For all the measurements it appears to be reasonable to round up all the readings measured with the periodontal probe.ġ. The goal of clinical periodontal charting is to record gingival recessions, probing depths, and attachments levels at six sites per tooth or implant in mm. “Patient advised that oral hygiene is not adequate to support formal periodontal therapy.Calibration of clinical periodontal charting.“Patient advised of smoking related to periodontal disease – increase risk factor for condition and poorer response to therapy”.“Patient advised that they are at risk of developing periodontitis”.“Patient warned of tooth mobility and tooth loss related to periodontal disease”.“Patient advised of mild/moderate/severe periodontal disease”.*Maintenance similar to above but likely to check probing depths and carry out maintenance scale* OTHER KEY PHRASES Emphasised need to be careful not to bite the lip or have anything too hot till the numbness has worn off. Warned pt of postop discomfort/sensitivity/recession and advised use of high fluoride toothpaste/Sensodyne. RSD using hand instruments and ultrasonic scaler … x 2.2 ml 4 % Articaine hydrochloride + 1:100,000 adrenaline as infiltrationsįull mouth supragingival debridement with ultrasonic … x 2.2 ml 2% Lidocaine hydrochloride + 1:80,000 adrenaline as ID block (Advised to use CHX during treatment if gingivae acutely inflamed/sore – warned against potential allergy and to immediately discontinue if any signs of allergy) Other aids: Flossettes? Interspace brush? Toothbrush: Demonstrated modified Bass technique in the mouth Pt explained more than 2 minutes is likely to be required to perform all oral hygiene measures.
Advised score needs to be optimal prior to next visit. Emphasised importance of excellent oral hygiene and maintenance to help achieve optimal treatment results. Smoking cessation? Pt advised of poorer response to periodontal therapy if continues to smoke.Īdvice given to improve residual plaque deposits, patient motivated and re-demonstrated technique intraorally (shown in the mirror).
Pt referred by X for non-surgical periodontal therapyĭiabetes advice? Pt advised that good glycaemic/blood sugar control is paramount to preventing progression of periodontitis. Once stable, emphasised the importance of life-long regular (to be defined according to risk but initially 3 monthly) maintenance appointments to ensure periodontal condition remains stable/pick up any relapse and treat as early as possible. Explained referral to specialist might become appropriate. Explained may need more than one course of non-surgical debridement. Following a course of non-surgical debridement, the condition would need to be reassessed by carrying out a 6PPC (full mouth measurements) and thereafter further treatment planned. Importance of good patient compliance to appointments and an optimal level of oral hygiene emphasised. Patient understood.Įxplained initial course of root surface debridement and tailored oral hygiene instruction would be required. We cannot cover any costs for new fillings/veneers/crowns/bridges. On most occasions a temporary filling can be placed or the veener/crown/bridge recemented but this is not guaranteed and it is a risk during the procedure. If this happens, it is usually because they were already loose or attached to unhealthy tooth. Explained that during the cleaning process, there is always a chance of damaging/loosening/decementing any restorations/veneers/crowns/bridges. Other side effects of treatment include pain, soreness, bleeding, swelling, bruising. Emphasised that during treatment the gums may shrink back due to recession and so the teeth can look longer with gaps in between teeth/’black triangles’. Discussed the risk of post-treatment sensitivity of the teeth, explained this usually lasts for a few weeks but in rare cases may remain indefinitely if does not respond to treatment for sensitivity. Benefits discussed included improving the lifespan of the teeth by reducing periodontal pockets and preventing progression of the condition. Discussed the treatment options including benefits, risks, time and cost – understood by patient and all questions answered.
Key risk factors: Suboptimal oral hygiene? Smoking? Medical condition? Stress?ĭiscussed diagnosis (type of condition and severity) and aetiology at length with patient and ensured they understood. Radiographs: Are these available from the referring dentist? Required? Oral hygiene- good/fair/poor, plaque-, calculus. Toothbrushing- Brushes /day with a F- toothpaste for mins (manual/electric) Smoking – /day x years (what substance is smoked?) Considering cessation?Īlcohol – units/week (or number of glasses of wine/pints of beer etc. Perio – Bleeding/Loose teeth/Halitosis/Bad taste/Difficulty eating/Sensitivity/Pain/Swelling/Gum boils/Aesthetics/Anything else
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