Working as a team tutorial 6

Question 1

Who are the members of the team tht take care of a patient who requires perio treatment?

Answer 1

GDP
Dental nurse/ oral health educator
Hygienist
Periodontal specialist
Dental therapist

Question 2

What needs to be in place for a dentist to prescribe LA to a hygienist/ therapist?

Answer 2

PGD - patient group direction - people are trained up under a directive and allowed to administer a medication under a prescription - with the suitable training.

Question 3

What should the prescription for LA for a nurse/ hygienist for example include?

Answer 3

Type of LA - including the makeup e.g. lidocaine 2%, 1:80,000 adrenaline
Max. dose
Frequency - AS REQUIRED
Route of administration - via injection

Question 4

What should the prescription to the oral health educator, dental hygienist/ therapist include for initial therapy in a patient with active periodontitis (rough)?

Answer 4

Baseline indices - MPBS
Note what risk factors have been discussed with patient
Mention what treatment been carried out already
Clear instructions on what you would like to be done
Please monitor OH
LA prescription
Review with referring dentist at specified time following completion of treatment

Question 5

What specifically should you ask oral health educator/ hygienist/ therapist to do for treatment of perio patient?

Answer 5

Discuss risk factor control with patient
Tailored OHI using TIPPS behaviour change method
Use LA as required - including prescription
Review with referring dentist at three months post-treatment completion
Follow S3 guidelines for treatment - following initial step 1 treatment carried out by me.

Question 6

When should periodontitis patients be referred?

Answer 6

Over 6mm pockets/ over 1/3 bone loss
Mobility
Furcation involvement - grade 2 and 3
If they are complexity level 3 - with grade C or stage IV with >2/3 bone loss

Question 6

What is level 2 complexity patient?

Question 7

What is grade 1 furcation involvement?

Answer 7

Initial furcation involvement.
Furcation opening can be felt on probing but the involvement is less than one third of the tooth width

Question 8

What is grade 2 furcation involvement?

Answer 8

Partial furcation involvement/
Loss of support exceeds one third of tooth width but does not go through and through.

Question 9

What is grade 3 furcation involvement?

Answer 9

Through and through involvement.

Question 10

What treatment should a GDP carry out before referral if any?

Answer 10

Carry out steps 1 & 2 treatment following S3 guidelines