As previously discussed, evaluation of a patient’s periodontal (gum) health is one of the primary cornerstones of a comprehensive dental exam.

The exam should include measuring and recording of the periodontal heath.

How is this done?

One major aspect of a periodontal exam includes measuring and recording of all the “pocket depths” in a patient teeth. Suffice to say this includes six (6) measurements around each tooth. These readings measure the amount (or loss of) bone around each tooth. The periodontal probe measures from the height of the tissue to the level of the bone. A normal reading would be 2mm with no bleeding. An unhealthy measure would be 4mm or greater with bleeding. Bleeding of the gums at any time means inflammation is present. Not good! Inflammation is what destroys the bone, and the bone is what keeps your teeth stable.

While decay may cause pain and trigger some timely treatment, periodontal disease ( the lay term is Pyorrhea) is very insidious. By the time it causes pain, much damage is done. Essentially, if you lose enough bone around a tooth, it will become mobile.

So….what would be the violation of the standard of care? A provider’s failure to take and record the measurements and to assign a Periodontal Classification to each patient. Periodontal disease doesn’t come on overnight. If one day your dentist says, “you have advanced gum disease,” there is a problem.

How is this avoided? Initial periodontal charting and subsequent charting at all your recall or follow up hygiene appointments. Anything less than this is unacceptable.

Questions or comments always welcome. Next time I will discuss X-rays.

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