ch 44 theory II


what are the final steps in providing evidence based dental and dental hygiene care?


evaluation of tx outcomes and oral health education interventions


______ ________ at the end of a sequence of dh interventions determines whether or not the goals in the pts care have been met


summative evaluation


when can info regarding the need for modifications of the original pt care plan be evaluated?


during the ongoing evaluation of tissue changes and pt sel care ability during multi-appt tx


a plan for evaluation of a pt care outcome includes: (3) during each appt


informal monitoringfeedbackmodifications


at the beginning of tx, methods for evaluating the success of dh tx include what?


re-collection of same clinical data (i.e. probing depths, bleeding)


what are the overall purposes of tx during maintenance? (4)


arrest diseaseprovide oral healthfunctioncomfort for pt


maintenance = ________ ______


continuing care


oral diseases do or do not recur? what is possible through combined personal and professional effort?


DO RECURCONTROL IS POSSIBLE


t/f lifelong preservation of teeth and their supporting structures is a realistic goal
True False


true


success of the maintenance program depends on the _________ by the pt of the maintenance procedure


understanding


a way to help the pt become aware of the concept of the maintenance phase is in the _______ ______ ______


initial care plan


t/f a fixed schedule is used for all pt's in oral health because the frequency is similar for each pt
True False


FALSE! NO fixed schedule because the frequency depends on the needs of each pt


for maintenance, appts may vary from ____ to ____ months


2-6


what are some predisposing diseases, conditions, and behaviors for periodontal disease?


diabetesHIV/AIDShost genetic factorssmokingstress


what are local factors of maintenance? (1)


rate of calc formation


what are restorative complications of maintenance? (2)


implants, prosthetic replacements


what are three "risks" for contributing factors of maintenance frequency?


perio disease activitydental carious lesionsoral cancer: tobacco and alcohol users


which 6 categories of pt's may need intervals of 2-3 months for special appointment requirements?


mentally or physically disableddiabetescardiovascular diseasept undergoing extensive dental carerampant dental cariesortho therapy


why might someone with diabetes need to be on a 2-3 mo recall??


it can predispose pt's to lowered resistance to infection; tissues MUST not be allowed to develop advanced disease


why might short appts be necessary for someone with cardiovascular disease?


brushing is a difficult procedure to carry outfort appts can be tolerated because of the fatigue factor


when a pt is undergoing ___________ ________ _________, the gingival or perio tx may be completed by the time appts for restorative phases of tx are underway. the first maintenance needs to be dated from the _______of the initial gingival and perio tx.
when extensive restorative prosthetic, or tx is in progress, the frequent tissue maint. during long term therapy is essential


extensive dental carecompletion


why would someone with rampant dental caries need to have 2-3 mo interval appts?


topical fl2 applicationdietary supervisionpersonal factors for biofilm control


what is PMT?


perio maint. therapy


what are the four PMT's?


preventivetrialcompromiseposttreatmentALL P to the M to the T


to prevent the initiation of disease in individuals without perio = (what PMT?)


preventive PMT


to proved an interm study period for borderline pts with conditions that ust be observed and further evaluated before a decision can be made for correctvie surgery or whether maint is possible wi/out further advanced disease therapy = (what PMT?)


trial PMT


to slow the progress of disease in pts for whom corrective surgery and advanced tx are indicated but cannot be implemented for reasons of health, economics or other personal factors= (what pmt?)


Compromise PMT


to prevent the recurrence of disease and maintain the state of perio health attained during perio therapy. It may be surgical or nonsurgical = (what PMT?)


Posttreatment PMT


t/f at maintenance appt assessment preparations are the same plan as for a new pt?
True False


true!


what needs to be completed at EVERY maintenance appt whether it is 3, 6, whatever month intervals for a pt of any age?(3)


reassessment, progress diagnosis, and maint. care plan


t/f radiographs are taken routinely
True False


FALSE! it is based on the dentist's determination of an individuals needs


what should be examined of the teeth during maint. appts?


integrity of restorations and sealantsdental caries: demineralization, early dental caries, and cavitated lesionssensitivity


during a perio exam with complete probing of maint appt, what three things are taken into consideration?


BOPattachment levelscompare with previous probings to check for changes


after applying a disclosing agent relating biofilm to teeth can help see areas of _______ ______, ________ and other signs of inflammation


gingival rednessenlargement


areas of special problems include __________ treated teeth, __________ areas, implants, _____ factors, and prosthetic appliances


endodontically postsurgicalocclusal factors


during continuing care, the pt is considered a _________


cotherapist


a perio pocket exam with bop indicates need for deep ______ and ______ _______


scaling and root planing


what type of anesthetic might be needed for perio scaling and debridement?


local anesthesia or subgingival gel


local delivery of antimicrobials when doing perio scaling and debrid should be administered for isolated ______ _____ _____


persistant deep pockets


should you plan on a number of appts for scaling and debrid?


yep, unless you are houdini and make the calc disappear (hey! maybe i should practice being a magician!)


what are the three points during pt care when the hygienist may confer with the dentist to determine the need for referral to a periodontist?


initiallylater during reevaluationduring maintenance


if a new pt comes in and has severe advanced perio or has uncommon perio disease (juvenile perio), NUG or NUP, or a drug-induced gingival enlargement (phenytoin for seizures), when would this be noticed during which of the three point referral stage?


initial


after perio quad scaling for nonresponsive or refractory type of mod or advanced perio condition, when would this be noticed?


later during the reevaluation for poss referral


pocket depth that prohibits access to complete debrid, furcation involvements that cannot be accessed without surgical methods, mucogingival problems (lack of attached gingiva near healthy receded gingival margin, and perio disease that is refractory (not responsive) should: be ________ _______ _______


referred during maint


recurrence signs and symptoms of perio infection indicates what?


recolonization of perio pathogens


recolonization of a pocket can occur within HOW MANY DAYS?


42 days!


without dail personal dental biofilm control and regular professional supervision and maint. procedures, _______ can recur


infection


t/f it depends on the pt how soon after completion of tx recurrence of perio happens.
True False


true!


what are 6 CONTRIBUTING factors for recurrence of perio disease?


insufficient biofilm removallack of compliance with maint apptsincomplete professional txtobacco usesystemic diseasesgenetic factors