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In: Horner K, Eaton KA (eds). : Faculty of General Dental Practice (UK); 2013
Adult patients are increasingly interested in having orthodontic treatment but many of these patients have periodontal problems. A periodontal examination should involve a basic periodontal examination (BPE) as well as the identification of any mobility, recession and gingival overgrowth. Each BPE code indicates different investigations and treatment. The cause of any mobility, recession and gingival overgrowth needs to be identified and then treated appropriately. Periodontal treatment may involve input from the patient's general dental practitioner or, if more complex treatment is required, referral to a specialist. Any periodontal problems identified should be addressed prior to orthodontic treatment.
CPD/Clinical Relevance: This article details how to carry out a periodontal examination and considers the implications of the findings on the provision of adult orthodontic treatment.
Article
Periodontitis is ‘a chronic inflammatory disease of bacterial aetiology that affects the supporting tissues around the teeth’.1 The Adult Dental Health Survey 2009 classified 17% of dentate adults as having very good periodontal health,2 but this indicates that a large percentage of the UK population experiences some level of periodontal disease. Amongst other things, periodontal disease can result in recession, drifting, mobility, compromised aesthetics and tooth loss. Because of these changes, patients with current or previous periodontal disease may request orthodontic treatment. As part of an orthodontic assessment it is important to assess patients' periodontal status as it may impact on their orthodontic treatment. The aim of this paper is to describe how a periodontal examination should be carried out in adults and the implications of the results of the examination.
The basic periodontal examination (BPE) is the screening tool for assessing periodontal health. It should be performed on all dentate adult patients as part of the initial examination. To carry out a BPE, the mouth is divided into sextants and, for each sextant, the highest score is recorded. Third molars are only included in the assessment if at least one of the first and second molars is missing. A score is only recorded if a sextant has more than one tooth present. The BPE should not be used around dental implants.1,3
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