Periodontics
Stavroula Tsirmpa
Dip DS MSc (perio)
Stavroula has been in practice limited to periodontics in London since 1995, and has been treating patients on referral here at the Southgate Referral Practice since 1997.
After completing an MSc course in periodontology in 1994 at the University Hospital of Manchester she obtained an E.E.C.scholarship for further training and research at the Periodontolgy Department Hospital of Aarhus, Denmark, which is universally considered a Centre for Excellence in Periodontology.
A wide range of non-surgical and surgical periodontal treatment is provided including regeneration procedures in order to replace the missing support of the periodontally compromised teeth.
Stavroula Completed the Certificate in Dental Implantology at the Eastman Dental Institute in 2002, and is a member of the Hellenic and British Society of Periodontology and American Academy of Periodontology.
Haroula Yennari - E.D.H
Hygienist
Haroula is a hygienist with many years of experience. She qualified with distinction in 1990 from the renowned Eastman Dental Hospital and was awarded the prestigious Eastman Nugent cup for gaining the highest marks in the final examinations for dental hygienists. Her main interests lie in treating advanced form of gum diseases, and she has worked in collaboration with periodontal specialists on many cases.
Knowing exactly when best to refer a patient can be tricky. Fortunately both the British Society of Periodontology and the American Academy of Periodontology (AAP) provide some expert guidance.
British Society of Periodontology guidelines
The basic periodontal examination (BPE) forms the basis for assessing the need for a periodontal referral.
BPE scores and findings
- 0. No bleeding or pockets detected
- 1. Bleeding on probing - no pocketing > 3.5mm
- 2. Plaque retentive factors present – no probing >3.5mm
- 3. Pockets >3.5mm but <5.5 mm in depth
- 4. Pockets >5.5 mm in depth
Additional furcation involvements and muco-gingival problems, generalised or localised, should be marked with a * in addition to the BPE score of the respective sextant (e.g. a sextant with bleeding on probing, no probing depth >3.5mm but furcation involvement would be scored as 1*).
According to the British Society of Periodontology referral policy guidelines, patients can be categorised into the following complexity degrees:
Complexity 1: BPE 1-3
Complexity 2: BPE 4
Complexity 3: BPE 4, and additional complicating factors such as smoking habit, age (<35 years), medical history, root morphology, rapid breakdown; additional need for dental implant therapy and/or augmentation/bone removal)
Patients with a complexity grade 2 or 3, furcation involvements or muco-gingival problems may require advanced periodontal therapy (e.g. surgical periodontal procedures or adjunctive therapies) and should therefore be referred to a Periodontist.
American Academy of Periodontology (AAP) guidance.
MAJOR RECOMMENDATIONS
Level 3: Patients Who Should Be Treated by a Periodontist
Any patient with:
- Severe chronic periodontitis
- Furcation involvement
- Vertical/angular bony defect(s)
- Aggressive periodontitis (formerly known as juvenile, early-onset, or rapidly progressive periodontitis)
- Periodontal abscess and other acute periodontal conditions
- Significant root surface exposure and/or progressive gingival recession
- Peri-implant disease
Level 2: Patients Who Would Likely Benefit from Comanagement by the Referring Dentist and the Periodontist
Any patient with periodontitis who demonstrates at reevaluation or any dental examination one or more of the following risk factors/indicators* known to contribute to the progression of periodontal diseases:
Periodontal Risk Factors/Indicators
- Early onset of periodontal diseases (prior to the age of 35 years)
- Unresolved inflammation at any site (e.g., bleeding upon probing, pus, and/or redness)
- Pocket depths ≥ 5 mm
- Vertical bone defects
- Radiographic evidence of progressive bone loss
- Progressive tooth mobility
- Progressive attachment loss
- Anatomic gingival deformities
- Exposed root surfaces
- A deteriorating risk profile
Medical or Behavioral Risk Factors/Indicators
- Smoking/tobacco use
- Diabetes
- Osteoporosis/osteopenia
- Drug-induced gingival conditions (e.g., phenytoins, calcium channel blockers, immunosuppressants, and long-term systemic steroids)
- Compromised immune system, either acquired or drug induced
- A deteriorating risk profile
* It should be noted that a combination of two or more of these risk factors/indicators may make even slight to moderate periodontitis particularly difficult to manage (e.g., a patient under 35 years of age who smokes).
Level 1: Patients Who May Benefit From Comanagement by the Referring Dentist and the Periodontist
Any patient with periodontal inflammation/infection and the following systemic conditions:
- Diabetes
- Pregnancy
- Cardiovascular disease
- Chronic respiratory disease
Any patient who is a candidate for the following therapies who might be exposed to risk from periodontal infection, including but not limited to the following treatments:
- Cancer therapy
- Cardiovascular surgery
- Joint-replacement surgery
- Organ transplantation
FEE GUIDE | |
Periodontal consultation (including radiographs) | £110 |
Non-surgical Periodontal Treatment | from £150 |
Flap Surgery | from £300 |
Frenotomy/Frenectomy | from £120 |
Regeneration treatments | from £550 |
Periodontal plastic surgery procedures | from £350 |
For how to refer click here.