Examining for Periodontal Disease
Inflammatory periodontal disease ranks among the most common chronic infections in humans.1 These infections are responsible for a large percentage of tooth loss in adults.2 In addition, the ubiquity and recurrence of periodontal disease, and the damage it causes, require frequent examinations to prevent — and, when indicated, treat — these conditions. Examining and recording data on the state of the periodontium should therefore be an integral part of the routine information gathered on every dentate patient. The emphasis of this article is on what constitutes an appropriate periodontal examination, the timing and extent of data collection, and how clinicians can determine end points in therapy based on this information.
The severity and course of periodontal disease can be profoundly affected by the patient’s systemic health. There is also accumulating evidence that chronic infections of all types, including periodontal conditions, can have negative systemic health effects.3 Therefore, gathering information on the patient’s overall health is an integral part of the clinical data. Questions about smoking and diabetes are especially important because both are significant risk factors for periodontal disease.4,5 Medications currently taken, along with drug allergies, should also be recorded. Additional medical history data should include demographics and familial medical/dental history, as well as baseline vitals, height and weight. Any unanswered questions related to the patient’s systemic health should be addressed in writing to the individual’s physician.
An overview of the head and neck, including muscles of mastication, the temporomandibular joints and an examination for any inappropriate extraoral findings, should be performed. This is followed by an intraoral examination designed to identify and record any abnormalities…more http://decisionsindentistry.com/article/examining-periodontal-disease/