Periodontal Debridement Routine Prevention or Necessary Treatment Dental

Periodontal Debridement

Routine Prevention or Necessary Treatment? �Dental prophylaxis OR periodontal therapy Removal of deposits from supragingival and subgingival surfaces of the teeth �Uses nonsurgical OR surgical instrumentation �To prevent OR arrest infection �General anesthesia for both What does that entail? Risks? Cost?

Explore the Teeth �Dental explorer – has a slender, wire-like working end that tapers to a sharp point and is used to explore the topography of the tooth surface �Explore for _____ Acid producing bacteria demineralization of enamel and dentin What is the most common surface affected? �Test for attrition vs. pulp exposure

Check for Attachment Loss �Periodontal probe � Round, blunt instrument � Miniature intraoral ruler that measures attachment levels: 1. Gingival recession 2. Sulcus depth 3. Loss of bone in furcation areas � Used to assess mobility of teeth and the presence of gingival bleeding What is normal sulcus depth for a canine? Feline?

Furcation

Periodontal Probe � ________ have millimeter increments at 1, 2, 3, 5, 7, 8, 9 and 10 mm.

Gingival Sulcus and Recession

Calculus Removers Removes gross calculus, supragingivally Which teeth do you think need this tool the most?

Scaling Above the Gingiva �Hand scaler – used to remove tartar / calculus supragingivally �Modified pen grasp technique Gives precise control of the instrument; limits wrist motion Where should all of your fingers be? Working end Shank Handle

Scaling Below the Gingiva �Curette-used to remove tartar subgingivally � Modified Pen Grasp *Tip is more round/dull than the hand scaler.

Periodontal Debridement Using Machines �Ultrasonic scaler- uses vibrations and irrigation to remove tartar from surface of tooth. Steady stream of water (strong mist) flushes out the sulcus AND can disrupt bacterial cell walls

Ultrasonic Scaler �Water through the tip also acts as a coolant; this machine can get very hot! �Move tip from the sulcus, coronally, away from the root’s apex. �Time line/tooth?

Ultrasonic Scalers: Two Options Magnetostrictive- magnetic field in the hand piece is created by a zinc and nickel “stack”, sends vibrations to the tip in an elliptical pattern 1. All surfaces of the tip vibrate! �Most vibrations are on the ____ Use least amount of vibrations �Found on the lateral surfaces Modified Pen grasp

Magnetostrictive Scaler �Hand piece Contains the stack, which is replaceable Stack is delicate and should not be bent or twisted! �Tip Stainless steel instrument Attaches to hand piece and secured in place with the _____. Many sizes available, specific to each patient Removed with the ______ (VERY IMPORTANT)

Magnetostrictive Scaler Use INCORRECT Distal third of tip should be held at 0 -15° from long axis of the tooth.

Ultrasonic Scalers: Two Options 2. Piezoelectric- ceramic discs or crystal that produces liner movements Only lateral surfaces vibrate More fragile, more skill required More expensive, growing in popularity

Periodontal Debridement �Polishing – VERY IMPORTANT The scaler microscopically scratches the tooth surface and creates more surface area quicker bacterial build up � 1 -3 seconds/tooth is all that is needed �Prophy angle- attachment that is connected to the hand piece Removable rubber cup holds polish, or _______

Polishing

Patient Position/Safety Comfortable for you and the patient �Plenty of light �Elevate neck; nose down Why? �Opening of mouth Oral speculum �Suction/gauze �Preemptive rinse? �PPE

Periodontal Debridement Safety-PPE

Oral Speculum �Cornell Feline Health Center study �Maxillary artery blocked �Blindness post anesthesia