What Is Full Periodontal Charting?

 

Periodontal charting is a routine part of your dental health. Maintaining these periodontal records helps your dentist to track the progression and treatment of gum disease. Gum disease in its earliest form can be reversible. However, once it progresses, bone loss and gum recession will occur.

Periodontal screening monitors your gum and bone health by measuring the spaces between your teeth and the surrounding gum and bone tissue. This information is essential because it can provide information on the overall health of your teeth, gums, and jaws.

How Is Periodontal Charting Performed?

Periodontal charting is the process of measuring periodontal pockets. This pocketing is the space between a tooth and the bone and gum tissue surrounding it. Your dentist or dental hygienist uses a specialized dental instrument known as a periodontal probe and will gently insert it into this space along with your teeth. This specialized probe has measurement markings that indicate how deep it can reach into this space to check the overall health of your bone and gums.

Typically, your dental hygienist will take six measurements surrounding every tooth to ensure that your entire smile is reviewed. The dentist will record these measurements and also check for bleeding and areas of gum tissue recession.

Healthy gum and bone tissue typically have pocketing measuring 1-3 millimeters and generally fit snugly around your tooth. Measurements exceeding 4 millimeters and deeper are a cause for concern since plaque and bacteria could be causing the tissue to become inflamed and pull away from the tooth. Areas of the mouth with readings over 4 millimeters are also often more sensitive to periodontal probing.

In areas of advanced gum disease, probing depths can reach as high as 12 millimeters. These areas with increased probing depths are known as periodontal pockets and are generally extremely difficult to keep clean at home. A periodontal chart helps your dentist organize the information about your gum tissue and diagnose and treat the progression of gum disease and gum recession.

What Questions Will Your Dentist Ask?

Along with periodontal charting, your dentist will also ask you a series of questions to better understand your periodontal health. They will ask if you are experiencing any ongoing dental issues like bleeding or discomfort when eating and chewing.

Other common questions can include:

• Are you flossing regularly? If yes, how often?
• Are you brushing regularly?
• Do you use an antibacterial mouthwash to freshen your breath?

The Meaning Of Periodontal Charting

Periodontal charting is a very thorough, methodical process and can significantly improve your chances of maintaining your smile for the long term. Pocket depths indicate how healthy your bone and gum tissue is.

 The typical range of periodontal pocket measurements include:

• 0-3mm without bleeding: Perfect! It means that there are no periodontal health issues present, and you are doing great maintaining good dental hygiene!
• 1-3mm with bleeding: Earliest signs of gingivitis. You will need to improve your at-home dental hygiene and possibly increase the frequency of professional cleanings to maintain your oral health.
• 3-5mm with no bleeding: This level of probing is an indication that there is a potential for periodontal disease. Routine professional dental cleanings cannot reach below 3-4mm, so you will probably need a scaling and root planing visit to improve your periodontal health.
• 3-5mm with bleeding: This is a more advanced stage of gum disease (periodontitis). This will require additional treatment, improved at-home care, and increased scaling and root planing visits every year.
• 5-7mm with bleeding: This is a sign of gum and bone tissue damage. Definitive treatment will be required over multiple visits. At-home care becomes even more critical to stop the progression of periodontal disease. At this point, you will be asked to return every 2-3 months for professional cleanings and to monitor periodontal oral health.
• 7mm and above with bleeding: You are now in an advanced stage of gum disease and will require aggressive treatment. Your dentist might recommend surgery to restore gingival tissue recession and bone loss. You will also need periodontal maintenance frequently to encourage the stopping of disease progression. This is when tooth loss becomes a real possibility.

If any areas of concern are discovered, your dentist will discuss them with you as part of the routine evaluation process. 

Periodontal Chart Oral Health Benefits

Because the earliest forms of periodontal disease are often painless, it is easy to overlook the signs and symptoms. During your routine examination, your dentist will carefully examine for the early signs of periodontal disease. If signs and symptoms are present, they will develop a preventive treatment plan and monitor your oral health going forward. Simple treatment steps will include a regular dental hygiene routine and maintaining regular dental check-ups. These can help prevent the further progression of gum disease.

If your dentist notices signs of more advanced gum disease such as red or inflamed gums, gingival recession, or measurements beyond 4 millimeters during periodontal probing. In this scenario, they will recommend periodontal treatment to address the issue before the infection progresses further.

Periodontal charting will also give your dentist a good idea of your dental hygiene regimen at home. 

Who Should Have Their Periodontal Charting Checked?

If you are experiencing discomfort or bleeding during chewing or brushing, it is vital to set up a dental appointment right away. These symptoms can be early signs of gum disease.

Other common disease symptoms include:

• Red or inflamed gum tissues
• Bleeding upon brushing and flossing
• Persistent chronic bad breath

Periodontal charting is an essential record of your dental care and should occur at least 2x a year. The optimal schedule for dental appointments is every six months. However, your dentist may recommend more frequent visits if they notice signs of advancing gingival disease.

Gum Disease Progression

Gingivitis

This is the earliest stage of gum disease and the only one that is reversible. Gingivitis is defined as the inflammation of the periodontal tissues surrounding the teeth. Signs of Gingivitis will include red, swollen gingival tissues and bleeding gums upon brushing, flossing, or even just chewing foods. Often these symptoms go unnoticed.

Early symptoms include:

• Chronic bad breath.
• Swelling and redness of the gums.
• Bleeding upon brushing or flossing, or eating.

Gingivitis is commonly found during puberty, pregnancy, menopause, and times of high stress. Poor dental hygiene is generally the most common cause of gingivitis, followed by medications and certain systemic medical conditions (diabetes). The goal of treatment is to restore healthy gum tissue.

Periodontitis 

The next phase is early periodontitis. In early periodontitis, the bone and gum tissues surrounding the teeth are both being affected. The bacteria will infiltrate between the tooth and gums, causing connective fiber separation.

The result is a periodontal pocket. Damage to the bone will begin to occur below the gum line. Following an at-home dental hygiene regimen will no longer be the only answer to bringing your oral tissues back to health.

Periodontitis signs include the following:

• Increased redness or swelling of the gums 
• Chronic bad breath
• Bleeding upon brushing or flossing
• Pocket depths between four and five millimeters

Advanced Periodontitis 

This is where the actual tissue destruction occurs. A minimum of 50% of bone support is lost. Teeth will begin to become mobile and shift. Scaling and root planings and possibly periodontal surgery interventions are necessary to salvage your smile. 

Periodontal Disease Conclusion

Periodontal charting recording is an integral part of preventive dental care. This charting will help your dentist monitor your bone and gum health and treat any changes that occur. The goal is to maintain overall oral health to keep you smiling for a lifetime!