The observation report and the investigation sheet:
- The survey sheet = we do not construct sentences
Anamnesis: First name, surname, marital status, etc.
- Reason for consultation: the reason why the patient came for consultation: either functional or aesthetic (recession, gingival hypertrophy, etc.)
*Pain as a reason for consultation: in case of emergency i.e. GUN, periodontal abscess, septum syndrome, DAM
- The history of the disease (becomes more important since the Hermitage classification is based on the history of the disease): historical account of the evolution of the reason for consultation
The Hermitage classification (atypical forms, does not limit age): is based on 2 criteria:
- The evolution of the pathology, if it is rapid we speak of aggressive, if it is slow we speak of chronic
- The correlation: between the amount of bacterial plaque and tartar and the level of lysis
- If the correlation exists, we speak of chronic periodontitis.
- When there is no correlation, we speak of aggressive periodontitis (little tartar but significant lysis even terminal), it is the bacterial specificity (bacteria of the red spectrum: anaerobic bacilli: AAC, Porphyromonas Gingivalis…)
| Gum diseases | Periodontal diseases |
| Plaque-induced only (only the direct local triggering factor: PB) = very rare Plaque-induced with cofactors (promoting factors): dental malpositions, ODF treatment (overlapping which promotes food and tartar stagnation) Plaque-induced modified by a systemic factor: endocrine disorders, hematological disorders, vitamin deficiency, hormonal disorders, medication (antiepileptics, antidepressants (Di-hydan), hypertensives, cyclosporines) *Glickman concept: when it comes to gingivitis, the indirect local factor (traumatic occlusion, interferences, prematurity, ODF treatment, etc.) never intervenes because it does not help the accumulation of PB, it aggravates bone lysis, it only intervenes when the inflammation reaches the co-destruction zone (irritation zone = the superficial periodontium) and it will deviate the inflammation path and instead of giving a horizontal lysis, it gives a vertical or oblique lysis | AggressiveChronicles |
In this classification we have the main diagnosis (gingivitis or periodontitis ) and the secondary diagnosis: abscess, interrelationships, gingival hypertrophy, aberrant frenulum, etc.
In contrast, the Page and Schroeder classification: is based on the clinical picture of the disease (typical forms):
- PPR: severe clinical picture with suppuration and ulcerations
- Localized PJ : free of inflammation (appears like a healthy condition) but existence of deep pockets
- Generalized PJ: same clinical picture as PPR except that lysis at the level of the molars is much more significant
- PPP: very rare
- Stomatological and general history: the notion of heredity has been proven for aggressive periodontitis, general diseases related to the periodontal state
- Endobuccal exo examination (inspection and palpation)
- The observation report: the same sequence of the investigation sheet but we only cite what is pathological (we only note the pathological things)
- This is the patient… aged … who presented for (reason for consultation) which dates back to (history of the illness).
- The patient and her family have no general illness.
- The patient’s dental history includes extraction of … and filling of … etc.
- The oral examination reveals such and such signs…
- Palpation of the lymph node chain reveals adenopathy of such size… if there is no pathology we skip this step
- Palpation of the TMJ reveals the presence of pain as well as a joint noise that presents itself as a clicking, a cracking… or a condylar play (jump, subluxation (reducible) or dislocation (irreducible)) symmetrical or not.
- The mouth opening is insufficient because of…
- The mucosa presents indentations, ulcerations, mouth ulcers, bleeding , etc.
- Examination of the brakes reveals pathological (high, low) or physiological brakes with a positive or negative Chaput test
- The gingival examination (we are not talking about the color, height, consistency… we are talking about inflammation) reveals mild, moderate or severe inflammation (GI) with a GI of 1, 2 or 3, SBI of 1…, PMA of…, the inflammation is much more severe at the anterior level compared to the posterior level…
- The survey revealed false or real pockets of 2 to 8, the deepest of which is located at the level of such sectors
- The special features:
Furcation lesions (classified according to Glickman)
Recessions, loss of attachment = recession + pocket depth
The presence or absence of suppuration, in this case we abstain from probing
- Dental examination revealed malpositions, overlaps, secondary diastemas (to periodontal disease), mobility (ARPA) and abrasions (AGUEL)
- Occlusal examination reveals the presence of prematurities and interferences (deductive or protrusive on the working or non-working side) at the level of such teeth
- The functional examination reveals the presence of dysfunctions (unilateral chewing, atypical swallowing, naso-oral breathing, etc.)
- Parafunctions (beyond the functioning of the central nervous system): bruxism, clenching, etc.
Dental crowns are used to restore the shape and function of a damaged tooth.
Bruxism, or teeth grinding, can cause premature wear and often requires wearing a retainer at night.
Dental abscesses are painful infections that require prompt treatment to avoid complications. Gum grafting is a surgical procedure that can treat gum recession. Dentists use composite materials for fillings because they match the natural color of the teeth.
A diet high in sugar increases the risk of developing tooth decay.
Pediatric dental care is essential to establish good hygiene habits from an early age.