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How do you explain Perio Probing to the patient?

I am wondering how you explain Perio Probing to the patient? I want to make sure they understand what I am doing and why I am doing it…any suggestions? I usually just start by saying that I am join got be taking some measurements between the tooth and the tissue to check for bone and tissue health. I explain that we do it once per year and I explain that we like to see numbers between 1-3. I’m just unsure what to say about numbers higher than that. I usually tell them if I get a measurement of a 4 that the tissue is slightly inflamed, measurements above that indicate that we are loosing some support. What do you guys think?



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8 Answers

I’m going to check your mouth for periodontal disease/gum disease. I take a mm measurement ruler between the teeth and gums. 3.2.1 is healthy. Any measurement from 4 to 12mm means you have some form of gum disease and will need a different type of cleaning instead of a Healthy Adult Cleaning. Periodontal/gum disease affects the bone, gums and supporting structures. I also take recession measurements where the gums may be receded. Zero is perfect. Etc…..

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I thnk what you are telling the patient should be adequate enough. One thing I like to day is that 1,2, and 3 are all EQUALLY healthy. I had one pt very concerned at the end of the probing because she heard a lot of 3s!

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We just got a great poster from the fine folks who make Arestin which shows the probe in a pocket and lists the pocket depths. I find it very helpful as they can see what I am talking about.

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I like to tell my pt’s as I start probing, “First I’m going to check the health of your gums. 1-3mm without bleeding indicates health. Any areas with deeper pockets may indicates periodontal disease, which would require a different type of cleaning. The deeper the pocket, the worse the disease is.” Depending on pt I show them the probe and go into deeper perio discussion depending on their condition. My recare pt’s usually know the routine.

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The first time I see a patient I show them the picture of the progression of perio disease. I explain to them 1’s and 2’s are good 3’s are okay with no bleeding explaining gingivitis. 4-5’s with bleeding bone loss etc, (I point to the next picture) and continue to explain the progression, Let them know higher numbers mean the support system of the tooth has been compromised and will need to be addressed. They are now tuned into the numbers I call off and when there is a 4 or 5 they already know where they are at. Regular patients to our office they have been doing it for a while, I just state almost exactly what you do then let them know last time numbers were good and I am not anticipating worse OR I tell them last time we were concerned with this and we will reevaluate…

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I tell the patient that I am going to measure down between the gums and the tooth to find the attachment point where the gums attach to the tooth. This helps us see how easy or difficult it is for the patient to keep their teeth clean all the way to the attachment. I let them know that we look for numbers between 1-3mm because you can floss down to 3mm, but not past. So 4mm and above the patient leaves gunk down there that requires additional cleanings to remove. I also explain that after we’ve done those deeper cleanings that the gums can reattach to the clean tooth surface. I do explain as well about perio disease and gingivitis, but i disagree with RDHMares that 3mm is gingivitis- it’s only gingivitis if it’s inflamed or bleeding… Also as you go more posterior the attachment points naturally are further down, so you will have healthy 3’s in the back.

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First I explain about WHERE I am measuring, I use the analogy of the location where the popcorn kernel “gets stuck” I tell them that that area measures about 3 mm or less and show a probe, pointing to 3mm. I then explain about the measurements in their mouth and my findings as it relates to their oral health. Keeping explanations that the patient can relate to is key. I generally use a dental term followed by an explanation or a lay term. Do not talk down just explain and as for feedback in understanding.

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I explain to the patient that periodontal disease is episodic and that once a year the dentist likes for us to do periodontal charting to see if there are any signs or symptoms of periodontal disease. I ask the patient to imagine that each tooth has a turtle neck and that by measuring the depths of the turtle necks we can determine if their bone and gums are healthy. I also tell them that we record bleeding points because healthy gums don’t bleed along and record recession, furcation and mobility. After I collect my data I show them a picture of the different stages of periodontal disease and what stage they are at. I then demonstrate to them in their mouth the proper way to floss by showing them how the floss needs to disappear in the turtle neck to remove the bacteria that causes gum disease. Then I discuss treatment of periodontal disease if needed.

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