Periodontology - Chapter 19 Lecture 1: Overview of Clinical Periodontal Assessment

Introduction

• The clinical periodontal assessment is a fact-gathering process that provides a comprehensive picture of a patient's periodontal health status.
• Essential for forming an individualized treatment plan.

Objectives of Clinical Periodontal Assessment

• Identify clinical signs of inflammation and damage to the periodontium.
• Determine periodontal health or disease.
• Collect data to assign a periodontal diagnosis.
• Gather baseline data for long-term monitoring.

Legal Responsibilities

• Dentists and dental hygienists must perform thorough periodontal assessments.
• Failure to diagnose periodontal disease can lead to malpractice claims.
• Documentation is crucial for recording treatment outcomes and monitoring health status over time.

Types of Periodontal Assessment

1. Periodontal Screening and Recording (PSR):

   • Efficient screening system for detecting periodontal disease.
   • Uses a WHO probe with a color-coded band for reference.
   • Results help identify patients needing comprehensive assessment.

2. Comprehensive Periodontal Assessment:

   • Required for patients with higher PSR scores or specific conditions.
   • Includes detailed data collection on the periodontium.

Components of Periodontal Assessment

• Probing depth measurements
• Bleeding on probing
• Presence of exudate
• Level of free gingival margin
• Tooth mobility and furcations
• Presence of calculus deposits and dental plaque biofilm
• Gingival inflammation
• Radiographic evidence of bone loss
• Local contributing factors

Additional Tests

• Used for patients not responding to conventional therapy.
• Bacterial identification, gingival fluid analysis, and genetic susceptibility tests.

Attached Gingiva

• Description of attached gingiva and its function.
• Calculation of its width is crucial.
  • Measured from the gingival margin to the mucogingival junction.
  • Width is total width minus pocket depth.

Clinical Attachment Level (CAL)

• Estimate of periodontal support around a tooth.
• Probing depths measured from gingival margin to sulcus base.
• CAL provides a more accurate indication of periodontal support than probing depths alone.
• Important for monitoring changes over time.

Conclusion

• Accurate measurement and documentation in periodontal assessments are critical for effective treatment planning and monitoring.