is the significance of obtaining medical and dental history in treating a patient with periodontal conditions?
2 Aside from conventional parameters such as probing depth, recession, mobility and bleeding on probing, what are the additional parameters that should be obtained during a comprehensive periodontal evaluation?
3 How did we derive periodontal diagnosis for this case of interest?
4 What is the importance of conducting a comprehensive periodontal evaluation for a patient who needs a dental implant?
5 Aside from periodontal charting, are there any other clinical findings that clinicians should record during their routine comprehensive examinations?
Answers located at the end of the chapter.
References
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TAKE‐HOME POINTS
A. The pathogenesis of periodontal diseases is multifactorial in nature, involving dental plaque, susceptible host, and environmental factors (Figure 1.1.4) [2]. Thus, during medical and dental history‐taking, clinicians should obtain information related to these factors.
Susceptible Host
Patients with diabetes may be at greater risk for developing periodontal diseases compared to healthy counterparts, especially when the diabetic condition is not under control (HbA1c >7.0%) [1,3]. If necessary, medical consultation with the patient’s physician should be considered. Furthermore, some patients may be susceptible to periodontal diseases genetically. Thus, under family history‐taking, the patient should be asked about the periodontal conditions of his or her family members.
Environmental Factor
Cigarette smoking is a risk factor for developing periodontal diseases [1,4,5]. Under social history‐taking, the patient should be asked about their smoking habit (i.e. never smoked, past smoker, or active smoker). Smoking habit should be recorded as number of cigarettes consumed per day as well as number of years of active smoking.
Figure 1.1.4 Pathogenesis of periodontal diseases.
Source: modified from Kwon and Levin [2].
Dental Plaque
Dental plaque is the etiologic factor for periodontal diseases [6]. Under dental history‐taking, patients should be asked about their routine home oral care or dental plaque control. Their daily frequency of toothbrushing as well as interproximal cleaning (i.e. floss, interdental brush, interdental toothpick) should be recorded. During clinical evaluation, a plaque disclosing tablet may be used to objectively record the patient’s plaque control as well. Furthermore, patients should be asked about their previous periodontal treatment as well as its outcome, all of which should be recorded. If necessary, a consultation with the patient’s previous dental or periodontal provider may be considered.
B.
Furcation Involvement
According to previous studies, furcated molars have a significantly greater chance to be lost than nonfurcated molars [7–9]. Thus clinicians should proactively evaluate molars (or any other multirooted teeth) for furcation involvement, which would ensure their treatment in a timely manner, improving their periodontal prognosis. For easier detection of furcation involvement,