Perio Flashcards
what are the components to give a perio diagnosis
localised or generalised - more or less than 30%
periodontitis
stage - % of bone loss - mid (3) or apical (4) third
grade - % of bone loss/age - c if greater than 1
current status - unstable
risk factors - diabetes, smoking
explain perio disease
caused by chronic inflammation of the gums - build up of plaque and bacteria on gums, not removed, inflammation not resolved, inflammation goes down into bone holding tooth in socket, causes bone loss - can result in mobile teeth and loss of teeth if not resolved
caused by plaque and bacteria but other factors make it worse - genetic, diabetes, smoking
explain periodontal treatment
oral hygiene is the most important thing in treating PD - we can help and support you as best we can but you need to keep your gums clean
remove and control risk factors - smoking cessation, diabetes control
removal of plaque retentive factors - overhang
pmpr of clinical crown - removal of calculus with both uss and hand scaling
assess engagement - modified plaque and bleeding scores
then continue with step 2 s3 guidelines - subginigval pmpr
how does smoking effect PD
effects vasculature - reduces blood flow, reduced healing capacity
reduced bleeding - might be asymptomatic
increase in pro-inflammatory markers - increase inflammation, exacerbate
increase in anaerobic bacteria in mouth - more destructive
how does diabetes effect PD
poorly controlled diabetes increases inflammation in body - increased inflammatory markers
explain ANUG
an acute infection, happens when someone is run down (stressed, malnourished), caused by plaque bacteria and causes ulcers around gums, starts rapidly and very painful
what are symptoms of ANUG
very painful gums
ulcerated, punched out papilla
slain over gums
hallitosis
how is ANUG treated
explain to PT what it is, whats caused it
smoking cessation
stress management
gentle irrigation of slain and debridement of gums under LA
OHI and CHX MW 2x daily
if systemic - prescribe 400mg metronidazole 3x daily for 3 days - no alcohol
review in one week and review PD
how is a PD abscess recognised
suppurating pocket
tooth +ve to EPT and ECT
no PA path
bone loss on rad
how is PD abscess treated
irrigation + debridement of pocket
CHX MW 2x daily for 5 days
if systemic - phenoxymethylpenicillin - 500mg 4x daily for 5 days
review and complete PD tx
when comparing pre and post tx 6ppc, what should be looked at
if any teeth have been XLA
gingival margin - recession suggests reduced inflammation
probing depths - deep pockets to begin with mean poor prognosis
furcation - difficult access to clean
mobility - difficult to clean and reduced prognosis
bleeding on probing - inflammation levels
what are reasons that PD tx might have failed
poor compliance - PT not motivated, poor OH
risk factors not controlled - PT still smoking or diabetes uncontrolled
difficult access - furcation involvement, deep probing depths
poor manual dexterity - OH compromised
overhangs present
operator poor
