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BDS2 Periodontics > Basic Periodontal Examination, Disclosing and Oral Hygiene Instruction > Flashcards

Basic Periodontal Examination, Disclosing and Oral Hygiene Instruction Flashcards

(65 cards)

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1
Q

what is the etiological agent of gingivitis and periodontitis?

A

plaque

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2
Q

plaque induced gingivitis

A

an inflammatory response of the gingival tissues resulting from bacterial plaque accumulation located at and below the gingival margin

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3
Q

4 clinical signs of plaque induced gingivitis

A

Bleeding on probing

High plaque score

High Bleeding scores

Gingival swelling and rednes

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4
Q

what will the patient notice in plaque induced gingivitis?

A

Blood in saliva

Bleeding with toothbrushing and interdental cleaning

Bad breath (Halitosis)

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5
Q

Key features of plaque induced gingivitis

A

REVERSIBLE inflammation of the gingival tissues

Swelling and bleeding at the gingival margins

Risk Factor for Periodontitis

Probing depths ≤3mm

No attachment loss

No radiographic bone loss

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6
Q

definition of periodontitis

A

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

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7
Q

clinical signs of periodontitis

A

Bleeding on probing

Radiographic bone loss

Gingival recession

Probing depths ≥4mm (Clinical attachment loss)

similar to plaque induced gingivitis

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8
Q

what will a patient with periodontitis notice?

A

Blood in saliva

Bleeding with toothbrushing and interdental cleaning

Bad breath (Halitosis)

Black triangles

Tooth movement

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9
Q

key features of periodontitis

A

Inflammation of the supporting structures of the teeth (gingiva and bone)

Bleeding on probing in active disease

Probing depths ≥4mm

Radiographic bone loss

Susceptible patients most at risk for tooth loss – Can be modified by systemic disease

NOT REVERSIBLE - halt the progression to get patient stable

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10
Q

good questions to ask when taking a dental history

A

How often do you brush your teeth?
Do you use a manual or powered toothbrush?
What toothpaste do you use?
Do you clean in between your teeth with floss or interdental brushes
Do you use any mouth rinse?
Do you attend the dentist regularly?
Do you have your teeth cleaned by the dentist/hygienist?

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11
Q

reason for taking dental history

A

Identify the oral hygiene and regime the patient uses

- Risk assessing for periodontitis with straightforward Qs

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12
Q

what is the mouth divided into for the basic periodontal examination?

A

sextants

7-4, 3-3, 4-7
wisdom teeth not included

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13
Q

screening tool for periodontal disease

A

Basic Periodontal Examination (BPE)

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14
Q

what probe is used in the BPE

A

WHO CPITN probe

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15
Q

what is the height of the black band on the WHO CPITN probe?

A

3.5-5.5mm

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16
Q

how to carry out a BPE

A

insert probe down the long axis of the tooth

walk WHO CPITN probe around gingival line and will fall into pocket

ball end can catch calculus under gum

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17
Q

what does a BPE indicate

A

what further assessment and periodontal treatment the patient requires

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18
Q

BPE Score 0

A

No probing depths > 3.5mm, no calculus/overhangs, no bleeding after probing

Black band completely visible

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19
Q

BPE Score 1

A

No probing depths > 3.5mm, no calculus/overhangs, bleeding after probing

Black band completely visible

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20
Q

BPE Score 2

A

No probing depths > 3.5mm, supra- or sub-overhangs, bleeding after probing

Black band completely visible

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21
Q

BPE Score 3

A

Probing depth(s) of 3.5 – 5.5mm present

Black band partially visible

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22
Q

BPE Score 4

A

Probing depth(s) of 6mm or more present

Black band entirely within pocket

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23
Q

BPE Score *

A

Furcation involvement

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24
Q

fluoride content of toothpaste in adults with permanent dentition

A

1350-1500ppm fluoride

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25
desensitising toothpaste
use of potassium-, stannous fluoride-, potassium and stannous fluoride-, calcium sodium phosphosilicate-, and arginine-containing desensitizing toothpastes for dentin hypersensitivity block dentinal tubules
26
what does chlorohexidine mouth wash do
reduce plaque build up and gingivitis
27
manual toothbrush technique
modified bass
28
toothbrushing duration
Almost universal recommendation that all people should brush their teeth twice a day for at least 2 min Expert opinion is that for periodontitis patients 2 min is likely to be insufficient
29
if have a BPE code 3
do a 6 point pocket chart for that particular sextant
30
if have a BPE code 4
full mouth pocket chart of all dentition
31
frequency of toothbrushing
few studies evaluating the association between tooth brushing frequency and periodontitis infrequent tooth brushing was associated with severe forms of periodontal disease. Further epidemiological studies are needed.
32
interdental cleaning impact on gingivitis
Using floss or interdental brushes in addition to toothbrushing may reduce gingivitis or plaque, or both, more than toothbrushing alone. Interdental brushes may be more effective than floss. Available evidence for tooth cleaning sticks and oral irrigators is limited and inconsistent.
33
what happens when you rinse with cholorhexidine for 4 weeks or more
extrinsic tooth staining calculus build up transient taste disturbance - not recommended for routine use
34
fluoride mouth rinse function
under supervision results in a large reduction in tooth decay in children's permanent teeth. little information about potential adverse effects and acceptability. - recommended for routine daily use if high caries risk
35
TIPPS oral hygiene instruction tools
Talk - About the causes of dental disease and discuss any barriers to effective plaque removal; Instruct - the patient on the best ways to perform effective plaque removal; Practise Plan - put in place a plan which specifies how the patient will incorporate oral hygiene into daily life; Support - support the patient by following up at subsequent visits
36
what is the hardest element in oral hygiene of a patient to change
their behaviour - habits take months Offering assistance, and seeking permission to give knowledge or teach skills facilitates patient ownership of the task. - The natural response to force is resistance Motivation is not static - Varies with individuals life factors and stresses
37
3 reasons why a clinician discloses teeth
Highlights to the patient where they are missing when cleaning their teeth Shows the clinician where they need to concentrate the patients efforts Gives the opportunity to learn effective toothbrushing skills
38
what % of people have some form of dental disease?
90%
39
what is oral biolfilm
a.k.a plaque After teeth cleaning, bacterial species colonise tooth surfaces and at the gingival margin
40
what does poor oral biofilm maintenance lead to
colonisation of pathogenic bacteria results in oral biofilm dysbiosis - can lead to hard and soft tissue disease
41
what can be done to control oral biofilm
Mechanical and chemical
42
properties of plaque
adhesive and cohesive - sticks to itself and other things (like honey)
43
how much of plaque biofilm can be left behind after brushing with a manual brush
50%
44
what brushes are technique sensitive
manual | sonic
45
sonic brush
sound waves, vibrates at high speed, disrupts the pellicle, not moving at a wide enough angle to bend and straighten to come back again. Technique sensitive (side to side)
46
oscillating rotating brush movement
3D action left right turn (45 degree oscillating-rotating) and pulsation,
47
how is plaque measured? (2)
- rustogi modified plaque index (RMNPI) | - turesky modified quigley hein index (TMGHI)
48
how is gingivitis measured? (2)
- probing (gingival bleeding index) | - amount of inflammation (modified gingival index)
49
pros of OR over other brushed
OR demonstrated more effective plaque removal and reduced gingival bleeding long term use Vs manual and sonic not technique sensitive 400-600 directional changes with manual brush - technique sensitive whereas Oscillating rotating 9,900 directional changes and 45,000 pulsations - So 55000 total
50
3 things that can happen if brush too aggressively
gum abrasion gum recession tooth structure loss
51
3 areas assess for OR brushes
effectiveness gentleness safety
52
when is a bristle not able to remove plaque?
when it is bent
53
oral b test drive
innovative demonstrative model) Let’s patients experience the benefits of Oral B Showing improves patient compliance Increasing patient confidence and trust in you
54
what is the primary cause of gingivitis
poor biofilm control
55
why is a power toothbrush more efficacious at preventing gingivitis than manual toothbrush
it physically removes more plaque
56
what % of toothpaste is the active component
0.2-10% rest is a complex formula humectants, water, abrasives, binders and buffers, surfactants
57
what does fluoride need to enter the oral cavity
a carrier (dissociates from) Complex carrier longer delivery time
58
fluoride carriers
Sodium fluoride stannous fluoride ammine fluoride sodium monoflurosuplphate
59
why has dental erosion been identified and increased since 2004?
diets have changed | more dietary acid
60
what does acid expose
dentinal tubules
61
how does stannous fluoride help prevent caries and tooth eroision
its ability to effectively deliver fluoride
62
properties of stannous
Stable Antimicrobial Bactericidal - kills bacteria Bacteriostatic - inhibits metabolic rate of bacteria (inhibits metabolic processes in biofilm), manage bacteria in mouth
63
bactericidal
kills bacteria
64
bacteriostatic
inhibits metabolic rate of bacteria (inhibits metabolic processes in biofilm), manage bacteria in mouth
65
how is plaque kept soft by toothpaste
Effective calculus and staining ingredients bind to calcium in tooth enamel which inhibits mineralisation of plaque, which keeps it soft for mechanical removal and blocks chromagen molecules from interacting with the tooth surfaces to reduce staining

BDS2 Periodontics (2 decks)

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