perio

Question 1

Which 3 conditions should be evaluated when assessing a pt’s perio risk?

Answer 1

1. diabetes (bidirectional)
2. cardiovascular disease
3. autoimmune diseases

Question 2

What should be prescribed for ANUG?

Answer 2

400mg metronidazole TDS for 3 days

Question 3

3 medications which commonly cause gingival hypoplasia

Answer 3

1. calcium channel blockers (amlodipine)
2. phenytoin
3. cyclosporine (used to prevent organ transplant rejection)

• can also be exacerbated by mouth breathing.

Question 4

Explain the impact of smoking on periodontal health.

Answer 4

• increased calculus formation
• deeper pockets
• greater recession and bone loss
• less BoP (nicotine is a vasoconstrictor)

Question 5

WHY is there a big impact from smoking on periodontal health?

Answer 5

• nicotine is a vasoconstrictor (reduced blood flow)
• impaired immune function
• delayed healing

1-4 cigarettes can increase risk of perio by 50%

Question 6

How are pack years calculated?

Answer 6

packs per day x years smoking

Question 7

How would you explain perio to a pt?

Answer 7

‘an infection of the tissues that support your teeth including the gums, ligaments and bone.
- happens when plaque builds up on your teeth and gums over time.
- 2 main types: gingivitis (early stage, reversible) AND periodontitis (later stage, irreversible) where pockets form leading to bone loss, mobility and tooth loss.

Question 8

Explain the causes of/ risk factors of perio to a pt:

Answer 8

• main cause is poor OH which leads to plaque buildup
• other factors leaving you more susceptible: smoking, diabetes, family history, medications.

Question 9

Explain symptoms of perio to a pt:

Answer 9

• swollen, bleeding gums
• bad breath
• teeth feel loose
• change in the way they fit together when biting

Question 10

Explain perio tx to a pt:

Answer 10

• important as it helps to stabilise (NOT reverse)
• needs good OHI + professional cleaning.
• professional cleaning is just a deeper clean under the gum to flush out bacteria.
• make a plan with the pt.

Question 11

Explain what caries is to a pt:

Answer 11

• dynamic process
• when eating, teeth enter a phase of demineralisation for up to 30 mins
• when pH returns above 5.5, the teeth can remineralise again
• when the teeth are in a chronic state of demineralisation (e.g: through frequent sugar attacks or plaque left on teeth), caries develops

Question 12

Explain to a pt what demineralisation is:

Answer 12

• critical pH for enamel is 5.5
• sugar attacks cause bacteria which produce acids to attack enamel.
• the acids dissolve the minerals in enamel, weakening it and leaving it susceptible to decay.

Question 13

Explain to a pt what remineralisation is -

Answer 13

• saliva acts as a buffer because the minerals impacted are found in it.
• remineralisation is when these minerals are deposited into enamel to repair the minor damage, preventing decay.
• fluoride aids this further.