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Gabby's Periodontal Philosophy., Description of Values, Purpose, To…

- - - - Clinical:
        
        Maintaining pockets 2-3 mm
        
        Pink firm stippled gums w/ little or no bleeding, or localized gingivitis.
        
        Generally healthy tissue, no signs of active disease (may have localized areas of disease.) No exudate
        
        No signs of attachment loss.
        
        Compliance with homecare
        
        Biofilm
        
        Pointed papilla
        
        may have recession
      - Radiographic, No or little interdental attachment loss/radiographic bone loss (bone levels typically 1-3mm apical to CEJ); facial or lingual recession may be present.,
    - - Generally healthy tissue, no signs of active disease (may have localized areas of disease.) preventative treatment no disease progression
    - - Recare: 6 month recalls. Educate patient with correct homecare including brushing and flossing methods.
      - Homecare:
        
        Education: Tell-Show-Do with brushing and flossing.
        
        Fluoride toothpaste 2x daily. Mouthwash if gingivitis
        
        Stannous toothpaste if hypersensitivity or moderate bleeding.
        
        Flossing methods and products.
        
        Floss string/picks
      - INSTRUMENTS
        
        Prophy (1110) Set-Up
        
        • Mirror
        
        • UNC Probe
        
        • 11/12 Explorer
        
        • Shepherds Hook Explorer
        
        • Nabers Probe
        
        • 4R/4L Curette
        
        • Barnhart 5/6
        
        • Younger-Good 7/8
        
        • H6/H7 Sickle Scaler
        
        Perio Mntc (4910) Set-Up
        
        • Mirror
        
        • UNC probe
        
        • 11/12 Explorer
        
        • 3A Explorer (optional)
        
        • 4R/4L Curette
        
        • Barnhart 5/6
        
        Pattison Gracey’s 1/2, 11/12, 13/14 (meant for PM)
        
        • Younger Good 7/8
        
        • Nevi 1 Sickle Scaler
        
        • Loma Linda 10/11
        
        • Nevi 4 (posterior sickle)
- - - - CLINICAL:
        
        Gingival Inflammation on Reduced Periodontium
        
        BOP
        
        Pocket depths increase
        
        Inflammation in gingiva only
        
        Swelling and redness
        
        Rolled or bulbous interproximal paillae
        
        NO attachment loss
      - RADIOGRAPHIC: No or minimal interdental bone loss
    - - • Scaling in presence of generalized moderate or severe gingival inflammation
        • The removal of plaque, calculus and stains from supra- and sub-gingival tooth surfaces when there is generalized moderate or severe gingival inflammation in the absence of periodontitis.
    - - INSTRUMENTS
        
        • Mirror
        
        • UNC Probe
        
        • 11/12 Explorer
        
        • Shepherds Hook Explorer
        
        • Nabers Probe
        
        • 4R/4L Curette
        
        • Barnhart 5/6
        
        • Younger-Good 7/8
        
        • H6/H7 Sickle Scaler
      - RECARE: After NSPT have patient return for PSE 4-6 wks later. Patient should then follow with frequent 3-4 month recalls. Every patient will very depending on stage and grade of disease.
      - HOMECARE: Education on flossing methods and products. May recommend something such as a waterpik as it could reach deeper than normal flossers. Tell-Show-Do with brushing and flossing. Fluoride toothpaste 2x daily. Floss pick. Sensodyne w/ sodium fluoride and potassium nitrate
- - - - CLINICAL:Generalized bleeding, tooth loss, furcation involvement, high pass score, active disease, gingival inflammation, increased probing depths, non-compliant with home care, mastication dysfunction, tissue may be reddish/bluish or pink depending if smoker
      - RADIOGRAPHIC: Bone loss, radiographic calc, furcation involvement, abscesses.
    - - HOMECARE:
        
        Products: inter-dental brushes, waterpik/water flosser, end-tuft brush
        
        Fluoride toothpaste 2x daily
        
        Soft bristle brush, or preferably electric toothbrush
        
        Smoking cessation/ nutritional counseling: protein for healing
        
        Sensodyne w/ sodium fluoride and potassium nitrate
      - INSTRUMENTS:
        
        NSPT Set-Up
        
        • Mirror
        
        • UNC probe
        
        • 11/12 explorer
        
        • 3A explorer optional
        
        • 4R/4L
        
        • Gracey’s 11/14, 12/13
        
        (Replace with mini gracey’s 11/12, 13/14, 15/16, 17/18
        
        • Langers 1/2 ,3/4, 5/6, 17/18 (they are rigid for calculus)
        
        • Nevi 4 Posterior Sickle
        
        • Loma Linda 10/11; McCall 17/18-
        
        Gracey Kit
        
        • Gracey’s 1/2, 7/8, 11/12, 13/14, 15/16, 17/18
        
        Furcation Kit
        
        • Micro-mini Graceys 1/2, 11/12, 13/14-issued Fall senior year
        
        • Quetin curets-issued Fall senior year
        
        • Sub-0 Vision Curvette-issued Fall senior year
        
        HIRSCHFELD FILES 3/7 and 5/11
        
        SUGARMAN FILES
      - RECARE: After NSPT have patient return for PSE 4-6 wks later. Patient should then follow with frequent 3-4 month recalls. Every patient will very depending on stage and grade of disease. Patient may need another round of NSPT, or they may need referred to a periodontist.
    - - Generalize bleeding
      - Active disease due to bleeding, inflammation, and high plaque score.
      - May be a systemic link: smoking, diabetes
- - - - • Clinical health on intact periodontium
      - • Clinical health on reduced periodontium in non-perio patient
      - • Clinical health on reduced periodontium in stable periodontitis patient
      - • Biofilm induced gingivitis on intact periodontium
      - • Biofilm induced gingivitis on reduced periodontium in non-perio patient
      - • Biofilm induced gingivitis on reduced periodontium in perio patient
      - • If biofilm induced gingivitis, determine if a) associated with biofilm alone b) mediated by systemic or local risk factors c) drug-influenced gingival enlargement
      - • Stage I periodontitis
  - - - • Gingivitis
      - • Gingivitis on Reduced Periodontium
      - • Stage I Periodontitis
  - - - • Gingival Inflammation on Reduced Periodontium
      - • Stage II Perio
      - • Stage III Perio
      - • Stage IV Perio
  - - - • Health on Reduced Periodontium
      - • Gingival Inflammation on Reduced Periodontium
      - • Stage II, III, IV Perio