Various types of periodontal probes can be used to measure pocket depths. Most clinicians have their own personal preferences in determining which probe to use.
Types of Probes
Most traditional probes are marked with 1-millimeter (mm) increments with the 4 and 6 mm marking absent. Many dental hygiene clinical boards require proficiencies with a probe reading of 1, 2, 3, 5, 7, 8, 9, and 10 mm. Some probes have a black band indicating the 3, 5, 9, and 10-mm markings. Other probes are marked at 3mm. Some clinicians prefer probes that are color coded because they are easier to read.
The Naber’s probe or the Furcation probe is a blunt ended instrument that is used buccally and lingually on the periodontal structure to locate possible furcation involvement.
|Figure 2. Periodontal Probes.|
Periodontal Probing Guidelines
Since periodontal probing is such an important aspect of the periodontal examination, the technique must be systematic and consistent. The operator, when probing, will:
- use a lateral “walking” approach
- use only one brand of probe to achieve standardization
- dictate findings to an assistant or a voice activated software program who will chart data on a form that allows comparison of readings over time
- record six regions around each tooth
- The probe is placed under the contact area between the line angles; making sure it is located at the interproximal area of the tooth
- The shank is rested between the teeth against the contact and the probe is angled under the contact area – always watching the angulation
- Round up to the next highest reading if the numbers on the probe are between one another
- Record the deepest reading in each segment
- Use all three measurements on the buccal and all three measurements on the lingual for accuracy
- Use radiographic images to verify the level of bone and the presence of bone loss
- Forcing the probe can penetrate the periodontal tissues, resulting in inaccurate pocket depths and discomfort for the patient
|Figure 3. Probing an Anterior Tooth.|
|Figure 4. Probing a Posterior Tooth.|
Even though periodontal probing is one of the best diagnostic tools to assess periodontal disease, there are also certain pitfalls to avoid:
- subgingival calculus can interfere with accurate readings
- in an area with elevated inflammation, the attachment is easily perforated
- the pocket may be too tight to probe
- the patient may present with hypersensitivity making accurate probing difficult
Visibility is another extremely important factor in accurate probing. It is important that the probe be clearly visible to obtain accurate results. The use of the air/water syringe and the evacuation system will help keep the probing areas visible.
Bleeding at the gingival margin or sulcus is often the first indicator of gingivitis or periodontitis. Bleeding, pocket depths, and radiographic images are used together to determine the periodontal condition. These measurements are significant for two different types of periodontal disease and their future treatment.