Perio Tribune United Kingdom Edition

Perio Tribune pages 11-14 A clinical audit of general dental practice Plaque-related perio management Perio Tribune pages 15-16 Rainer Buchmann looks at integrated dentistry Perio meets implant dentistry Perio Tribune pages 17-18 Rachel Kendrick looks at Acteon’s Air-n-Go system Beauty and health Perio Tribune Management of plaque related periodontal conditions A clinical studying the assessment and management of plaque-related periodontal conditions of patients by the practitioners at a general dental practice in Hertfoldrshire in 2013 A bstract: Undiagnosed and un- managed periodontal conditions are fast becom- ing one of the biggest areas of litigation and complaints within the dental field. Thor- ough periodontal assessment is vital for diagnosis, treat- ment planning and monitoring the progression of periodontal disease. This is a report of a clinical audit that studied the periodontal assessment car- ried out at a general dental practice in Stevenage, Herts. This audit was conducted over a seven month period, analys- ing 50 patients for each audit cycle. A new protocol for peri- odontal assessment using the guidelines of the British Soci- ety of Periodontology was in- troduced. The results demon- strate a marked improvement in assessing the periodontal condition of patients in this general dental practice. Clinical relevance: Regular periodontal assess- ment is required to aid diag- nosis, treatment planning and monitoring of disease. Without such assessment, it is possible to misdiagnose, develop incor- rect treatment plans and pre- vent objective assessment of disease progression. With the periodontium being the scaf- folding for all other restorative techniques performed by den- tists, this is an essential area which must not be overlooked or under managed. Null Hypotheses: The five dental practitioners being audited would not ex- ceed the expected percentage of 50 per cent of patients be- ing provided with Gold Stand- ard treatment with regards to periodontal monitoring and management. The five dental practition- ers being audited would ex- ceed the expected percent- age of less than 10 per cent of patients being provided with Unacceptable treatment with regards to periodontal moni- toring and management. Aim: The aim of this audit is to as- sess periodontal screening and subsequent non-surgical peri- odontal treatment for patients with plaque-related periodon- tal conditions at the practice compared to that suggested in guidance documents. The main objective for the audit is to investigate the standard of screening and treatment patients are receiv- ing with regards to their peri- odontal condition. This will be achieved by ensuring that the number of ‘Unacceptable’ treatments provided is mini- mal, meaning the majority of patients seen at the practice receive at least an ‘Acceptable’ level of treatment, if not the ‘Gold Standard’ level. In this way, the audit aims to disprove the first null hypothesis. A secondary objective is that, as long as the first objec- tive is achieved, the major- ity of the patients receive the ‘Gold Standard’ of screening and treatment with regard to their periodontal condition. In this way, the audit aims to dis- prove the second null hypoth- esis. Description: This audit examined sets of patient’s notes kept by the five dental practitioners (GDP’s) working at the practice with regards to their periodontal screening process and any follow up treatment based on this. The type of treatment investigated was the initial treatment phase of plaque- related periodontal conditions which concerned patient’s oral hygiene habits, and any pro- fessional and patient-based cleaning of their teeth i.e. non- surgical periodontal therapy. Specific risk factors for pa- tients were not included, such as smoking status and medical conditions. Ten patients were chosen at random from each of the GDP’s day lists. These patients had been seen within four weeks of 17th December 2012; the start date for the au- dit. This gave an overall sam- ple size of 50 patients, which was deemed a decent sample size for the audit. A four week period prior to the date of the audit was chosen meaning that any periodontal treatment suggested for the patient at the time of their exam was likely to have been carried out or at least started by the start date of the audit. Notes before this were not investigated as this may not represent the most current practice of the practi- tioners being audited. Inclusion criteria for the pa- tients were as follows: • The patient must have been seen for an exam within the four weeks prior to the au- dit start date. This ruled out the possibility that the patient had attended for an emer- gency appointment in the last four weeks, where a full exam including a periodontal screening may not have been carried out. • The patients must have been over 18 at the time of their most recent exam and any edentulous patients were ex- cluded. This meant that an exam must ‘The aim of this audit is to assess periodon- tal screening and subsequent non-surgical periodontal treatment for patients with plaque-related periodontal conditions at the practice compared to that suggested in guidance documents’ Ref 1.0 Flowchart constructed in order to grade patients notes with regards to their periodontal screening and management page 12DTà

Perio Tribune United Kingdom Edition

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