Periodontal Chart

[Yvone Brem]

APeriodontal Chart is also referred to as a gum chart. It is a graphic chart dental professionals use for organizing the information about your gums. Periodontal charting is the best way to uncover the difference between patients that are periodontally healthy and those with periodontal disease.

The initial periodontal examination and probing can be quite traumatic to patients in whom significant periodontal disease is present. Inflamed, swollen soft tissues and teeth with deep periodontal pockets will be extremely sensitive during this examination.

3-5mm with bleeding: Early stages of gum disease, the beginnings of Periodontitis. This may require additional treatment, better home care and three to four visits to the dentist per year.

5-7mm with bleeding: This means soft and hard tissue damage, as well as bone loss. Definitive treatment is required, over several visits, greatly improved home care and many more hygiene visits to prevent tooth loss.

Periodontal charting is an essential aspect of oral health care. Unhealthy teeth and gums can cause pain and severe health complications if left untreated. The qualified staff at Caputo Dental performs regular gum pocket depth measurements to develop a comprehensive periodontal chart to help you maintain the best oral health possible.

Your dentist uses a small probe with markings to measure the pockets around your teeth and between the gums. This distance is used to distinguish the overall health of your gums. For each tooth, six different measurements are recorded.

Healthy gums have a measurement of 1-3 mm. Areas of concern have pocket measurements of 4 mm or more. If there is any sensitivity during probing, this also serves as a red flag. Areas with larger measurements typically have high sensitivity.

The larger the pocket around the tooth, the bigger the concern. More space means more plaque buildup, which could lead to gingivitis. If measurements reach 7 mm, periodontitis may need gum flap surgery to eliminate tartar, plaque, and bacteria to control the infection.

According to the CDC, periodontal disease and tooth decay are the top threats to oral health. Gum disease can be painless and often go unnoticed. Periodontal disease occurs when gingivitis is left untreated.

Once the pockets surrounding the teeth reach 5 mm or larger, the risk for infection increases, leading to advanced cases of periodontitis where the bones pull away from the gums and loosen, risking tooth loss.

The best way to prevent periodontitis is to maintain good oral hygiene, brushing twice a day for two minutes each and flossing daily. Visit your dentist twice per year for an exam and cleaning to keep your periodontal charts updated. Be careful of the foods you eat and reduce your intake of sugary foods to keep your gums healthy.

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All information is for internal use only and is kept confidential.

Florida Probe Corporation has been the industry leader in computerized probing and charting for over 20 years. We are proud of our history, longevity and innovation in this field. The Florida Probe Handpiece (computerized probe) was invented at the University of Florida in 1985 in response to a request by the National Institutes of Health and received FDA approval in 1987. Soon after, a computer program was added to organize and track changes in patients' periodontal health. This was the beginning of the Florida Probe System. read more >

In 2009, we are pleased to announce a major upgrade to our FP32 perio charting software, Version 9, which features E-pad digital signature capture and storage for Patient Diagnosis Sheets/informed consent; Live Chat feature within the actual software; SQL database management and support for our new wireless keypad (part of the GoProbe System).

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Periodontal charting refers to a chart utilized by a dental care professional (periodontist, dentist, registered dental hygienist) to write and record gingival[1] and overall oral conditions relating to oral and periodontal health or disease.

The dental professional with the use of a periodontal probe can measure and record a numerical value for various areas on each tooth. These numbers, often referred to as probe measurements, can be assigned to the depth of the gingival sulcus, the location and depth of root furcations, the size and length of oral pathology, the loss of periodontal fiber, the clinical attachment loss (CAL), alveolar bone loss, and help in assessing and determining a periodontal disease classification associated and classified by the American Academy of Periodontology (AAP).

Dental charting is a process in which your dental healthcare professional lists and describes the health of your teeth and gums. Periodontal charting, which is a part of your dental chart, refers to the six measurements (in millimeters) that are taken around each tooth.

Once your teeth are numbered, your hygienist will examine your teeth. They may probe your gums to check the depths of your gum pockets. Usually six readings per tooth are recorded. This is called periodontal charting. Your hygienist will use an instrument to check the tops of your teeth for decay.

After your charting is complete, your hygienist will usually clean your teeth. Then your dentist will do an examination. If there is anything of concern marked on your chart, your dentist will investigate it more thoroughly.

After a regular checkup and a dental charting, your dentist will tell you what you need to do next. If there are issues of concern, your dentist will recommend things you can do at home, such as regular flossing, or using an electric toothbrush. They will probably also schedule another appointment for any procedures that are needed, like filling a cavity.

Not all dental charting is created equal. Sure, there is the standard set of 32 teeth, and everyone should chart restoratively as well as record pocket depths, but our experience shows that there is a vast difference between how a General Dentist and a Periodontist chart cases.

Dental charting often includes a separate chart for restorative findings and for probing depths. When treatment planning it is vital to readily see both detailed periodontal data and the restorative condition in one view. Since general dentists are mostly concerned about recording data related to the dentition itself, their charts tend to focus on the progression of decay and the status of existing and or planned restorations.

The mental energy it takes to manually calculate things such as attachment levels, not only take up unnecessary mental bandwidth but also limit the judgment and capacity of the entire team. When calculations are already being created as the data is entered, it eliminates the need for your team to guess and or wait for the answers/ results. And it's tidier. Neat!

Flipping pages back and forth comparing data between visits is not only exhausting and confusing, but it also leaves more room for error. Periodontists often evaluate several years in comparison all at one time. PANDA Perio enables you to toggle between up to 5 visits all on one page so that no detail is overlooked. Take a look at how PANDA compares periodontal charting click here.

In summary, the primary reason to use a specialty Periodontal chart as opposed to using a chart for general dentist boils down to bandwidth. Periodontists are usually storing detailed information in their minds and often adapt to doing extra work. Even though Periodontists themselves are trained to tolerate this level of detail manually, there is the danger that they can become so immersed in the details they more easily lose sight of the bigger picture. Studies show that spending much of your resources on details which could be automated, detracts from your bottom line and productivity.

PANDA Perio excels and is superior to other products for the Periodontal practice because it was designed by Periodontists. Our co-founders spent years negotiating various options until they concluded that it had to be very comprehensive in the way data is collected, and somewhat flexible and customizable to address their individual needs since this can vary significantly between each provider. It's so customizable that there are already fields to record and track potential COVID-19 cases.

Question: What is the standard of care for new and existing patients with regard to periodontal screening and recording (PSR) versus full comprehensive periodontal charting? Also, where can I find the documentation for the standard? I have always thought that the standard is documented six-point periodontal charting, including recession, furcation, and mobility at least one time a year for existing patients and for all new patients.

These ideas do not thoroughly define the standard of care. Actually, the standard of care refers more to a set of expectations, specifically that the dentist or dental hygienist will use a degree of care and skill that is expected of a reasonably competent clinician acting in the same or similar circumstances.1,2

State boards of dentistry exist to protect the public from substandard care. They are mandated to investigate claims made by the public regarding care issues involving the standards of care of dentistry and dental hygiene.

PSR was originally developed as a way to expedite the screening process of periodontal health to indicate when a comprehensive periodontal exam is needed. As such, PSR was never intended to take the place of a comprehensive periodontal assessment. It is merely a screening protocol. When I taught in a dental hygiene program, we used PSR to determine periodontal severity level in order to help us decide if the patient should be seen by a freshman or senior student.

Once, in an office where I was consulting, I conducted a chart audit of 30 adults who had been in for preventive care in the past year. Of the 30 charts, only two had a current periodontal charting. Five patients had no periodontal charting at all. This is not unusual. The reason the hygienists were not conducting chartings is that they did not have the necessary time or help with recording. Dentists/employers should identify the barriers to charting and implement a solution so regular periodontal charting/recording is the standard in an office (i.e., once per year for all adult patients). My mantra to dental hygienists is to always have their periodontal radar engaged. They should always be looking for periodontitis.

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