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Lecture 7
Scaling and Post-Op Instructions
| Term | Definition |
|---|---|
| The purpose of treatment is to | create an environment in which the gingival tissue can heal and be maintained in health by the patient. |
| Incidental curettage | Incidentally or accidentally remove diseased tissue from the pocket wall |
| Intentional curettage | Purposely remove diseased tissue from the pocket wall with instruments. This is not done by hygienists. |
| Periodontal debridement | Scaling above and below the gum line to remove plaque and calculus. End point = biologically acceptable root surface to promote healing |
| Root planing | Removing cementum or surface dentin that is rough. End point= smooth root. This is an old technique. |
| Channeling | Using a systematic, overlapping approach. Scale in sections. |
| Subgingival scaling | Rely on tactile sensitivity. Watch the terminal shank. |
| Rationale/Benefits of Scaling | 1. Stop progress of disease 2. Induce changes in microorganisms; 3 month recall 3. Create healthy environment 4. Easier for patient to maintain tissues when healthy 5.Initial prep for perio surgery 6. Prevent recurrence |
| Use this to see under the tissues | Radiographs |
| Areas to avoid | caries, margins of restorations, enamel defects-CEJ & dentin |
| Approach to scaling | Use treatment plan, based on individual needs, determined by your assessment |
| Single appointment | Minimal calculus and you can complete the whole mouth in one appointment |
| Multiple appointments | Excessive calculus and cannot complete the whole mouth in one appointment |
| Healing time before reassessment in a dental office where you are employed | 4-6 weeks |
| Healing time before reassessment in dental school clinic | 2-3 weeks |
| Immediate evaluation | After scaling and before dismissing the patient for the day |
| Follow-up "on-going" evaluation | Evaluating over a series of appointments. Re-explore and re-scale previously scaled quadrants. Evaluate after 2-3 weeks in dental school clinic or 4-6 weeks in dental office |
| Recall maintenance interval | RDH determines how often the patient needs to be seen based on the perio assessment and diagnosis. It could be 3 months, 4 months, 6 months, 12 months. |
| Tissue response | is the most important measure of success in periodontal debridement |
| hypertonic salt solution | 1 teaspoon in 8 ounces of water |
| Primary reason for a 3 month recall | It takes approx. 42 days without daily biofilm control for the subgingival plaque to recolonize to a pathogenic potential. The RDH uses curettes to debride the root surfaces where toothbrushes and floss cannot reach. |
| How often should a patient be seen typically? | As needed |
| Key points for instrument selection | amount and tenacity of calculus; location; depth of pocket; consistency of tissue; |
Created by:
schubring
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