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Scaling and Post-Op Instructions
|The purpose of treatment is to
|create an environment in which the gingival tissue can heal and be maintained in health by the patient.
|Incidentally or accidentally remove diseased tissue from the pocket wall
|Purposely remove diseased tissue from the pocket wall with instruments. This is not done by hygienists.
|Scaling above and below the gum line to remove plaque and calculus. End point = biologically acceptable root surface to promote healing
|Removing cementum or surface dentin that is rough. End point= smooth root. This is an old technique.
|Using a systematic, overlapping approach. Scale in sections.
|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
|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
|Minimal calculus and you can complete the whole mouth in one appointment
|Excessive calculus and cannot complete the whole mouth in one appointment
|Healing time before reassessment in a dental office where you are employed
|Healing time before reassessment in dental school clinic
|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.
|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?
|Key points for instrument selection
|amount and tenacity of calculus; location; depth of pocket; consistency of tissue;