List+and+describe+different+treatment+options+for+periodontal+disease.

=Treatment Options for Periodontal Disease =


 * There are five phases of treatment options for periodontal disease.**


 * Emergency Phase**: bring all emergency and other criteria under control such as treating periodontal abscess, extracting hopeless tooth, and RCT to resolve pain.


 * Phase I Therapy**: is initial therapy or nonsurgical therapy. This phase mainly tries to control and eliminate the etiologic factors of the disease process such as OHI, plaque removal, nutritional counseling, scaling and root planing, and smoke cessation.


 * Phase II Therapy:** is surgical phase of treatment such as implants or endodontic therapy. The goals for this phase are to treat the disease and prevent the spread of disease as well as improve the prognosis, and esthetics. Some examples of defects which need surgical intervention would be mucogingival defects, or sever pocket depth. Severe pocket depths will need surgical pocket therapy to eliminate the pathogenic changes in the pocket walls, to create a stable, easily maintainabable state, and possibly promote regeneration. The effectiveness of periodontal therapy is predictated on the sucess of eliminating calculus, plaque, as well as diseased cementum. The results of pocket theraphy are: an active pocket becomes in active and a long junctional epithelium in formed. Surgical pocket therapy can creat a healthy sulculus. Healthy gingival attachment can promote attachment of periodontal fibers to the cementum.


 * Phase III Therapy:** is restorative phase, which involves in filling, crowns, bridges, partial dentures, and full dentures.


 * Phase IV Therapy:** is maintenance phase. This phase includes assessments, plaque and calculus removal, and chemotherapeutic agents. The patient will continually be in this phase because they are maintaining throughout their life.

Treatment options will depend on the prognosis of the patient through assessments. The patient may not enter phase II or III if the do not need retorative or surgical dental work. Risk factors and dental history should also be considered when deciding the prognosis through a thoroughly health history. Treatment then should be implemented through evidence-based decisions. Suggested Dental Hygiene Treatment Plans for Periodontal Disease Case Types. All types include: 1. Assessments 2. Patient education and plaque control instructions 3. Scaling 4. Establishing appropriate maintenance interval 5. Re- evaluation(s)

Type I: In Gingivitis, often completed in one appointment Treatment options include anesthesia if sensitivity present or to decrease bleeding One option: supragingival irrigation Another option includes no treatment

Type II: Slight Chronic Periodontitis – Reinforce plaque control at subsequent visits Treatment options include anesthesia if sensitivity present or to decrease bleeding One option: subgingival irrigation Another option includes no treatment

Type III: Moderate Chronic or Aggressive Periodontitis – Reinforce plaque control at subsequent visits Anesthesia Quadrant scaling One option: subgingival irrigation Another option includes no treatment

Type IV: Advanced Chronic or Aggressive Periodontitis – Reinforce plaque control at subsequent visits Anesthesia Quadrant scaling One option: subgingival irrigation Another option includes no treatment

Type V: Refractory Chronic or Aggressive Periodontitis – Reinforce plaque control at subsequent visits Anesthesia Quadrant scaling One option: subgingival irrigation Another option includes no treatment

Note: Many options can still be added to each type. Other options may also include smoking cessation and nutritional consultation.

The preferred sequence of periodontal therapy is as follows: 1. Emergency Phase 2. Intitial Phase: Phase I Therapy 3. Maintenance Phase: Phase IV Therapy 4. Surgical Phase-Phase II Therapy or Restorative Phase: Phase III Therapy. The hygienist is often responsible for Phase I and Phase IV Therapy. Some factors that can affect the sequence of care are urgency such as pain or an abscess, risk factors for peridontal infections and caries such as root exposure or xerostomia, amount of calculus, quadrant selection, severity of condition and individual patient requirements. Some individual patient requirements include pain control, physical disabilities, anxiety or stress and their understanding of periodontal disease.

Presenting the Tx Plan: The purpose of presenting the tx plan to the patient is to educate the patient and to provide information to the patient for informed consent. The hygienist should present the entire treatment plan as a unit and should use appropriate terminology and engage the patient in the treatment plan. She/he should begin the discussion on a positive note, use visual aids and explain the procedures thoroughly. It is also essential that the patient has informed consent which gives permission from the patient to the hygienist to proceed with treatment. The patient must understand the treatment plan, the extent of their disease, and all treatment options. The patient also has the right to refuse any treatment which is called informed refusal. Having open communication with the patient is imperative for the success of the treatment plan.

Hint: Think about sequence of treatment, goals of therapy, criteria for determining success, failure, and possible side effects to the dentition.