Periodontics
Diagnosis and staging
Periodontal questions require you to integrate clinical attachment loss, probing depth, bleeding on probing, radiographic bone loss, and risk factors. Know the distinction between gingivitis and periodontitis, and between plaque-induced and non-plaque-induced disease. Understand the role of systemic factors such as diabetes and smoking, and the concept of risk-based staging and grading. Recognize that mobility and furcation involvement alter prognosis and treatment choice.
Traps in question stems
A frequent trap is treating a deep pocket as automatically requiring surgery when nonsurgical therapy and reassessment come first. Another is confusing pseudopockets from gingival enlargement with true attachment loss. Questions may test whether antibiotics are indicated: they are adjunctive, not a substitute for mechanical debridement, and are reserved for specific situations. Watch for questions about when to refer and when to extract a hopeless tooth.
Rule of thumb
Use the "re-evaluate before escalating" rule: complete nonsurgical therapy, reassess at 6-8 weeks, and only then decide on surgery or referral. If bleeding on probing persists at re-evaluation, the patient is not yet stable.
Worked example
A smoker with generalized 6 mm pockets and 4 mm attachment loss. The best initial management is nonsurgical debridement plus smoking cessation counseling, then reassessment. Jumping to flap surgery or antibiotics before reassessment is the classic wrong answer.