Step 4 supportive care

Question 1

What pocket depth is defined as being stable?

Answer 1

Less than 4mm pocket and no bleeding

Question 2

What is the main aim of step 4 supportive/ maintenance care?

Answer 2

Aims to prevent deterioration in the periodontal condition, maintain stability and identify and manage any sites which show deterioration at an early stage
Continual re-assessment of patient’s perio status at each visit.

Question 3

State some causes that may contribute to periodontal deterioration?

Answer 3

Change in risk factors - started smoking or developed diabetes
Continued presence of calculus or plaque biofilm on root surfaces
Changes leading to inadequate OH - change in manual dexterity, or frequency of home care visits
Changes in attendance - longer intervals between recall visits

Question 4

How often do you have to do a 6PPC with perio patients in supportive care?

Answer 4

Once a year

Question 5

When does a patient move to step 4 treatment?

Answer 5

Only once patient has stabilised go to step 4
6-8 weeks after treatment

Question 6

What factors decide the timeframe for tailored recall appointments?

Answer 6

Depending on severity of disease
Response to treatment
Risk factors
Patient compliance

Question 7

What is a tool that can be used for periodontal risk assessment for deciding patient time for recall?

Answer 7

Pre-Viser spider diagram tool
Looks at 11 factors to predict best recall time

Question 8

What are the steps of step 4 supportive care?

Answer 8

Reinforce OHI, risk factor control and behaviour change
Regular targeted pmpr as required at tailored sites to limit tooth loss
Consider evidence based adjunctive efficacious toothpaste and or MW to control gingival inflammation