1: Periodontal Examination & Diagnosis Flashcards
(51 cards)
6 components of history taking?
reason for attendance (complaint) history of complaint past medical history past dental history family history social history
medical history: uses?
- partially help to explain the perio disease seen
- alert precautions needed to ensure patient safety
- alert precautions for clinician to safeguard themselves, staff and other patients
past dental history: uses?
previous perio disease/treatment attendance pattern OH habits presence and care of appliances problems with latex, LA/GA, bleeding other dental treatment
family history: uses?
genetic link in some forms of perio disease: aggressive periodontitis
positive family history: increase monitoring frequency, may prompt more aggressive treatment if required
screening of siblings/children of affected patients is recommended
social history: uses?
occupation, family: availability for treatment
reveal risk factors: smoking, alcohol habits, stress
what does stress to do periodontal health?
reduces immune function
reduces saliva flow
increases salivary viscosity, acidity, glycoprotein content
- favoring plaque accumulation
how to assess periodontal disease?
must be done thoroughly and carefully, disease varies from site to site within mouth
- each periodontal site/micro-environment is assessed
components of the 5 point periodontal examination?
- lack of BOP
- probing depth
- loss of attachment: ACJ-base of pocket
- tooth mobility
- furcation involvement
lack of BOP - indicates what?
lack of disease activity, at that site and at that time
30% of BOP sites -> LOA
no BOP - almost 100% no LOA
why are pockets >3mm significant?
what does periodontal treatment aim to do?
- they cannot be reliably cleaned by patients. probing depths will influence treatment plan.
- perio treatment aims to reduce pocket depths
what index is used to measure tooth mobility?
miller’s index
miller’s index - describe the different degrees?
0 - horizontal movement up to and including 0.2mm
1 - horizontal movement of >0.2mm but =1mm
2 - horizontal movement of >1mm
3 - movement in both horizontal and vertical planes
causes of mobility: 3 main dental causes?
- periodontal disease, leading to loss of support
- peri-radicular disease
- occlusal trauma
what is furcation involvement?
what is the prognosis for teeth with furcation involvement?
- area between roots of multi-rooted teeth can be probed in horizontal plane (probe goes between tooth)
- reduced prognosis
diagnosis: should be in place before ____?
diagnosis should be in place before treatment planning
diagnosis is based on which 2 things? where to find other clues?
- BOP
- LOA
+ in medical/family history
what does diagnosis have NOTHING to do with? why?
probing depths, as pockets could be true or false
systematic diagnosis of periodontium? for periodontitis and gingivitis
1) distribution, severity, type, periodontitis
2) distribution, type, gingivitis
3) alternatively, periodontal stability
patient with BOP - diagnosis
generalized disease vs localized disease?
> 30% sites bleeding - generalized disease
most cases of gingivitis are chronic or acute?
chronic gingivitis
examples of acute gingival conditions?
describe them
ANUG, abscesses
- they are more specific, less common, and usually associated with pain
diagnosis of gingivitis: what to write in notes for diagnosis of localized disease?
localized chronic gingivitis affecting e.g. lower anteriors
describe in DETAIL the four parts used to describe a case of periodontitis
i. distribution: localized/generalized
ii. severity: slight/moderate/severe
iii. type: chronic/aggressive
iv. periodontitis
periodontitis: how does LOA vary with the severity of the condition?
slight: 1-2mm LOA, bone loss up to 1/3rd of root length
moderate: 3-4mm LOA, bone loss >1/3rd, 1/2 root length and/or furcation involvement
