week 2 ppt Clinical Decision-Making in Periodontal Care

Clinical Decision-Making

Team process for diagnosing periodontal conditions.

Purpose of the Fundamental Diagnostic Questions

Key inquiries to assess periodontal health status.

What are the 3 fundamental questions?

1.Does the clinical assessment indicate periodontal health or inflammatory disease in the periodontium?

2.If the clinical assessment indicates inflammatory disease, is the disease gingivitis or is it periodontitis?

3.If the patient has gingivitis, what type of gingivitis? (or periodontitis)

Signs of Inflammation

Clinical indicators of periodontal disease presence.

Symptoms of Disease

Patient-reported issues indicating possible periodontal problems.

Silent Disease

Periodontal disease without noticeable symptoms for patients.

If patient notices disease, this means what?

Disease has progressed

Symptoms of Stage IV periodontitis:

Loose teeth, difficulty chewing, profuse gingival bleeding, or bad taste in mouth

Periodontal Health

Absence of overt or hidden inflammation signs.

Gingivitis

Inflammation without loss of periodontal attachment.

Periodontitis

Inflammation with loss of periodontal attachment.

Documenting Periodontal Disease

Standardized recording of periodontal conditions and severity.

Peri-implant mucositis

damage to soft tissue only

Peri-implantitis

damage to soft tissue and surrounding bone

What is "Flexibility" in Diagnosis

Adjusting diagnosis based on multiple periodontal conditions.

Important to realize that "gingivitis" or "periodontitis" may not.....

represent the total periodontal condition

Examples of flexibility

-recession

-aberrant frenum/muscle positioning

Case Type System

Classification system for classifying perio conditions/reporting to insurance companies.

Purpose of Periodontal Master Treatment Plan

Sequential outline for DDS/DH to eliminate disease and restore a healthy periodontal environment.

Assessment Phase

Initial data collection and immediate treatment needs. (emerg, exo)

Nonsurgical Periodontal/

Bacterial Control

Therapy

Using measures like educational/DH care to control gingivitis and periodontitis.

Surgical Therapy

Invasive procedures such as surg, imp, and RCT for periodontal disease management.

Restorative Therapy

Restoration and replacement of damaged or missing teeth. (Re-eval after 6 weeks)

Periodontal Maintenance

Ongoing care throughout life to prevent disease recurrence.

Refractory Periodontitis

Worsening condition despite compliance with treatment.

Periodontal care requires adjustment overtime because:

-it's dynamic & changes overtime.

-tissue can remodel

-perio destruction can happen throughout life

Documentation Requirements

Includes assessment data and treatment services performed.

Chart/Progress Notes

Records of assessment data, patient tx done and educational instructions.