Full assessment

Question 1

When do we carry out a Full periodontal assessment?

Answer 1

After BPE score of more than 3 or 4

Question 2

After recieving a BPE if 4 how long often must full periodontal assessments be carried out?

Answer 2

Initially every 3 months until stabilised

For rest of lives at least yearly

Question 3

When is a referal to a specialist made?

Answer 3

If not responded well to treatment

If worsening despite good plaque control

If patient has underlying systemic illness e.g. diabetes

Question 4

What does the full periodontal assessment tell us (5)?

Answer 4

• Site specific nature of disease
• Extent and severity of disease (more localised takes less time to treat)
• Treatment planning
• Moniter disease and hygiene therapy
• Predict likely treatment outcome

Question 5

What makes an individual more susceptible to periodontal disease?

Answer 5

Crowding

Durnications

Right hand = miss tip left buccal area when brushing

Question 6

What are the clinical signs of periodontitis (7)?

Answer 6

• True pocketing >4mm where attachement loss has occured
• Recession
• Supparation (problem with pulp or apex = not only periodontal!)
• Mobility
• Migration (different directions fue to lips or opposing dentition)
• Furcation involvement
• Bone loss on radiographs

Question 7

What 5 things do we record in a full periodontal assessment?

Answer 7

• Pockets
• Bleeding
• Supparation
• Mobility
• Furcations

Question 8

Which probe do we use to do a full periodontal assessment?

Answer 8

Williams probe

Question 9

What are the measurement intervals on the BPE/WHO probe?

Answer 9

0. 5
1. 5
2. 5
3. 5
4. 5

Question 10

What are the measurement intervals on a Williams probe?

Answer 10

1

2

3

5

7

8

9

10

Question 11

How much pressure do you apply a williams probe with?

Answer 11

2.0 - 2.5 N (enough to start blanching your nail)

Question 12

In which ways is the shape adapted for periodontitis?

Answer 12

It is fine = enters narrow pockets

Blunt end = avoids damage

Question 13

How many sites on each tooth do we probe at?

Answer 13

6

Question 14

What is bleeding a sign of?

Answer 14

Acute inflammation

(lack of bleeding = lack of disease activity but may occur if probing is too forceful & less bleeding in smokers)

Question 15

Which two things may cause drainage of pus?

Answer 15

When released during probing

On pressure of the gingiva

(associated with bad taste)

Question 16

How do we test mobility?

Answer 16

Put finger against one side of tooth

Push on other side with metal handle of instrument

Question 17

Which index do we use to measure tooth mobility?

Answer 17

Miller mobility index

(write in roman numerals!!)

Question 18

What is grade 0 mobility?

Answer 18

No mobility (<0.2mm) = physiological

Question 19

What is grade I mobility?

Answer 19

Horizontal mobility of <1mm

Question 20

What is grade II mobility?

Answer 20

Horizontal mobility >1mm

Question 21

What is grade III mobility?

Answer 21

Includes vertical mobility of any degree

= must be extracted as will move whenever you masticate!

Question 22

Which classification system do we use to measure furcation involvement?

Answer 22

Hamps

Question 23

Which probe do we use to measure furcation involvement?

Answer 23

Williams probe

Question 24

What is a grade 1 furcation involvement?

Answer 24

Up to 3mm

= difficult but maintainable

Question 25

What is grade 2 furcation involvement?

Answer 25

Probe goes in 6mm but not all the way through

Question 26

What is grade 3 furcation involvement?

Answer 26

Probe passes all the way through the roots

Question 27

How do we measure gingival recession?

Answer 27

Use a williams probe to measure the distance from the CEJ to the gingival margin at 6 sites per tooth

Question 28

Why can it sometimes be difficult to measure gingival recession?

Answer 28

It can be difficult to see the difference bwtween enamel and root due to wear from brushing

Question 29

Which classification system do we use for recession?

Answer 29

Millers = 4 categories, assesses both hard and soft tissues = both diagnostic & prognostic (class 3 & 4 cannot be surgically corrected)

Question 30

What is Class I gingival recession?

Answer 30

Does not extend to mucogingival junction No alveolar bone loss No soft tissue loss from interdental area

Question 31

What is Class II gigival recession?

Answer 31

Extends beyound mucogingival margin (harder for patient to clean = looks less healthy) Good interdental papillae No alveolar bone loss or soft tissue loss in interdental area

Question 32

What is Class III gingival recession?

Answer 32

extends beyound mucogingival margin, some bone & soft tissue loss

Question 33

What is class IV gingival recession?

Answer 33

recession beyond mucogingival junction

Question 34

What can cause gingival recession (9)?

Answer 34

* Root anatomy (enamel pearls/bulbous roots) * Root angulation/tooth position/crowding * Thin labial bone/dehiscence (sheathing around tooth incomplete) * Thin gingival biotype * Toothbrush trauma * Periodontal disease * Traumatic occlusion * Habitual (nail biting, piercing, pen chewing = jiggling forces on teeth) * Orthodontic arch expansion (teeth pushed out towards edge of arch)

Question 35

What are the 3 different types of radiographs taken?

Answer 35

* DPT = all teeth & bone but not all detail needed * Full mouth periapicals (goes to apex of every tooth) * Periodontal diagnositic unit (PDU) = left & right vertical bitewings plus periapicals of anterior teeth