Periodontal Assessment 3 Plaque and Bleeding Score PDF

Plaque and bleeding scores taking every time Important to take plaque scores to monitor OH Periodontal Assessment 3 Disclosing aids visually as plaque is same colour as teeth Plaque and Bleeding Score Founda7ons of Clinical Skills and Prac7ce Sarah...

Plaque and bleeding scores taking every time Important to take plaque scores to monitor OH Periodontal Assessment 3 Disclosing aids visually as plaque is same colour as teeth Plaque and Bleeding Score Founda7ons of Clinical Skills and Prac7ce Sarah Balian  4 point - buccal, mesial, distal, palatal/lingual Intended Learning Outcomes 6 point - same as 6ppc By the end of the session students should be able to: Revise previous components of periodontal assessment. De5ne the process of disclosing and discuss di8erent types of toned disclosing solu:on and their modes of delivery. Discuss the bene5ts of disclosing in rela:on to the pa:ent and the clinician. Demonstrate the calcula:on of the plaque score using 4 point and 6 point char:ng Interpret the results of the plaque score and impact on oral health messages. Explain the relevance of the bleeding score in rela:on to oral health prac:ces – using immediate and delayed bleeding. Interpret the results of the bleeding score and impact on oral health messages. Useful Videos hCps://www.youtube.com/watch?v=n2T3n8olEmw hCps://www.youtube.com/watch?v=bZ61Quba5Rk Recap REF WHEN POSSIBLE!!!! How will you show them the current state, explain the target & set the target? How will you assess if they met the target? How will you measure ‘engagement’?  How will you monitor? Create necessary changes? Anything speci5c required? How will you monitor? Maintain status quo? Improvements? Coaching? Personal Trainer? In sulcus but not root surfaces  Talking Engaged Disclosing Non-Engaged OH Improved No or not enough OH By ≥ 50% or more in improvement plaque & marginal By ≤50% or more in plaque & bleeding scores marginal bleeding scores Plaque levels ≤20% or ↓ Plaque levels ≥20% or ↓ Bleeding scores ≤20% ↓ Bleeding scores ≥20% ↓ Met targets designed by Not met targets designed by clinician from the the clinician from the previous previous appt appt Says want ‘pallia:ve care’ Plaque Score Founda7ons of Clinical Skills and Prac7ce Sarah Balian What is disclosing? Disclosing agents work by changing the colour of dental bio5lm in order to provide a contrast with the tooth surface. Bio5lms have the capacity to retain large no. of dye substances due to the interac:on. The polarity di8erence between the components of the dye and bio5lm. Electrosta:c interac:ons (proteins) and hydrogen bonds (polysaccharides) bind the par:cles together. Surfaces which are bio5lm free can easily be rinsed o8. What is in disclosing solu7on? Contain a dye Typically a vegetable dye, such as (Phloxine B) Stains plaque a bright colour (typically red or blue) Proper7es of a disclosing agent? Water Taste soluble Non- Ease of allergenic use Ease to Flavouring? remove Support pa7ent Colour – co- contrast? opera7on Dura7on? See nothing to seeing something Types of disclosing solu7on Single tone Two tone Three tone Light blue - picks up acid levels OR mature plaque Bacteria convert sugar to acid Biofilm less than 3 days old - reddish pink Biofilm more than 3 days old - blue  Couple times a week - maybe weekend Use before brush and then after - shows where missed Types of disclosing solu7on Tablets Liquid Pre-loaded pellets Why disclose for the pa7ent? Educa7on / Re- Self-monitoring & Mo7va7on Personalised OH educa7on evalua7on See Why disclose for the clinician? Direc7on for OH Recording in pa7ent notes Visualisa7on Mo7va7on for you prac7ces – progression/predic7on Minimally invasive if using as guide to remove Equipment needed PPE Warning / consent / colour Vaseline CoCon wool / Pledget Disclosing solu:on Eyes Scribe Removal mechanism Dappins pot Microbrush Suc:on  Record my score Recording plaque scores 6 point plaque score 4 point plaque score Same as 6ppc Buccal, mesial, distal, lingual/palatal 192 128 Plaque Index Calcula7on 1. Strike o8 teeth missing 2. Total number of surfaces (teeth number x 4 or 6) 3. Mark & add up the number of areas Number of tooth surfaces = 4 x 28 = 112 with plaque OR 6 x 28 = 168 4. Divide the total number of surfaces covered in plaque by total number of Number of surfaces with plaque present surfaces Number of surfaces with plaque present / number of tooth surfaces 5. Mul:ply by 100 to get % = PLAQUE INDEX Plaque Index Example Number of surfaces= 28 x 4 112 Number of sites that had stained plaque 6 6 ÷ 112 = 0·05 ·05 x 100 = 5% What message are you giving the pa7ent? You have 5% of plaque in your mouth – what is the goal? Goals Plaque present 5% Plaque free 95% Goals Plaque present 78% Plaque free 22% Buccal, Lingual or Interproximal? Communica7on with team members Clear Indicate start point State when crossing midline If in doubt – ask! Bleeding Score Founda7ons of Clinical Skills and Prac7ce Sarah Balian  What does bleeding represent? Localised or generalised Indication of periodontal disease progressing Less 10% bleeding clinical gingival health Early signs of gingival inflammation 10-30% localised >30% generalised Immediate Delayed Bleeding with gentle pressure - as soon as you insert probe How do you take a bleeding score? Insert probe - WHO probe Immediate bleeding Look at the image As soon as you insert the probe gingiva will bleed What does this tell you? Inflammation Is this site easy at access and cleansable? Delayed bleeding You insert the probe to the base of the pocket and bleeding happens a few seconds later? What does this tell you? Periodontal pockets present Deeper inflammation Is this site easy at access and No - periodontal pocket present cleansable? Where is the pa7ent cleaning? Truths – pa7ent aaends and claims they are brushing twice a day and using interdental brushes daily Troubleshoo7ng Recommended Reading E8ect of visual method vs plaque disclosure in enhancing oral hygiene in adolescents and young adults: a single-blind randomized controlled trial, Peng Y et al, American Journal of Orthodon:cs and Dentofacial Orthopedics 2014, 145(3) A comparison of bacterial plaque disclosants in periodontal disease. Cohen et al 1972. J Periodontal 43(6):333-338 The e8ect of a preven:ve programme on dental plaque, gingivi:s and caries in schoolchildren. Results aqer one and two years. Axelsson, P, & Lindhe, J Journal of Clinical Periodontology, 1974(1):126-138 Dental plaque – classi5ca:on, forma:on, and iden:5ca:on , Viorica chetru et al, Interna:onal Journal of Medical Den:stry, volume 3, issue 2 April/June 2013, pp. 139-143 Image references hCps://www.alibaba.com/product-detail/ACID-RED-97-ACID-SCARLET-BA_62008462382.html hCps://www.thetoothandgumshop.com.au/shop/cleaning-aids-accessories/caredent-disclotabs-plaque-disclosing-tablets-copy/ hCps://nwpd.com.au/helping-children-brush-beCer/ hCps://www.amazon.co.uk/Disclosing-Tablets-Plaqsearch-Chews-Plaque/dp/B01E4AER00 hCps://www.ebay.co.uk/itm/153543073314?chn=ps&norover=1&mkevt=1&mkrid= hCps://www.primeum.com/en/blog/mo:va:on-of-commercial-people-boos:ng-e8ec:veness hCps://www.teachhub.com/classroom-ac:vi:es/2009/05/top-12-pioneers-in-educa:on/ hCps://www.cam.ac.uk/research/news/genes-intuence-ability-to-read-a-persons-mind-from-their-eyes hCps://www.lawcomm.co.uk/blog/new-government-guidance-issued-to-home-movers-during-the-covid-19-outbreak hCps://en.wikipedia.org/wiki/Accolade hCps://www.piCsburghparent.com/the-tooth-is-connected-to-the-everything-%E2%80%A8/ hCps://www.sharrockinsurance.co.uk/are-your-tools-insured/ hCps://www.amazon.co.uk/S:cker-Solu:ons-Reward-Chart-S:ckers/dp/B00V4BQIWS/ref=asc_df_B00V4BQIWS/?tag=googshopuk- 21&linkCode=df0&hvadid=255488099025&hvpos=&hvnetw=g&hvrand=17321884733143004539&hvpone=&hvptwo=&hvqmt=&hvdev=c&hvd vcmdl=&hvlocint=&hvlocphy=9045917&hvtargid=pla-421911591970&psc=1