BSP guidlines Flashcards
(41 cards)
What are the BPE scores and what do they mean
0= <3.5mm pockets
1= <3.5mm pockets, BOP
2= <3.5mm pockets, plaque retentive factor
3= 3.5-5.5mm pockets
4= >5.5mm pockets
What would be classified as gingival health
<10% BOP
What would be clasified as localised gingivitis
10-30% BOP
What would be classified as generalised gingivitis
> 30% BOP
If there is a sextant with a code 3 and no obvious interdental recession what would you do
Radiographic assessment and initial perio therapy
Review after 3months including a 6PPC
After a 3month review of a sextant score of 3 when could you move to the 0/1/2 score pathway
If in review no pockets >/=4mm and no radiographic bone loss
After a 3month review of a sextant score of 3 when would you move to the code 4 pathway
If in review pockets >/=4mm and/or radiographic bone loss
Wgat would you do to a sextantt with a BPE score of 4
Radiographic assessment and full periodontal assessment including 6PPC
When staging and grading perio what are the STAGING scores
Look at worst site of radiographic bone loss
<15%= Stage 1
Coronal third= stage 2
Mid third of root= stage 3
Apical third= stage 4
With the staging scores of perio what do the scores actually mean
stage 1=early/mild
stage 2=moderate
stage 3=severe
stage 4=very severe
When staging and grading perio what are the GRADING scores
% bone loss dividedd by pt age
<0.5= Grade A
0.5-1.0= Grade B
> 1.0= Grade C
What do the GRADING scores of perio mean
A= slow progression
B= Moderate progression
C= Rapid progression
When would periodontitis be classified as currently stable
BOP<10%
PPD</= 4mm
No BOP at 4mm sites
When would periodontitis be classified as currently in remission
BOP>/= 10%
PPD</= 4mm
No BOP at 4mm sites
When would periodontitis be classified as currently unstable
PPD>/= 5mm
or
PPD >/= 4mm with BOP
What is required to be diagnose with periodontitis
Presence of interdental attachement loss at 2 or more non-adjacent teeth
How many steps is therew in the BSP guidlines and what are they
4
Step 1- Building foundations for optimal Tx outcomes
Step 2- Subgingival instrumentation
Step 3- Managing non-responsive sites
Step 4- Maintenance
What does step 1 centre around and what does it involve
Proffesional mechanical plaque removal and involves OHI advice, pt education, removal of stains/plaque/plaque retentive factors
What are the steps in stage1of BSP perio Tx guidlines
I: Explain disease, risk factors and TX alternatives, risks and benifits including no Tx
II: Explain importance of OH, encourage and support behaviour change for OH improvement
III: Reduce risk factors
IV: Provide individually tailored OH advice including interdental cleaning, PMPR including sub/supra G scaling of clinical crown
V: Select recall period as per guidlines considering risk factors
How could you explain disease to Pt
The gum disease present in your mouth is caused by bacteria in dental plaque which collect around the gum margin (where the crown of the tooth joins the root). The dental plaque irritates the gums causing them to swell and sometimes bleed during tooth brushing. The dental plaque spreads below the gum margin onto the root. The gum irritation also spreads and this irritation/inflammation can eventually damage the
bone that surrounds the teeth. In the long run this may lead to the teeth becoming loose and, eventually, falling out. We want to try to stop this bone destruction continuing and so prevent you losing teeth
What do you do after step 1
At re-call period re-evaluate to see if pt is engaged or not
If pt is engaged move to step2 if not back to step1
What would be classified as an engaged and non-engaged pt
engaged:
> /= 50% improvement in plaque and bleeding scores OR
plaque levels </= 20% and bleeding levels </= 30% OR
Pt has met targets outlined in ther personal self care plan as determined by healthcare practitioner
non-engaged:
< 50% improvement in P&B scores OR
plaque levels >20% and bleeding scores >30%
What is step 2 and what does it involve
Sub G instrumentation
Involves root surface instrumentation or debridement
Whats the difference betweeen Sub G scaling and debridement
Sub G scaling= involves identifying the calculus and removing it
Debridement= involves taking a systemic approach and washing/cleaning away endotoxins in cementum
