Flashcards in Scaling & Posttreatment Deck (38)
What are the two goals we want to accomplish when we scale or root debridement tooth surfaces.
1. Establish healthy peridontal tissue.
2. Eliminate pathogenic microorganisms and health of the tissue.
What is the definition of scaling?
Instrument on crown and root to remove plaque, calculus, and stain.
What is the definition of curettage?
Removal of diseased soft tissue inside the pocket wall (incidental & intentional).
What is the definition of root debridement?
Scaling above and below the gumline to remove plaque and calculus.
What is channeling?
Systematic overlapping sequence used for scaling.
When scaling subgingivally, what part of the instrument do we rely on to know that the instrument is adapted correctly to the tooth surface?
The terminal shank
What are the benefits of scaling?
1. Stop or interrupt the progress of disease.
2. Changes in quality and quantity of subgingival microorganisms.
3. Create a healing environment for tissues.
4. Effectiveness of patients plaque control methods.
5. Prep for more advanced perio therapy.
6. Prevent recurrence of disease through maintenance and supervision of treatment.
What do you assess before you begin scaling?
2. Probe & Explore to determine amount and location of calculus
3. Examine Radiographs
4. Know areas to avoid (caries, restorations, and enamel defects)
How do you manage a patient that requires multiple appts?
1. COMPLETE all surfaces of any tooth where instrumentation has started.
2. NEVER leave a tooth partially finished.
3. COMPLETE a quadrant or two quadrants (max and mand) on the same side for comparison.
What are symptoms of pain?
How long does healing take after root debridement/scaling?
4-6 weeks (2weeks for school)
What can you do to control pain?
Correct Principles of Instrumentation
Work Posterior to Anterior
Flush/Irrigate the area
What can you do if you break an instrument tip?
1. Get an instructor
2. Cease operation retain retraction
3. Do NOT alarm the patient
4. Examine oral cavity
6. Examine sulcus with spoon like stroke
7. Use a perio retriever if available
8. Take a PA or BW
What are the 3 types of evaluations?
What should tissues look like after treatment?
Teeth should be smooth, Gingiva should be in a position to heal.
Besides scaling, what else affects the outcome of successful treatment?
Patient education and maintain and heal tissues.
What factors need to be considered when determining how often a patient should return for maintence?
Risks for Diseases (periodontitis, caries, oral cancer)
Pre-disposing diseases (sickle cell)
Compliance with Biofilm control
Rate of calculus formation
Restorative (implants, prosthetics)
When do you refer a patient to a periodontist?
New Patients: severe perio, aggresive perio, NUG, drug induced gingival enlargements.
Re-eval: after root debridement if non-responsive
What is the most important measure of success in periodontal debridement?
What advice can you give a patient for pain post appointment?
-Bleeding: Rinse with ice water, moistened tea bag, gauze,
-Hypertonic salt solutions
-Sodium bicarbonate solution
-Diet: Bland, nutritious foods and vitamin supplements, avoid refined sugar, citrus fruits, excess carbs
True or false; root planing is a technique still used today?
False, it is an old technique
What is root planing?
Removal of cementum.
Why do we need cementum?
It is an attachment site for epithelium.
What appearance does calculus take on?
Chalky, white, yellow or black(because of pigments of blood)
Why do smokers tend to have less blood from scaling?
Nicotine constricts blood flow.
When does immediate evaluation occur?
Immediately after scaling, you re-explore after calculus removal before dismissal.
When is a follow up evaluation?
4 weeks to evaluate scaled quadrants and rescale then start on new areas.
When is a recall evaluation?
How frequently should a perio patient be seen because the bacteria are becoming more virulent?