Periodontal Decision Making Therapy And Record Keeping System

Author : Lindsey Williams
Publisher :
ISBN 13 :
Total Pages : 0 pages
Book Rating : 4.:/5 (141 download)

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Download or read book Defining Periodontal Health written by Lindsey Williams and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Objective: This pilot study aims to gather baseline clinical and patient reported data of individuals with periodontitis who underwent non-surgical periodontal therapy to evaluate clinical outcomes, gauge endpoints of periodontal therapy, and determine if periodontal health has been achieved according to the health model described by Mariotti and Hefti. The collected data will be used over time to ascertain clinical outcomes (i.e., tooth retention in painless function) for the management of periodontal disease. Materials and Methods: Eighteen patients who declined periodontal surgical treatment following initial non-surgical therapy were recruited from the Department of Periodontology at The Ohio State University College of Dentistry between September 2021 to March 2022. These participants were recruited to participate in a recall maintenance program that entailed non-surgical periodontal maintenance therapy every three months. Tooth survival, periodontal stability, and patient satisfaction were evaluated for this baseline data study and are planned for comparison after one year. Biographic and demographic information was collected for each patient including patient age, biologic sex, education, employment status, and whether the patient possessed insurance. Full mouth periodontal charting was completed during the initial data collection visit. Clinical measures recorded included periodontal pocket depths, gingival margin (recession), clinical attachment levels, furcation involvement, mobility, and plaque score. Probing depth statistical analysis was also extracted from AxiUm electronic dental health charts for each patient. A health questionnaire was constructed by researchers to obtain patient demographics and assess various measures of periodontal health including participant’s ability to function, perception of the health of their gums, satisfaction with the appearance of their gums and smile, and characteristics of their smile that are dissatisfying. Data collected from questionnaires and clinical measurements was organized into a spreadsheet format and descriptive data was analyzed using frequency distributions (numbers and percentages), measures of central tendency (means), and measures of dispersion (standard deviation). Results: Of the eighteen participants, seven were male (39%) and eleven were female (61%). Age ranged from 20 to 79 years of age with an average age of 50.2 ± 16.5. When asked about rating one’s current level of pain when chewing, the average response was 0.3 ± 0.6 indicating a lack of pain or presence of mild pain. When rating one’s gum health, seven patients (39%) reported perceptions of good gum health, five patients (28%) reported fair, four (22%) reported poor, and two (11%) reported very good gum health with no participant reporting an excellent state of gum health. Four questions were posed in regard to each participant’s ability to chew and answers were reported as All the Time, Very Often, Fairly Often, Sometimes, or Never. First, when asked whether they have been prevented from eating food that they would like to eat, ten patients (56%) reported never, five (28%) reported sometimes, two (11%) reported fairly often, and one (6%) reported all the time. Second, when asked if it takes patients longer to finish meals than other people, fourteen patients (78%) reported never, three (17%) reported sometimes, and one (6%) reported fairly often. Third, when asked if their enjoyment of food has decreased due to a decline in their ability to chew, eleven patients (61%) stated never, three (17%) reported sometimes, two (11%) reported fairly often, one (6%) reported very often, and one (6%) reported all the time. Finally, when asked if they avoid eating around other people, fourteen (78%) reported never while four (22%) reported sometimes. Overall satisfaction with chewing was also polled amongst participants. Eight patients (44%) reported that they were very satisfied, eight (44%) reported that they were satisfied, one (6%) reported that they were somewhat satisfied, and one (6%) were unsatisfied. Finally, when asked about the ability to chew or bite certain foods, fifteen patients (83%) stated that they were able to eat all listed foods while two patients (11%) stated that they have difficulty eating firm meat and one patient (6%) stated that they have difficulty with raw carrots and fresh apples. Participants were asked to rate their gum appearance on a scale of 0-10, where 0 is very unsatisfied and 10 is very satisfied. Measures of central tendency and measures of dispersion were 4.7 ± 2.8 indicating a majority of patients were somewhat unsatisfied with their gums. Similarly, when asked about the appearance of their smile, the average response was 4.8 ± 3.1, indicating that a majority of patients were also somewhat unsatisfied with their smile. Of the things that patients indicated could be improved about their smile and appearance, patients identified they would change teeth position (72%), gum position (28%), teeth color (50%), gum color (6%), and only two participants reported that they would not change anything about the appearance of their smile (11%). Patient probing depth statistics were generated from AxiUm charting software to analyze the distribution of probing depths in millimeters in each sextant of the mouth. Six sites per tooth were in each sextant of the mouth were recorded for both the maxillary and mandibular arches and categorized in three groups—0-3.0 mm, 3.5-5.0 mm, and 5.5+ mm, or Group 1, Group 2, and Group 3, respectively. Averages of the total number of sites per sextant were calculated for each probing depth group. For the upper right sextant, there was an average of 6.1 ± 6.1, 6.8 ± 3.6, and 2.6 ± 3.0 among sites in Groups 1, 2, and 3, respectively. The maxillary anterior sextant averaged 26.1 ± 7.6, 6.4 ± 4.4, and 1.2 ± 1.9 among sites Groups 1, 2, and 3, respectively. The upper left sextant had an average of 12.6 ± 7.1, 4.9 ± 3.3, and 2.1 ± 2.7 for Groups 1, 2, and 3, respectively. The lower right sextant had an average of 12.7 ± 4.3, 7.4 ± 3.5 and 2.6 ± 2.7 for Groups 1, 2, and 3, respectively. The mandibular anterior sextant had an average of 28.7 ± 7.1, 5.8 ± 5.6, and 1.0 ± 2.2 among sites in Groups 1, 2, and 3, respectively. Finally, the lower left sextant averaged 11.2 ± 4.9, 9.1 ± 4.6, and 1.7 ± 2.2 among sites in Groups 1, 2, and 3, respectively. Conclusions: Oral health should seek to adopt a wellness model that considers a balance of mind, mouth, and well-being that affords a patient the right to honor their autonomy in evaluating their personal perceptions of wellness. This preliminary report sought to explore the feasibility of adopting the modified wellness model introduced by Mariotti and Hefty. This model focuses on four principal characteristics to assess periodontal health: (1) a functional dentition, (2) painless function, (3) stability of the periodontal attachment apparatus, and (4) the psychological and social well-being of the individual. By gathering long term clinical data and patient questionnaires, it is the aim of this longitudinal study to eventually establish ways in which to adopt this paradigm into practice. Future studies are required to evaluate the practicality and reliability of this model and its proper utilization in clinical decision making and patient management. It is the author’s hope that this model of health and wellness can evolve and be a more universally accepted way to define periodontal health.