v5

Question 1

What is the provisional diagnosis?

Answer 1

My provisional diagnosis is Generalised Periodontitis.

This is justified by the combination of generalised inflamed, spongy gingiva and severe generalised recession, indicating irreversible attachment loss.

Question 2

What defines ‘Generalised’ in this diagnosis?

Answer 2

It is classified as ‘Generalised’ because these signs are present on more than 30% of sites.

Question 3

What is required for a definitive diagnosis?

Answer 3

A definitive diagnosis requires further investigation, including a comprehensive periodontal assessment.

This includes probing depths, bleeding on probing, and a full radiographic series.

Question 4

What does the Stage and Grade of the disease indicate?

Answer 4

The Stage indicates the severity and complexity of the case, while the Grade assesses the rate of progression and influence of risk factors like smoking.

Question 5

What is the first phase of the treatment plan?

Answer 5

The first phase is the Systemic Phase, where I investigate histories that impact care.

Question 6

Why is a comprehensive medical history review important?

Answer 6

It is critical because a condition like undiagnosed diabetes would severely hinder healing.

Question 7

What is the focus of the Acute Phase?

Answer 7

The focus is on addressing urgent issues, such as managing significant hypersensitivity due to severe generalised recession.

Question 8

What is the cornerstone of the Control Phase?

Answer 8

The cornerstone is cause-related therapy, starting with intensive Oral Hygiene Instruction.

Question 9

What does full mouth non-surgical debridement involve?

Answer 9

It involves eliminating the bacterial cause of the infection over multiple appointments with local anaesthesia.

Question 10

What referrals are required in the Definitive Phase?

Answer 10

Referrals are needed for a full restorative assessment, a specialist periodontal opinion, and comprehensive planning for missing teeth replacement.

Question 11

What is the focus of the Maintenance Phase?

Answer 11

The Maintenance Phase is lifelong, focusing on preventing relapse and ensuring long-term stability.
“Finally, the Maintenance Phase is lifelong. I have assigned this patient a high risk for both future periodontitis and root caries, given the disease severity, exposed roots, and poor oral hygiene. Therefore, they must be enrolled in a Supportive Periodontal Therapy program with a strict 3-monthly recall interval. Each recall with me will involve re-assessment, professional debridement, and reinforcement of their oral hygiene to prevent relapse and ensure long-term stability.

Question 12

What recall interval is assigned for the patient?

Answer 12

The patient must be enrolled in a Supportive Periodontal Therapy program with a strict 3-monthly recall interval.