Determining the Periodontal Prognosis

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Determining the Periodontal Prognosis

Determining the Periodontal PrognosisTrying to determine the prognosis starts with the assumption that after treatment the patient will at the least use the Sonicare Diamond Clean tooth brush and clean in between their teeth twice daily and present for supportive care every 3 months.

Following the tenants of the anti-inflammatory diet to improve their immune system function would help immensely, but 95% of people don’t even read the materials I recommend.

In a recent article in the Journal of Periodontology, (February, 2014), researchers followed patients for 25years and looked at their treatment outcomes.  They found that smokers had a 246% greater chance of loosing their teeth compared to nonsmokers! 

If a patient smokes, the results are never as good and the longevity of the dentition is shorter. 

Prognosis: Should be updated yearly

Good: Teeth that have pocket depths of 4-5mm and no mobility. These teeth should respond well to therapy and expect them to last a lifetime. They are good candidates for any needed restorative care (fillings, crowns, bridges, etc).

Fair: Teeth with pocket depths in the 5-7mm range with limited mobility. These teeth usually respond well to therapy and get back into a maintainable state and could be restored as desired.

Questionable: These teeth have a questionable outlook beyond 5-7 years because the pocket depths are in a 7-8 mm range, the breakdown extends into the furcation regions, class II mobility, and there are usually significant occlusal problems at this point. Only restore these teeth with clear and written expectations about longevity, costs, benefits, etc.

Hopeless: These teeth have Pd’s greater than 8mm, advanced furcation involvement, class II & III mobility, and are generally having routine abscesses. We usually recommend extracting these teeth, but in some cases will try laser assisted therapy as a last resort and plan to extract them if they continue to be infected. We do not recommend they be restored except for caries control during the first year after treatment.