Tuesday, December 18, 2012

Comprehensive Periodontal Examination

Evaluation of patient's periodontal status requires obtaining a relevant medical and dental history and conducting a thorough clinical and radiographic evaluation.

1. A medical history should be evaluated to identify predisposing conditions that may affect treatment, patient management and outcomes. Such conditions include diabetes, hypertension, pregnancy, smoking, substance abuse and medications and other existing conditions that impact traditional dental therapy.

2 A dental history including the reason for the visit and information about past dental and periodontal care and records will be useful.

3.TMJ and other extra oral structures must also be evaluated.

4. Intra oral tissues and structures including oral mucosa, muscles of mastication, lips, floor of mouth, tongue, salivary glands, palate and the oro pharynx should be examined.

5.  Examination of teeth and their replacements should include observation of missing teeth, condition of restorations, caries, tooth mobility, tooth position, occlusal and interdental relationships, signs of para functional habits and pulpal status.

6 Current radiographs  for evaluating status of periodontium and dental implants.

7.Determination of plaque and calculus distribution.

8. Periodontal soft tissue and peri implant tissue examination.

9. Probing depths, clinical attachment levels and bleeding on probing is evaluated.

10. Muco gingival relationships including abnormal frenulum attachments, gingival recession and deficiencies of keratinized tissue.

11. Presence, location and extent of furcation invasions.

Additional diagnostic aids like diagnostic casts, microbial and other assessments add value  to a thorough examination..

Based on the results of the examination, a diagnosis and proposed treatment plan should be presented to the patient. Patients should be informed of the disease process, therapeutic alternatives, potential complications, the expected results and the patient's responsibilities in treatment. Consequences of no treatment should be explained to the patient.

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