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Digital Probing and Charting for Periodontal Pocket Measurement

Periodontal probing and charting are essential components of a thorough dental examination. The depth and number of periodontal pockets represent a history of periodontal disease. Identification and assessment of periodontal pockets are critical for an accurate diagnosis of periodontal disease. A traditional periodontal probe is inserted into the periodontal pocket parallel to the root surface until resistance is achieved at the base of the tissue attachment. A measurement of the periodontal pocket is performed by using markings on the periodontal probe and a landmark such as the gingival margin or the cementoenamel junction (CEJ). There are variables, however, that can affect the reading of the probe including examiner skills, pressure applied, and the condition of the sulcular tissue. Interexaminer calibration is necessary to guarantee accurate readings of periodontal pockets.1 

Recent advances in the improvement of automated periodontal probing techniques are helping to standardize the measurements of periodontal pockets. An automated probing device can be used to measure and record the periodontal sulcus or pocket, ensuring rapid, accurate, periodontal measurements. Such technologies may eliminate the need to visually read, manually record, or verbally call out probing measurements and assist in the effort to standardize measurements among practitioners. 

The practitioner operates the probe by gently probing around each tooth. A foot pedal is utilized in conjunction with the handpiece to select from a list of data to be entered or to undo previous entries or errors. Measurements are recorded automatically on a computerized graphic chart. The system can record pocket depth, bleeding, suppuration, recession, hyperplasia, furcation, plaque, mobility, missing teeth, minimal/no attached gingiva, risk factors, and medical alerts.  

A primary benefit to the use of an automated system is the time-saving element to record a periodontal chart. Recording pocket depth readings is faster than conventional methods. Periodontal charting can be expected to be entered from 5 to 15 minutes depending on the extent of the examination. This time savings enables dental assistants to accomplish additional patient- or office-related tasks.  

Electronic charting can save a dental office time and money by recording directly to a chart. Periodontal charts may also be e-mailed promptly to insurance companies and other providers. Dental offices that currently utilize dental software programs can integrate an electronic periodontal probe into existing dental software programs. In addition, this can be easily connected to a computer via its USB port and cable. 

A digital-based approach to periodontal probing and charting also enables the practitioner to conduct patient education simultaneously with the examination. Additionally, the diagnosis may be printed and distributed to the patient. Comments on the handout regarding diagnosis may be included as well as estimated treatment appointments, follow-up appointments, treatment recommendations, and home care instructions. Finally, the handout provides a patient signature line for an opportunity to obtain informed consent from the patient.  

Current and precise periodontal charts are critical for dental practitioners to document and provide an accurate diagnosis of a patient’s periodontal condition. A common lawsuit in dentistry today is related to insufficient documentation regarding periodontal diagnosis and treatments.2 

 

Conclusion  

Identification and assessment of periodontal pockets are critical for an accurate diagnosis of periodontal disease. Advancements in electronic charting technology enable the accurate recording of periodontal pocket measurements and standardization of these measurements among practitioners. 

 

*Assistant professor, Dr. Madeleine Haggerty Dental Hygiene Program, Youngstown State University, Youngstown, Ohio.  

 

References  

  1. Buduneli E, Aksoy O, Kose T, Atilla G. Accuracy and reproducibility of two manual periodontal probes. An in vitro study. J Clin Periodontol 2004;31(10):815-819.  
  2. Palat M. The patient’s periodontal record. Its legal Implications. J Dent Pract Adm 1990;7(1):16-22.  
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