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Periodontal Philosophy ~ To Provide Quality and Evidence-Based Care…
Periodontal Philosophy
~ To Provide Quality and Evidence-Based Care Through Periodontal Therapy And Education , In order To Restore & Maintain the Oral Health of Our Patients.
Health
Instrumentation:
11/12 & 3A Explorer, UNC Probe, Sickles, 4R/4L, YG 7/8, Cavi straight slimline.
Clinical Signs:
~ Localized, mild, delayed bleeding
~ Bleeding in less than 10% of sites
~ There is no attachment loss - the clinical attachment level is at the CEJ
~ Only 1-2 inflamed sites
Homecare Products:
Soft Bristle Toothbrush, Fluoride Toothpaste, Floss/Picks, Tongue Scraper, Mouthwash
Gingivitis
Instrumentation
: UNC Probe, 11/12 Explorer, 4R/4L, R/L slimlines, YG (subgingival debridement), AP Gracey's.
Oraquix or Possible LA
Clinical Signs
:
~ Interdental papilla: bulbous or swollen
~ Bleeding: bleeding upon gentle probing
~ Gingival margin: swollen; may cover more of the crown
~ Color : red or reddish blue
~ Sulcus: Depth may be greater than 3 mm.
Homecare Products:
Crest Gum & SEbsitivity, Soft Toothbrush, Floss & Listerine.
When to refer patients out:
Refer to periodontist if NSPT was unsuccessful
Refer to MD if patient hasn't had a physical in 2+ years
Refer to periodontist if Stage 3 or higher
Refer to MD if possible underlying systemic link to disease
Refer to MD for uncontrolled hypertension
Periodontitis
Instrumentation:
Nabors Probe, 3A Explorer, Rigid/Mini Gracey's, Langers, Quentins, McCall, Sickles, Files, R/L cavitron, Tribend & Parkell.
Local Anesthetic.
Clinical Signs:
~ Interdental attachment loss
~ Bone is more than 2mm from CEJ
Increased probe depths
~ RBL present
~ Possible tooth loss
Homecare Products:
Proxabrushes, Soft Bristle Toothbrush, End Tuft Brush, Rupper tip stimulator, Waterpik, Chlorohexedine, Fluoride Toothpaste.
Appointment Sequence:
RHH, BP ➡️ EO/IO ➡️ Radiographs ➡️ Clinical exam tabs ➡️ Chart suspicious areas ➡️ CRA ➡️ Dental Exam ➡️ Perio chart ➡️ DRA ➡️ Explore ➡️ Ultrasonic ➡️ Explore ➡️ Handscale areas left with calculus ➡️ Explore ➡️ Coronal Polish ➡️ Floss ➡️ Homecare instructions.
PSE Appointment: Periocharting ➡️ Evaluate Healing ➡️ Explore Areas Where Inflammation is Present ➡️ Debridement of Troubled Areas ➡️ Explore ➡️ Coronal Polishing ➡️ Fluoride Varnish ➡️ Homecare.
Purpose:
Service learning
Debridement
Research
Nutritional counseling
Homecare instructions using tell-show-do
Patient education specific to their needs
Values: Quality & Collaboration
Collaborating with other health professionals to provide the best patient care
Following HIPAA Guidelines
Proper Instrumentation
Continuing Education
Evaluation
Ask for feedback
Self-Assessment
WHAT
Bleeding on Probing
Attachment Loss
Edema
PASS Score
Radiographic Bone Loss
Systemic Factors
WHY
Inflammation is sign of active disease
Biofilm & Calculus Removal
Restore Patients Oral Health
WHEN
Increased Pocket Depths
Poor Homecare
Generalized BOP
Presence of systemic Diseases Affecting the Oral Health of the Patient
3 Month Recare after NSPT Treatment to maintain bone loss levels