Hi everyone, I'm Prateek, a dentist and specialty doctor and in this video we're going to be looking at the Basic Periodontal Examination and why we do it. If you want
to see more educational videos like this then please make sure to subscribe to this channel.
So what is the basic periodontal examination or the BPE? The BPE is a simple and effective way
of carrying out periodontal screening on most of our patients. It's not a method of diagnosing but
is a method of screening them so that we can provide them with the appropriate periodontal
management that they may require. It's simple, it's quick and it's highly effective. So which
instrument do we use to carry out a BPE? We use the World Health Organisation, or WHO, probe which has
several markings in order to help us carry out a BPE. On the end there is a 0.5 millimetre diameter
ball-end. There are then two black bands on this probe - one running from 3.5 millimetres to 5.5
millimetres and then the other running from 8.5 millimetres to 11.5 millimetres. In order to check
the BPE for patients we divide the mouth into sextants. We have upper right 7 to upper right 4,
upper right three to upper left three, upper left four to upper left seven. And then the lower arch we
have lower left seven to lower left four, lower left three to lower right three and lower right four
to lower right seven. In adults we assess all teeth within each sextant apart from third molar
teeth, unless the first or second molars are missing and in order for a sextant to qualify
there should be at least two teeth within that sextant - if there's only a single tooth then this
can be joined into the adjacent sextant and you just put an X for the original sextant. In order
to measure the BPE, the probe is walked around the teeth at all sites and a force of around 20
to 25 grams should be used. This is essentially enough to make the skin blanch underneath your
nail. As the probe is being walked, the worst BPE should be recorded for that sextant. In children,
all six sextants are assessed, however we use six index teeth in order to do this. We have the upper
right six, upper right one, upper left six, lower left six, lower left one and lower right six. In
terms of recording the BPE, we have several scores that we can use and these scores help us direct
periodontal management for our patients. So in adults, we have score 0 which essentially
means there is no pocketing, there is no bleeding and there are no plaque retentive features - so
this is a relatively healthy dentition. We have a score of one and this usually indicates some
bleeding upon probing but still no pocketing or other plaque retentive features. So a score of
two indicates that there isn't any pocketing, however there are plaque retentive features
such as overhanging restorations or calculus. Now in the scores of zero, one and two as there
is no pocketing evident, the black band of the BPE probe would be fully visible - that first black band
between 3.5 and 5.5 millimetres. Then we move on to a BPE score of three. Now the BPE score of three
we have pocketing between 3.5mm to 5.5mm i.e the first black band
of the BPE probe is going to be partially visible. There may or may not be bleeding along with this
and then a BPE score of four would indicate pocketing greater than 5.5mm
and this would mean on the BPE probe you would not be able to see any of the black band. We can also
use a star to indicate furcation involvement and this can be done alongside the other BPE numbers -
this is why even though you may find a BPE of 4 quite early on in sextant, it's still useful
to check the other teeth to ensure there is no furcation involvement. In terms of recording the BPE
for children, we usually start at the age of 7. And from the ages of 7 to 11, we only use a simplified
BPE scoring system of zero, one and two and this is to account for any false pocketing that they may
have. From 12 and above, we use the full range of BPE numbers. So like I said, the reason we carry out
the BPE is to help us direct effective management in terms of periodontal health for our patient.
So if we look at the scoring systems - a score of zero, you typically just want to motivate the
patient and encourage the oral hygiene regime they already have. With a score of one, where we have some
bleeding upon probing, you may want to just make some tweaks to the oral hygiene regime that the
patient has at home to try and improve things a little bit more. With a BPE score of 2, along
with oral hygiene advice, we should be looking to correct any plaque retentive features so whether
that's scaling of any calculus or adjusting restorations. Now under the new classification,
with a BPE score of 3, if this is the first time a patient has recorded a BPE score of three,
we would carry out initial therapy so correction of plaque protective features oral hygiene advice
and review them in three months. If the score still persists in three months, then we would treat them
as though they have periodontal disease and we would carry out a full periodontal assessment. With
a BPE of four we would assume that they do have some degree of periodontal disease and we would go
straight to a full periodontal assessment. So there we've looked at what the BPE is and why we use
it and the way it helps direct our treatment. My recommendation in this video is an Instagram account
called the_toothy_diaries and this is an Instagram account run by a dental student at the University
of Sheffield called Megan. Megan's Instagram account is an excellent learning resource
with plenty of quizzes and questions being put on her stories - make sure to check her account
out. I hope you found this video useful - please make sure to like, comment and subscribe and let
me know of any other topics that you would like me to cover. Until the next video - take care!