ICP-27 Epidemiology and Classification of Periodontal Disease Flashcards
(49 cards)
What are the important purposes of epidemiology
- Determine amount and distribution of disease in a population
- Determine the cause of the disease
- Apply knowledge to control the disease, promote, protect and restore oral health
What does prevalence mean
The % or proportion of the population affected by the disease at a single point in time
What does incidence mean
The number of new cases of a disease occurring in the population over a defined period of time
What do we look at when measuring periodontal disease
Measure:
- Current disease: pocketing or probing measurements that reflect current level of inflammation
- Historic disease: bone loss, clinical attachment loss (CAL)
- Treated disease: pockets or probing depths that have reduced to <4mm, bone loss is irreversible when occurs
What are the different measures of plaque levels
- Detection: look visually or use a probe to detect
- Identify presence of quantify: dichotomous scoring, indices
- Full mouth assessment of plaque: 4 or 6 points/tooth
- Partial assessments: plaque index, turesky scores
What are the different measures of bleeding
- Detection: use of a probe on gentle use
- Timing of bleeding: immediate = marginal gingival health shows inflammation
delayed = more common when marginal health is good but associated with deep pockets - Identify or quantity: dichotomous scoring, indices
- Full mouth assessment: 4 or 6 points/tooth
- Partial assessments: gingival bleeding index
What is measured when carrying out full periodontal charting
- Probing pocket depth (PPD): distance from gingival margin to base of pocket in mm
- Recession: distance from gingival margin to the CEJ in mm
- Clincial attachment loss (CAL): distance from CEJ to pocket (recession + PPD) in mm
- Mobility: horizontal or vertical mobility
- Furcation involvement
How do we scale tooth mobility in periodontal charting
In degrees from 0-3
Describe what a BPE probe looks like
BPE probe - generic af, has ting ball at end and black bands 3.5-5.5mm and 8.5-11.5mm
Describe what a Naber’s probe looks like and what it is used for
Like a fish hook sorta, it is curved and has markings every 3 mm
Used to investigate furcation involvement
Describe what a William’s probe looks like and what it is used for
More generic than fookin BPE probe and has markings at 1,2,3,5,7,8,9 and 10 mms.
Used for full 6 point pocket charts
Describe what a UNC probe looks like and what it is used for
Similar to BPE probe and has markings for all mms. and has black bands at 4-5mm, 9-10mm and 14-15mm,
What is the difference between PPD and CAL
- Probing Pocket Depth (PPD): distance from gingival margin to base of pocket in mm.
- Clinical Attachment Loss (CAL): distance from CEJ to pocket base in mm.
What % of adults have some bleeding
50-60%
As a general trend what has happened to the prevalence of periodontal pocketing over time
- Reduction in mild disease
- Slight increase in the prevalence of more severe disease
- Severe disease are concentrated in a relatively small proportion of the population
What local risk factors can affect the risk of periodontal disease/pocketing
- Anatomical
- Enamel pearls/root grooves/ furcations/ recession
- Tooth position
- Malalignment/ crowding/ tipping
- Iatrogenic
- Restorative margins/ partical dentures/ orthodontic appliances
Name some modifiable systemic risk factors for periodontal disease/pocketing
- Specific bacteria
- Smoking
- Diabetes Mellitus
- Oral Hygiene
- Stress
- Obesity
- Immunodeficiency
- Certain medications
- Diet
Name some non-modifiable systemic risk factors for periodontal disease/pocketing
- Age
- Genetics
- Hormonal influences (like those related to pregnancy)
What are the models for the progression of periodontitis
Gradual destruction model: assumes a slow continuous rate of progression
Burst Theory: Periods of rapid breakdown interspersed with long periods of quiescence
What factors need to be considered in a periodontal diagnosis
- Health of Disease?
- Form of disease: is there gingivitis (reversible) or periodontitis (irreversible)
- Distribution/Extent: affects only a few or all of the teeth
- Severity of the disease: how much disease has the patient and in the past
- Speed of progression: how quickly has disease occurred
- Stability: Is the disease currently active or is it stable
- Risk factors: what is contributing to the disease
What are the main forms of periodontal disease
- Periodontal health: PPD <4mm and no/low levels of bleeding
- Gingivitis: gingival bleeding without bone/attachment loss
- Periodontitis: bone/attachment loss
What forms does periodontitis present itself in
- Periodontitis (most common): combines acute and chronic periodontitis
- Necrotising periodontitis: necrotised papillae, halitosis, pain, stress
- Periodontitis as a manifestation of systemic disease:
- Genetic condition, metabolic disease, immunodeficiency
What are some systemic genetic conditions that can lead to periodontitis
- Papillon Lefecre syndrome
- Leukocyte adhesion deficiencies
- Chediak-higashi syndrome
What metabolic diseases can lead to periodontitis
Hypopohosphatasia
