Periodontal care

Question 1

What are the risk factors for periodontal disease?

Answer 1

• Smoking
• Diabetes
• Pregnant patients more risk of developing pregnancy gingivitis

Question 2

What should you do if patient has BPE with score of 4 in any sextant or score of 3 in more than one?

Answer 2

• Full periodontal examination
• Record in notes
  Patients with 3 in one = only periodontal charting in that sextant

Question 3

What is involved in full periodontal examination?

Answer 3

• 6 point pocket chart
• Dental caries
• Occlusal discrepancies
• Problems with restorations
• Radiographs to assess bone levels
• Plaque and gingivitis scores

Question 4

What are the tips for treatment planning of patient with perio?

Answer 4

• Explain treatments, what it involves and intended results and explain what consequences of no treatment will be
• Make clear it is chronic condition and needs to be managed
• Management is a partnership between patient and clinician
• Ensure patient is periodontally stable before advanced procedures like implant
• If wanting implants then fully inform about increased risk of complications due to oral health history

Question 5

What is the oral hygiene TIPPS behaviour change strategy?

Answer 5

Talk
Instruct
Practise
Plan
Support
- Raise stopping smoking
- Encourage better lifestyle changes (diet, activity , alcohol consumption)

Question 6

What to do if patient has gingivitis and gingival enlargement?

Answer 6

• Remove supra-gingival plaque, calculus and stain and sub gingival deposits
• Where enlargement is drug related consider physician
• Re-assess to determine if resolved

Question 7

What to do if patient has periodontitis?

Answer 7

• Remove supra gingival plaque, calculus and stain
• Root surface instrumentation at sites of >= 4mm probing depth
• Advise may feel discomfort and sensitivity
• Full periodontal exam minimum of 8 weeks post treatment
• Manage acute conditions using local measures first
• Only prescribe antibiotics if evidence of infection or systemic involvement
• 0.2% chlorhexidine mouthwash until acute symptoms subside
• Review within 10 days and further PMPR and arrange recall