Scaling and Post-Op Instructions
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| The purpose of treatment is to | create an environment in which the gingival tissue can heal and be maintained in health by the patient.
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| Incidental curettage | Incidentally or accidentally remove diseased tissue from the pocket wall
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| Intentional curettage | Purposely remove diseased tissue from the pocket wall with instruments.
This is not done by hygienists.
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| Periodontal debridement | Scaling above and below the gum line to remove plaque and calculus. End point = biologically acceptable root surface to promote healing
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| Root planing | Removing cementum or surface dentin that is rough. End point= smooth root. This is an old technique.
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| Channeling | Using a systematic, overlapping approach. Scale in sections.
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| Subgingival scaling | Rely on tactile sensitivity. Watch the terminal shank.
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| 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
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| Use this to see under the tissues | Radiographs
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| Areas to avoid | caries, margins of restorations, enamel defects-CEJ & dentin
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| Approach to scaling | Use treatment plan, based on individual needs, determined by your assessment
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| Single appointment | Minimal calculus and you can complete the whole mouth in one appointment
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| Multiple appointments | Excessive calculus and cannot complete the whole mouth in one appointment
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| Healing time before reassessment in a dental office where you are employed | 4-6 weeks
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| Healing time before reassessment in dental school clinic | 2-3 weeks
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| Immediate evaluation | After scaling and before dismissing the patient for the day
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| 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
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| 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.
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| Tissue response | is the most important measure of success in periodontal debridement
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| hypertonic salt solution | 1 teaspoon in 8 ounces of water
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| 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.
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| How often should a patient be seen typically? | As needed
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| Key points for instrument selection | amount and tenacity of calculus; location; depth of pocket; consistency of tissue;
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Created by:
schubring
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