According to the ODQ, more than 50% of individuals over 30 years old are affected by the periodontal disease. In order to allow the dentists to diagnose the periodontal disease, the PSR must be done to adequately detect the periodontium and maintain it.
The PSR (periodontal screening and recording) is used for a quick detection, allowing treatments that are less invasive and less costly. It will lead to the periodontal exam.
The dental hygienist practices probing of each sextant to detect periodontal problems.
Many periodontal probes exist to detect diseases. The most common one is the CP-11.5B Screening Probe, recognized for easy usage by being able to read fast. Therefore, regardless of the probes used, the method must be standardized.
For example, it is primordial to probe directly in the furcation of each molar.
- Each tooth must be probed 6 times to ensure proper screening.
- The highest measure per sextant determines the PSR code.
- The probing force used should not exceed 25 g. of pressure.
It is necessary to remove a good portion of tartar in order to obtain accurate measurements.
To request the patient to a complete periodontal examination, the PSR code of 3 must be noted in at least two sextants or a PSR code of 4 in one or more sextants.
However, to request a localized periodontal examination, one sextant must have a PSR code of 3 or be noted with a *.
Here are examples of problems found when there is presence of localized periodontal disease.
- Defective filling
- Extensive cavity
- Endo-Perio
- Endodontic lesion
- Radicular fracture
- Cracked tooth
- Enamel loss
- Natural roughness of the tooth
- Occlusal vertical trauma (TfO, Trauma from Occlusion)
- Root proximity
Note that what will be observed in the mouth is usually worse than reality. Always keep this vision in mind. It goes the same when analyzing x-rays.
The diagnosis will be given by the dentist once the visual and radiological examinations are completed.
|
PSR Code |
Description | Therapeutical suggestions | Possible diagnosis |
| 0 | No tartar nor flawed marginal finish, no bleeding during probing, no clinical signs | Preventive maintenance | Healthy periodontium |
| 1 | No tartar nor flawed marginal finish, bleeding during probing | Dental hygiene Instructions, follow-up plan | Gingivitis, gingivitis on reduced periodontium |
| 2 | < 3.5 mm during probing, supra or subgingival tartar and/or flawed marginal finish | Dental hygiene Instructions, follow-up plan | Gingivitis, gingivitis on reduced periodontium |
| 3 | < 4 à 5.5 mm during probing | One code of 3 : proceed with a detailed periodontal examination of that sextant; two code 3 : proceed with a completed periodontal examination, take necessary X-rays | Localized or generalized, juvenile or moderate chronic periodontitis |
| 4 | >6 mm during probing | Proceed with a detailed periodontal examination of the complete mouth and take X-rays | Localized or generalized severe chronic periodontitis |
| * | Presence of periodontal abnormalities: furcation defect, teeth mobility, mucogingival problems, ≥3.5 mm of recession | Proceed with a detailed periodontal examination of the sextant and take X-rays | Trauma from occlusion, missing attached gum, aberrant frenum, problematic gingival recession |
| x | Sextant with less than 2 teeth |
Beyond all required data, it is important to know how to communicate well to our patient about his periodontal condition. We can therefore explain properly the interaction between the bacteria and the immune system.
And so, the PSR, which leads to the periodontal examination, will allow the diagnosis of the periodontal disease.
Best regards,
Sylvie Proulx, Paroconseil