Updated S3 perio guidance Flashcards
(29 cards)
What is the BSP guidelines an adaptation of?
EFP 4 step approach
what are the 4 stages of the EFP approach?
- risk factor management
- subgingival debridement
- reassessment
- maintenance/ supportive perio therapy
What is step 1 of the BSP S2-level guidlines?
building foundations for optimal treatment outcomes
What are local risk factors controlled in step 1?
supra gingival biofilm control
what are systemic risk factors controlled in stage 1?
smoking cessation and glycaemic control in patients with diabetes
How is supra-gingival biofilm controlled?
oral hygiene instruction
PMPR
removal over restorative overhangs
What should be the outcomes of an engaging patient?
favourable improvement in oral hygiene 50% reduction in plaque and bleeding scores
OR
plaque scores less than or equal to 20% and bleeding score less than or equal to 30%
OR
patient has met targets outlined by healthcare professionals
What is step 2 in the BSP S3 guidlines?
subgingival instrumentation
What is subgingival debridement known as?
PMPR
What is the aim of subgingival debridement in step 2?
disrupt the dysbiotic subgingival biofilm and remove subgingival calculus
In what instance is full mouth PMPR not suitable and why?
systemic disease due to increased systemic inflammation
what should not be used to treat periodontitis?
systemic antibiotics
when may systemic antibiotics be used in periodontitis patients?
grade C cases
younger patients
when may patients be re-evaluated (step2)?
3 months
what is step 3 of the BSP S3 guidelines?
managing non-responding sites
why may treatment fail?
- inadequate oral hygiene
- inadequate PMPR
what type of pockets may we referred for perio surgery?
deep residual pockets especially associated complex anatomy
what is considered complex perio anatomy?
vertical bony defects, furcations
what would happen if referral isnt possible for unmanageable sites?
treatment under palliative supportive care
What is step 4 of the BSP S3 guidelines?
maintenance
what is maintained in step 4?
risk factors especially OHI and PMPR
Why is caution needed with palliative supportive periodontal care?
risk of accusation of supervised neglect
what does supra-gingival PMPR replace?
scale and polish
How far may supra-gingival PMPR enter the gingival crevice?
2-3mm
