BPE 4 or * management flowchart
BPE 4 or * management flowchart
Confirm the periodontal diagnosis before treatment begins, record it in the notes and inform the patient.
If there is obvious evidence of interdental recession, this suggests the patient has periodontitis.
For all patients with a diagnosis of Periodontitis, annual periodontal charting should be recorded, not only BPE
1. Carry out further periodontal examination of the whole mouth and record necessary radiographs to enable treatment planning.
2. Provide Step 1 of treatment
- Discuss and arrange risk factor management and support to control disease, including OHI
- Provide PMPR and removal of plaque retentive features as part of Step 1 of treatment
- Re-evaluate
3. After Step 1 of treatment, is the patient engaging with treatment?
If yes:
-
- Move to Step 2 of treatment
If no:
Consider:
-
- Repeating Step 1 of treatment
- Moving to Step 2 of treatment
- Moving to Step 4 of treatment
4. Provide Step 2 of treatment
- Continue to support risk factor control and OH and provide subgingival PMPR where needed
- Allow time for healing then carry out review periodontal charting (not BPE) in the whole mouth to assess response
5. After Step 2 of treatment, is the patient periodontally stable or are treatment goals achieved?
If yes:
If no:
-
- Consider the possible reasons for this.
- Provide Step 3 of treatment
(repeated subgingival PMPR) or consider referral* - Review and rechart post-treatment - is the patient stable or are treatment goals achieved?
- If yes - provide Step 4 of treatment
- If no - consider the possible reasons for this; repeat Step 3 of treatment or consider referral*; review post-treatment
* Referral can be considered at any step, check local referral criteria.
If referral is not possible, provide further subgingival PMPR, where possible, and then Step 4 of treatment