Perio Ch.12

informed consent

-Dental hygienist provides complete and comprehensive information about the recommended plan for periodontal instrumentation -Patient needs to make a well-informed decision about accepting or rejecting proposed treatment -Also includes possible risks or unanticipated outcomes of treatment as well

caution!

-Do not assume that all probes have the same pattern of millimeter markings. -A millimeter ruler can be used to determine the marking pattern of a particular probe.

functions of probes

-Findings from an examination with a periodontal probe are used to determine the health of the periodontal tissues. -Probes are used like miniature rulers for making intraoral measurements

healthy sulcus

-Junctional epithelium is the tissue that forms base of the sulcus -Sulcus defined as the distance from the gingival margin to the coronal-most part of the junctional epithelium

other uses of probes

-Measure sulcus and pocket depths -Measure clinical attachment levels -Determine the width of the attached gingiva -Assess for the presence of bleeding -Measure the size of oral lesions -Measure longitudinal response of periodontium to treatment

attached gingiva

-Part of the gingiva that is tightly connected to the cementum on the root and to the connective tissue cover of the alveolar bone

interdental gingiva

-Portion of the gingiva that fills the area between two adjacent teeth apical to the contact area

Probe in a Healthy Sulcus

-Probe inserted into a healthy gingival sulcus *In health, the probing depth should be from 1 mm to 3 mm in depth*.

depth measurement

-Record six areas or zones per tooth. -Record one reading per zone (the deepest). -Round up measurements to nearest full millimeters.

parallelism

-The probe working-end is positioned as parallel as possible to the root surface. -The probe must be parallel in the mesiodistal dimension and the faciolingual dimension.

gingival sulcus

-The v-shaped space between the free gingiva and the tooth surface -A periodontal probe is inserted into this space to assess its health

millimeter markings

-The working-end of a probe is marked in millimeter increments. -There are many different patterns of millimeter markings. -Color-coded probes are marked in bands.

interproximal readings

-Walk the probe between the teeth until it touches the contact area -Slant the probe slightly so that the tip reaches under the contact area. -In this position, gently press downward to touch the soft tissue base

Design of Probe working-end

-Working-end is blunt and rod shaped -Cross section may be circular or rectangular -Calibrated with millimeter markings

Florida Probe

-computer-assisted probe with digital readouts and computer data storage

Calibrated periodontal probe

-marked in millimeter increments -evaluates health of periodontal tissue

Documenting Consent

-written consent: plan signed by patient & hygienist in patient chart -verbal or implied consent not as legally sound as written consent

probe tip

1-2 mm of the side of the probe

stroke pressure

A pressure exerted with the probe tip against the soft tissue base of the sulcus or pocket should be between 10 and 20 g.

Probe in Periodontal Pocket

A probing depth deeper than 3 mm indicates a periodontal pocket.

Markings at Certain Intervals

Marks are found at 1, 2, 3, 5, 7, 8, 9, and 10 mm.

measurements recorded

Measurements are recorded for six specific sites or zones on each tooth. *the deepest reading is recorded*

Informed refusal

Occurs when the patient refuses treatment after he/she has been fully educated regarding the consequences of not receiving the treatment.

mandible gets in the way

Reposition the instrument handle to the side of the patient's face to reach the distal surfaces of the maxillary molars.

probing depth

The distance in millimeters from the gingival margin to the base of the sulcus or periodontal pocket as measured with a probe

correct adaptation of probe tip

The probe tip is kept in contact with the tooth surface throughout the walking stroke

incorrect adaptation of probe tip

The probe tip should NOT be held away from the tooth.

color coded probe

This example is marked at 3, 6, 9, and 12 mm

Walk the Entire Circumference

Walking strokes with the probe should cover the entire circumference of the sulcus or pocket base.

periodontal pocket

a gingival sulcus that has been deepened by disease; depth is greater than 3 mm

probe walking stroke

a series of bobbing strokes that are made within the sulcus or pocket while keeping the probe tip against the tooth surface -junctional epithelium not always a uniform depth *do not remove probe with each stroke*

gingival pocket

is deepening of gingival sulcus caused by detachment of coronal portion of junctional epithelium and swelling of tissue

UNC 15 probe

millimeter markings at 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, and 15 mm.

Free gingiva

the unattached portion of the gingiva that surrounds the tooth in the region of the CEJ