Periodontitis And Myocardial Infarction: A Shared Genetic Pr

[Drsumitra]

 PERIODONTAL RISK ASSESSMENT 

Since less than 10% of patients who have periodontal disease are receiving treatment, a periodontal risk assessment should be performed on all new and existing patients. A common assessment now being used by many dentists is the Stat-Ck Periodontal Risk Assessment (PRA) It was developed in 2002 by Gottehrer and Shirdan.⁸ The first part of the assessment records a history of smoking, history of heart disease, medications taken, and for females, any hormonal problems.

The risk assessment is designed to provide information for both the dentist and patient concerning the present periodontal status. It is done to determine if there is active disease present by examining all the teeth circumferentially with a periodontal probing; grading each of the quadrants following the traditional test format of A to F. A is asymptomatic; B presents with bleeding; C with calculus above the gum; D with deposits below the gum; and F signifies a failing area. The categories are listed and described in the risk assessment chart, as pictured in Figure 1. The patient must participate in the screening probing by observation with a full-size patient mirror. When active disease is present, patients will see bleeding from the periodontal tissue which most likely they have not even seen when brushing. This can be the most positive confirmation of the presence of disease, affirming the need for interventional treatment. 

The Stat-Ck PRA replaces the periodontal screening and recording as a screening test with actual results recorded rather than a recommendation for further evaluation. Unlike a traditional 6-point probing which must be performed once the patient begins treatment, the A to F format is more easily understood by patients, thus allowing a simple way for them to understand their current periodontal status. The patient should participate in the screening probing, observing bleeding from the periodontal pocket that occurs when the probing is done; remember that this bleeding may not have been seen with routine brushing/flossing of the same areas. This confirms for the patient that active disease is present. Once the probing is completed, it must be explained to the patient that this bleeding is not normal. 

The Stat-Ck PRA explains the results of the screening, with suggestions for treatment for each category. It can include suggestions for removal of hopeless teeth and placement of crowns, or appropriate restorations to control and/or reduce risk for recurrent decay.