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BDS5 OSCE Revision > Periodontics > Flashcards

Periodontics Flashcards

(58 cards)

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1
Q

What factors from a patient history may indicate periodontal disease

A

Bleeding on brushing
Swollen gums
Bad breath
Loose or drifting teeth

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2
Q

what are local risk factors for periodontitis

A

plaque
overhanging restorations
orthodontic wires
dental crowding
partial dentures

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3
Q

what are systemic risk factors for periodontitis

A

smoking
diabetes
family history of periodontitis
stress
osteoporosis
rheumatoid arthritis
ethnicity

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4
Q

what are risk factors for gingival enlargement

A

pregnancy - hormonal changes and modified immune response
puberty - hormonal changes
calcium channel blockers for hypertension
phenytoin for epilepsy
ciclosporin (anti-rejection drug)
tricyclic antidepressants and beta blockers may cause dry mouth which can attribute to peridontitis

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5
Q

what is looked for in a visual examination of patients’ teeth with regards to periodontal disease

A

recession on smooth an interdental surfaces
gingival inflammation
crowded, drifted or malpositioned teeth
levels of plaque
presence of calculus
presence of sinuses or suppuration
occlusion

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6
Q

where are the bands on a BPE probe

A

between 3.5mm and 5.5mm
between 8.5mm and 11.5mm

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7
Q

what is the diameter of the ball on the end of a BPE probe

A

0.5mm

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8
Q

what probing force should be used for BPE exam

A

20-25g

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9
Q

what is a BPE score of 0

A

black band completely visible
no probing depths more than 3.5mm, no calculus, no overhangs, no bleeding on probing, no plaque

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10
Q

what is a BPE of 1

A

black bland completely visible
no probing depths more than 3.5mm, no calculus or overhangs but bleeding on probing present

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11
Q

what is BPE of 2

A

no probing depths more than 3.5mm but supragingival plaque or overhangs present

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12
Q

what is BPE of 3

A

probing depths of at least 4mm present
black band partially visible

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13
Q

what is BPE of 4

A

black band not visible
probing depth of at least 6mm

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14
Q

what teeth are used for children’s BPE exam

A

16, 11, 26, 36, 31, 46

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15
Q

at what age are the full range of BPE scores used

A

12-17 year olds

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16
Q

what BPE codes are used in children 7-11

A

0-2

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17
Q

if a child has evidence of periodontitis or unexplained gingival enlargement what should you do

A

refer to consultant in paediatric dentistry, restorative or specialist periodontitis

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18
Q

what is the treatment after BPE of 0 found

A

no perio tx required

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19
Q

what is the treatment after BPE score of 1 found

A

OHI and other risk factor control advice

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20
Q

what is treatment following BPE score 2

A

OHI
risk factor control advice
removal of supra and subgingival calculus

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21
Q

what is treatment following a BPE score of 3

A

OHI, risk factor control advice, supra and subgingival scaling
detailed 6PPC of affected sextant at post treatment re-evaluation

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22
Q

what is treatment following BPE score of 4

A

OHI, modify risk factors, supra and subgingival PMPR, 6PPC pre and pst therapy, radiographs pre and post therapy

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23
Q

how to explain periodontal disease to a patient

A

destructive disease which is caused by inflammation due to build up of plaque on teeth below the gum which causes irreversible destruction of the bone
can lead to tooth mobility

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24
Q

what are risks of periodontal treatment

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A

recession - leads to sensitivity, lengthening of teeth, increased susceptibility to root decay, black triangle formation
temporary increase in mobility
avoid treatment in first trimester of pregnancy

25
what are treatment options for recession
monitoring use of desensitising agents, varnishes composite restorations orthodontics surgery
26
what probe is used for 6PPC
UNC probe
27
what is recorded in 6PPC
height of gingival margin pocket depth mobility furcation involvement bleeding
28
what are reasons periodontal treatment can fail
smoking poor patient compliance inability of patient to practice OH effectively in hard to reach areas stress, diabetes, pregnancy, malnutrition, poor diet
29
how do you stage and grade perio
stage : 1 - less than 15% bone loss 2 - coronal third of root 3 - middle third 4 - apical third grade : (% bone loss divided by pt age) A - less than 0.5 B - 0.5-1 C - more than 1
30
what suggests a patient is currently stable
less than 10% BOP PPD less than or equal to 4mm no BOP at pockets of 4mm
31
what is suggestive of a patient in remission
BOP greater than or equal to 10% PPD less than or equal to 4mm (no BOP at 4mm sites)
32
what suggests a patient's perio is unstable
PPD greater than or equal to 5mm PPD greater than or equal to 4mm with BOP
33
what makes up a periodontal diagnostic statement
extent (localised/ generalised) stage grade stability risk factors
34
how would you describe acute necrotising ulcerative gingivitis or periodontitis to a patient
rare condition presenting as acute form of gum disease which develops faster and more severely resulting in pain, destructive ulceration and dead tissue
35
what are risk factors of ANUG
stress immunocompromised smoking severely malnourished poor OH sleep deprivation HIV
36
what are the symptoms of ANUG
pain bleeding loss of papillae halitosis sloughing present pseudo-membrane formation
37
how is ANUG treated
ultrasonic debridement and removal of necrotic tissue chlorhexidine 0.2% twice daily if systemically unwell can prescribe 400mg metronidazole TID for 3 days if patient on warfarin - doxycycline 1 x 200mg tablet on first day and then 1 x 100mg tablet for 21 days
38
what is occlusal trauma associated with periodontitis
injury resulting in tissue changes in attachment apparatus due to excessive occlusal force
39
what factors cause increased mobility in occlusal trauma
short roots widened PDL shorter PDL inflammation
40
what are signs and symptoms of occlusal trauma
widening of tooth PDL tooth mobility fremitus wear facets fracture migration of teeth root resorption
41
how is occlusal trauma treated
splint teeth - if advanced, issues eating or stabilisation during PMPR fix occlusal relations
42
what are signs and symptoms of perio-endo lesions
deep pockets spontaneous pain TTP purulent exudate mobility sinus discolouration
43
what is treatment of perio-endo lesions
RCT analgesia chlorhexidine 0.2% antibiotics if systemic involvement review in 10 days and PMPR
44
what are signs and symptoms of periodontal abscess
swelling pain TTP - laterally bleeding suppuration fever lymphadenopathy
45
what is the treatment for perio abscess
subgingival PMPR incision and drainage of pus analgesia chlorhexidine 0.2% when pain free recall for PMPR antibiotics if systemic - penV 250mg 2 tablets QID for 5 days
46
what is the difference between perio abscess and periapical abscess
peio abscess more acute perio abscess occurs on vital teeth lack of PA pathology in perio abscess perio abscess has long narrow pocket and bone loss on one side only
47
what is the mini sickle (red)
double ended scaler triangular in cross section buccal and lingual surfaces supragingivally
48
what is the columbia curette
double ended scaler semi-circular in cross section used anywhere in the mouth subgingival scaling
49
what is the grey gracey curette
single cutting edge scaler subgingival scaling of upper and lower anteriors
50
what is the green gracey curette
single cutting edge subgingival scaling of buccal and lingual surfaces
51
what is the orange gracey curette
single cutting edge subgingival scaling of mesial surfaces
52
what is the blue gracey curette
single cutting edge subgingival scaling of distal surfaces
53
what is the yellow hoe scaler
gross supra and subgingival scaling on buccal and lingual surfaces anterior and posterior
54
what is the red hoe scaler
supra and subgingival scaling of mesial and distal surfaces anterior and posterior
55
what are the S3 guidelines (Steps)
1 - explain disease to pt, OHI, tailored advice, reduce risk factors, supragingival PMPR 2 - if engaging patient subgingival PMPR, reinforce OHI 3 - reevaluate after 3 months, re-perform subgingival PMPR in non-responding sites, in sites of 6mm consider referral 4 - supportive care, recall determination
56
what is termed an engaging patient in S3 guidelines
BOP less than or equal to 30% plaque scores less than or equal to 20% or 50% reduction in both
57
what is the diagnostic criteria for peri-implant mucositis
presence of bleeding or suppuration on gentle probing no increased pocket depth compared to previous exam absence of bone loss
58
what is diagnostic criteria for peri-implantitis
increased bleeding or suppuration on probing increased pocket depth compared to previous presence of bone loss

BDS5 OSCE Revision (16 decks)

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