Assisting with Periodontal Procedures

Periodontal disease

Inflammatory disease of gums + bone → bone loss

ADA Classifications

• Type I (none)

• Type II (mild)

• Type III (moderate)

• Type IV (severe)

What are the signs of periodontal disease?

• Gingival changes

• Inflammation

• Bleeding

• Exudate

• Pockets >3mm

What is the difference between scaling, root planning, and curettage?

• Scaling → removes calculus

• Root planning → smooths root

• Curettage → removes diseased tissue

Ultrasonic scaler

High-frequency sound waves → vibrations + water remove deposits

• Fast

• Reduces hand fatigue

When is ultrasonic scaling used?

• Supra/subgingival deposits

• Furcations

• Pre-surgical cleaning

• Ortho cement

• Overhangs

What are the contraindications for ultrasonic scaling?

• Demineralized areas

• Restorations

• Implants

• Respiratory disease

• Communicable disease

• Immunocompromised

• Swallowing issues

• Pacemaker

Why is HVE used with ultrasonic scalers?

To reduce contaminated areasols

What are key facts about periodontal antibiotics?

• Tetracycline (effective, affects birth control)

• Penicillin (less effective, affects birth control)

What antimicrobial agents are used in periodontal care?

• Chlorohexidine (gingivitis, stains)

• Fluoride rinse (reduces bleeding)

What are locally delivered chemotherapeutics? (placed in gum pocket)

• Arestin (gel)

• Tetracycline fiber

• Chlorhexidine chip

What does a periodontal probe measure?

Pocket depth

• <3mm

• 6 readings per tooth

What are the uses of the Nabers probe & 11/12 explorer?

• Nabers → furcation

• 11/12 → detects supra/subgingival calculus (long,thin, curved)

What are the features of curettes? (Universal vs. Gracey)

• Universal → 2 cutting edges, 90’

• Gracey → 1 cutting edge, area specific, rounded toe

What are Gracey 11/12 & 13/14 used for?

• 11/12 → mesial

• 13/14 → distal

What are the features of a sickle scaler?

• Triangular

• Pointed tip

• Two cutting edges

• Interproximal use

What is the difference between prophy & root planning?

• Prophy = supragingival, preventive

• Root planning = subgingival disease treatment

What are RDA duties in a perio office?

• Assist procedures

• Remove sutures

• Place/remove dressings

• Coronal polish

• Fluoride

• OHI/Post-Op Instructions

What does a root planning set up look like?

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