Lecture 5

Question 1

DH process of care

Answer 1

Assessment
Diagnosis
Planning
Implementation
Evaluation

Question 2

clinical periodontal assessment

Answer 2

a fact gathering process designed to provide a comprehensive picture of the patient’s periodontal health status

Question 3

why is a comprehensive periodontal assessment important

Answer 3

there is a legal obligation to perform and document findings of a periodontal assessment for every patient

forms the basis for periodontal diagnosis and individualized treatment plan

Question 4

objectives of the periodontal assessment

Answer 4

detect: clinical signs of inflammation in the periodontium
identify: damage to the periodontium already caused by disease
provide: the dental team with the information used to assign a periodontal diagnosis
document: features of the periodontium to serve as a baseline data for long-term patient monitoring

Question 5

documentation

Answer 5

assessment is not complete until all of the information gathered has been accurately recorded in the patient’s record
accuracy is important
baseline data is used to evaluate the success or failure of perio therapy and for long term monitoring

Question 6

standard of care

Answer 6

for dentists and DH to complete an accurate and thorough periodontal assessment on every patient

Question 7

two types of periodontal assessment

Answer 7

periodontal screening examination
comprehensive periodontal assessment

Question 8

periodontal screening examination

Answer 8

may be used as one of the first steps in a patient’s periodontal assessment
a quick information gathering process to determine signs of health, gingivitis, periodontitis

Question 9

PSR technique

Answer 9

special probe: world health organization (WHO) probe
mouth is divided into sextants, each receiving a code (0, 1, 2, 3, 4)

Question 10

documenting the PSR

Answer 10

codes 0, 1, 2 colored band is completely visible

Question 11

code 0

Answer 11

no bleeding/calculus/defective margins
appropriate preventative care

Question 12

code 1

Answer 12

bleeding on probing
no calculus/defective margins
appropriate preventative care
appropriate biofilm removal

Question 13

code 2

Answer 13

calculus and/or defective margins present
appropriate therapy/PT education
biofilm removal
calculus removal
defective margins corrected

Question 14

code 3

Answer 14

probing depths 4mm-5.5mm
calculus/defective margin/BOP may or may not be present
a comprehensive periodontal assessment is required for affected sextant
if 2 or more sextants score code 3: a comprehensive full mouth periodontal assessment is required

Question 15

code 4

Answer 15

PD >5.5mm
a comprehensive full mouth periodontal assessment is necessary to determine an appropriate treatment plan

Question 16

code *

Answer 16

a * is added to a sextant when a clinical abnormality is found
furcation
mobility
mucogingival problem
recession 3.5mm or greater

Question 17

comprehensive periodontal assessment includes

Answer 17

probing depth measurements
BOP
presence of exudate
location of free gingival margin
gingival width/attached gingiva
mobility
furcation involvement
presence of calculus/biofilms
gingival inflammation
radiographic evidence of bone loss
presence of local contributing factors

Question 18

gingival margin coronal to CEJ is recorded as a _____ number in axium

Answer 18

negative

Question 19

gingival margin apical to CEJ is recorded as a _____ number in axium

Answer 19

positive

Question 20

gingival pocket

Answer 20

due to gingival enlargement
no attachment loss
no apical migration of JE

Question 21

periodontal pocket

Answer 21

sulcus over 3 mm in depth
apical migration of JE
loss of periodontal tissues/bone

Question 22

clinical attachment level

Answer 22

a clinical measurement of the true periodontal support around the tooth

Question 23

CAL accurately monitors change over time because it

Answer 23

is calculated from a fixed point on the tooth’s surface; the CEJ

Question 24

gingival margin at normal level

Answer 24

the probing depth and the CAL are the same

Question 25

gingival margin receded

Answer 25

the gingival margin level reading is added to the probing depth reading

Question 26

gingival margin significantly above CEJ

Answer 26

subtract gingival margin level reading from the probing depth reading

Question 27

gingival width

Answer 27

measure the total width of the gingiva from the gingival margin to the mucogingival junction

Question 28

attached gingiva

Answer 28

the part of the gingiva that is tightly connected to the cementum on the cervical third of the root and to the connective tissue cover of the alveolar bone

Question 29

width of attached gingiva on facial max and mand

Answer 29

widest on incisors and molars narrowest on canine and biscuspids

Question 30

width of attached gingiva on lingual on mand

Answer 30

widest on molars narrowest on incisors

Question 31

exudate

Answer 31

referred to as suppuration may be revealed using light finger pressure axium recordings: B (bleeding), N (no bleeding), S (suppuration)

Question 32

pus

Answer 32

composed of mainly dead WBC which can occur in response to infection such as periodontal disease

Question 33

mobility

Answer 33

horizontal: movement in facial/lingual direction vertical: depressible

Question 34

class 1 mobility

Answer 34

up to 1 mm horizontal

Question 35

class 2 mobility

Answer 35

1-2 mm horizontal

Question 36

class 3 mobility

Answer 36

> 2 mm horizontal/depressible

Question 37

furcations and classes

Answer 37

maxillary molars are tri-furcated mandibular molars are bi-furcated class I: probe penetrates <1mm class II: probe penetrates >1mm class III: probe passes through class IV: probe passes through and clinically visible

Question 38

presence of biofilm and calculus

Answer 38

can be identified using such instruments as the periodontal probe or an explorer disclosing solution calculate a plaque score

Question 39

never disclose before having what checked by your instructor

Answer 39

gingival description

Question 40

detecting calculus

Answer 40

use direct visual examination with mouth mirror use compressed air to assist in identification of supragingival depositis tactile examination using explorer radiographs

Question 41

occlusion: signs and symptoms or trauma

Answer 41

tooth mobility fremitus tooth migration wear facets pain (TMJ and/or musculature)

Question 42

radiographic signs of trauma from occlusion

Answer 42

widening of PDL increased thickness of lamina dura vertical bone loss root resorption