting structures of the teeth. Loss of attachment, recession, bleeding on brushing and bone loss

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6
Q

Define “periodontitis”

A

An inflammatory disease initiated by bacteria which, in susceptible people, causes severe inflammation and loss of bone around the teeth.

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7
Q

What are the clinical signs of periodontitis?

A
  • Bleeding on probing
  • Radiographic bone loss
  • Gingival recession
  • Probing depths >4mm (clinical attachment loss)
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8
Q

A patient reports the following symptoms: black triangles on teeth, bad breath (halitosis), blood in saliva and tooth movement. Which condition does the patient likely have?

A

Periodontitis

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9
Q

What is the Basic Periodontal Examination (BPE)?

A
  • A screening tool for periodontitis
  • Mouth divided into sextants
  • A WHO CPTN probe is walked around the gingival margin of the teeth
  • Indicates what further assessment and periodontal the patient requires
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10
Q

What size is the ball on a WHO CPTN probe?

A

0.5 mm

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11
Q

What depth does the black band on a WHO CPTN probe represent?

A

3.5-5.5 mm

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12
Q

What are the 6 sextants the mouth is divided into during a BPE?

A
Upper right (17 to 14) 
Upper anterior (13 to 23) 
Upper left (24-27)
Lower right (47 to 44) 
Lower anterior (43 to 33) 
Lowe left (34 to 37)
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13
Q

Where is the normal position of the gingival margin in healthy individuals?

A

At the amelocemental junction

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14
Q

If the gingival margin is apical to the amelocementral junction, what is this referred to as?

A

Gingival recession

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15
Q

What are the problems associated with receding gums?

A
  • Patients may be concerned as to the appearance of receding gums
  • Exposed root surfaces may be sensitive
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16
Q

What does BPE score of 0 mean?

A
  • Black band completely visible
  • No probing depth >3.5mm
  • No calculus/overhangs
  • No bleeding on probing
17
Q

What does a BPE score of 1 mean?

A
  • Black band completely visible
  • No probing depths >3.5 mm
  • No calculus/overhands
  • Bleeding on probing
18
Q

What does a BPE score of 2 mean?

A
  • Black band completely visible
  • No probing depths >3.5 mm
  • Supra or sub-gingival calculus or overhangs present
  • Bleeding on probing
19
Q

What does a BPE score of 3 mean?

A
  • Black band is partially visible

- Probing depth 3.5-5.5 mm

20
Q

What does a BPE score of 4 mean?

A
  • Black band entirely within pocket

- Proving depth >5.5 mm

21
Q

What does a * indicate on a BPE score?

A

Furcation involvement

22
Q

What is the treatment plan for BPE = 0?

A

No treatment required

Diagnosis = health

23
Q

What is the treatment plan for BPE = 1?

A
Diagnosis = gingivitis 
Treatment = plaque and gingivitis index, and oral hygiene demonstration
24
Q

What is the treatment plan for BPE = 2?

A
Diagnosis = gingivitis 
Treatment = plaque and gingivitis index, oral hygiene demonstration and removal of supra gingival plaque calculus and stain
25
Q

What is the treatment plan for BPE = 3?

A
Diagnosis = periodontitis 
Treatment = plaque and gingivitis index, oral hygiene demonstration, removal of supra gingival plaque calculus and stain, AND full periodontal examination and root surface instrumentation of sextants scoring 3
26
Q

What is the treatment plan for BPE = 4?

A

Diagnosis = periodontitis
Treatment = as for BPE 1-3; and full periodontal exmaination and root surface instrumentation in ALL sextants
Consider referral to a specialist

27
Q

What is the treatment plan for *?

A
  • = furcation involvement
    Diagnosis = periodontitis
    Treatment will depend upon BPE score 0-4
    Consider referral to a specialist
28
Q

Name the local risk factors for periodontitis.

A
  • Calculus
  • Malpositioned teeth
  • Overhanging restorations
  • Partial dentures
29
Q

Name the systemic risk factors for periodontitis

A
  • Diabetes
  • Smoking
  • CVD
  • Pregnancy
  • Drugs that cause gingival overgrowth
30
Q

How does a dentist assess the presence of plaque?

A

By running a probe gently around the entrance to the gingival sulcus

31
Q

When recording plaque and gingivitis scores, which tooth surfaces are checked?

A

4 surfaces: buccal/labial, mesial, distal and palatal/lingual

32
Q

What does a score of 1 indicate in recording plaque and gingivitis scores?

A

Bleeding is present

33
Q

What does a score of 0 indicate in recording plaque and gingivitis scores?

A

Bleeding is absent

34
Q

If over 30% of sites have a score of 1 in a plaque and gingivitis index, what does this mean?

A

Generalised gingivitis

35
Q

If over 10% but less than 30% of sites have a score of 1 in a plaque and gingivitis index, what does this mean?

A

Localised gingivitis

36
Q

How do you calculate a plaque score?

A

Number of surfaces with plaque x 100/ total number of teeth x 4

37
Q

How do you calculate a bleeding score?

A

Number of surfaces with bleeding x 100/ total number of teeth x 4