A periodontal examination is a

clinical examination In a physical examination, medical examination, or clinical examination, a medical practitioner examines a patient for any possible medical signs or symptoms of a medical condition. It generally consists of a series of questions about the patient ...

of the

periodontium The periodontium is the specialized tissues that both surround and support the teeth, maintaining them in the maxillary and mandibular bones. The word comes from the Greek terms περί ''peri''-, meaning "around" and -''odont'', meaning "tooth". ...

(gums). It is routinely carried out in

dentistry Dentistry, also known as dental medicine and oral medicine, is the branch of medicine focused on the teeth, gums, and mouth. It consists of the study, diagnosis, prevention, management, and treatment of diseases, disorders, and conditions o ...

and allied specialties. Many different techniques are used around the world. A report by

World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...

in 1978 led to the creation of the Community Periodontal Index of Treatment Needs (CPITN) and a

periodontal probe A periodontal probe is an instrument in dentistry commonly used in the dental armamentarium. It is usually long, thin, and blunted at the end. The primary purpose of a periodontal probe is to measure pocket depths around a tooth in order to establ ...

termed WHO 621 ("Trintity"). It has a ball end of diameter 0.5 mm and a first colored band at 3.5 - 5.5 mm. Another colored band at 8.5 - 11.5 mm may be present. The CPITN was intended to provide a global standard for clinical practise and research, but several different periodontal screening tools were adapted from it. The Periodontal Screening and Recording (PSR) is increasingly used in the United States, Canada and Brazil. The Basic Periodontal Examination (BPE) is extensively used in the United Kingdom and New Zealand. The Primary Essential Periodontal Examination (PEPE) is used in Australia. All these methods use the WHO 621 probe.

Basic Periodontal Examination

This is the technique recommended by the

British Society of Periodontology The British Society of Periodontology is a society of periodontologists (i.e. Dental Care Professionalss who specialize in treating gum diseases) in the United Kingdom. It was founded in 1949 and its aim is to "promote the art and science of period ...

since its introduction in 1986. It is a screening tool which is used to quickly obtain a rough picture of the periodontal condition and treatment needs of an individual, but it does not provide an exact periodontal diagnosis.BASIC PERIODONTAL EXAMINATION (BPE)
British Society of Periodontology, 2011 For the purposes of a BPE, all the teeth in a person's mouth are divided into sextants (i.e. 6 parts), namely the upper right second molar to the upper right first premolar, the upper right canine to the upper left canine, the upper left first premolar to the upper left second molar, the lower right second molar to the lower right first premolar, lower right canine to the lower left canine, and the lower left first premolar to the lower left second molar.

Wisdom teeth A third molar, commonly called wisdom tooth, is one of the three molars per quadrant of the human dentition. It is the most posterior of the three. The age at which wisdom teeth come through ( erupt) is variable, but this generally occurs betwe ...

are not included because

pericoronitis Pericoronitis is inflammation of the soft tissues surrounding the crown of a partially erupted tooth, including the gingiva (gums) and the dental follicle. The soft tissue covering a partially erupted tooth is known as an ''operculum'', an area ...

and

tooth impaction An impacted tooth is one that fails to erupt into the dental arch within the expected developmental window. Because impacted teeth do not erupt, they are retained throughout the individual's lifetime unless extracted or exposed surgically. Tee ...

may cause isolated periodontal defects which do not represent the general periodontal condition of the rest of the mouth. At least 2 teeth must be present in a sextant for it to be scored. If only 1 tooth is present in a sextant, the tooth is included in the adjoining sextant. The probe is "walked around" measuring the depth of the gingival crevices/periodontal pockets (the gap between the tooth and the gums, "below the gumline") with a force of approximately 20 - 25 gm (20 - 25 N) (about the force using when writing with a pencil). The worst finding in a sextant dictates the sextant's BPE score. The BPE is usually recorded in a table of six boxes (see diagram). The scoring is as follows:

CPITN Index

PSR Index

The PSR (Periodontal Screening and Recording) system was first introduced to the United States in 1992. It is based on the CPITN index.

Spanish Periodontal Examination

In teeth 16, 11, 25, 32, 36 and 45, the following is assessed: • Probing depth (PS - profundidad de sondaje) • Bleeding on probing (BOP: +/-) • Loss of attachment with bitewings (Horizontal bone loss/ Vertical defects) (If said teeth are absent, the immediately adjacent teeth are taken as a reference or failing that, whichever is closest clinically affected.)

References

{{periodontology Periodontology