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Explore Perio Charting

Radhalekshmi SS
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Periodontal Charts, also known as Perio Charts, are utilized in dental care to assess the health of the gums by measuring the space between a tooth and the adjacent gum tissue. A dental professional uses a probe to gently insert into the space between the tooth and gums to determine the depth and document any indications of periodontal disease.

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Navigate to Perio Chart

Watch this video for a step-by-step explanation.

  • Select the patient using the Global Search Bar > hover over Clinical > select Perio Chart.

  • You will be directed to the Perio Chart grid of the previous examinations.

  • When the Perio chart loads, if no periodontal exams are recorded, it will display 'No Prior Perio Examination'.

Add Perio Chart

  • Click + Add Chart.

  • Enter the following information on the Add Chart modal:
    • Provider: Select the provider.
    • Location: Select the location where the perio examination is being conducted.
    • Exam Date: Choose the exam date.
Tip: To select a previous date when a perio chart was made, checkmark the Select a previous Date.

  • Click Add.

Note: Users cannot delete a Perio Chart.

Once a new perio-chart gets added.

  • You can either Copy from previous exam or Start on a fresh new Perio Chart.
    • To Copy, checkmark the 'Copy from previous exam' checkbox.

Note: By doing this, you can make changes inside the existing chart and add in the new measurement.

Edit Perio Chart

For completed perio exams, changes can be made only within 24 hours after completion.

To edit the perio-chart, perform the following steps,

  • Click the Edit icon.

  • You can make the changes such as,
    • Edit the Provider and Location.
    • Edit the Values and Conditions.
  • After making the necessary changes,
    • Click Finish.

Recording Perio Values

When a patient visits a practice for a check-up, either a dentist or dental hygienist uses an instrument called a probe and gently inserts it into this space. The measurements taken using this probe will be recorded in the perio chart and could be later used to determine the health of your gums.

  • Enter the values in the panel on the right within the blue-highlighted box.
  • You can also enter the values directly onto the perio chart. 
    • The chart may automatically advance to the next field to expedite the chart completion based on your practice settings.

  • As you enter the values, the perio graph is automatically illustrated based on the values.

  • The Direction of Probing and Depth level can also be set up in the Practice Settings. To know more click here.

perio chart.gif

  • You can quickly select the required tooth by directly clicking on a tooth on the Perio Chart.

  • The Depth levels (in mm) will be displayed on the perio chart with specified colors for visual cues to indicate when these warning, danger, or loss levels are reached.

  • Once you have covered all teeth in the Perio Chart, click Finish.

Note: In cases where a measurement of 10+ is required, press and hold the ALT Key and then type the full number. Similarly, to enter a negative Gingival Margin, press and hold the ALT Key and then type the number.

Mark Conditions on a Tooth

If there is a certain condition for the tooth, you can perform the following steps:

  • To mark any conditions on a tooth:
    • Select the Tooth.
    • Click on any of the listed Conditions on the right.

Print Perio Chart

You may be redirected to the print screen as you click Finish on the Edit Section, or you can manually print the Perio Chart.

  • Click Print icon on the top right.

  • Select the information
  • Click Print.

Elements of Perio Chart

Dive deep with this detailed walkthrough video.

  • The i icon below the clinical summary gives the users an idea about what abbreviations and what Symbols stand for.

Abbreviations for Tooth Parameters Used in Perio Examination

  • Pocket Depth (PD): Pocket Depth is the most important variable for evaluating the health of a pocket. PD is measured in millimetres from the gum line. PD is the most common measurement recorded.
    • PD will display in color on the chart if it meets or exceeds the alert depth specified in the Practice settings.

  • Gingival Margin (GM): The gingival margin, commonly referred to as the 'gum line', is the area of the gingiva closest to the tooth surface.
    • The Gingival Margin (GM) represents the recession of the gum line and is measured from the Cemento-Enamel Junction (CEJ). When the gum line is below the CEJ, GM is assigned a positive value, and when the gum line is above the CEJ, GM is assigned a negative value.

  • Clinical Attachment Level (CAL): CAL is a calculation of Pocket Depth and Gingival Margin: CAL=PD+GM. The CAL rating reflects the overall risk of losing the tooth. The higher the CAL number, the greater the chance of losing the tooth.

  • Mucogingival Junction (MGJ): MGJ is the meeting of the thick, protective gingival tissue around the teeth and the friable mucous lining of the cheeks and lips. MGJ concerns the health of the area where the gum tissue and cheeks meet. MGJ is assigned a value between 0-9.

  • Mobility (MOB): MOB is the amount of mobility a tooth has within its socket, and one of the following ratings is assigned to each tooth. MOB is assigned a value between 0-3.
    • No apparent mobility
    • Grade I: Slightly more than normal (<0.2mm horizontal movement)
    • Grade II: Moderately more than normal (1-2mm horizontal movement)

  • Furcation Grade (FUR): FUR is the amount of tissue destruction in areas on a multi-rooted tooth where the roots diverge. FUR is measured by determining if the gums have receded enough to expose the roots. FUR cannot be measured on anterior teeth because they only have one root.
  • FUR is assigned grade ratings as follows:
    • 1 = Incipient bone loss.
    • 2 = Partial bone loss
    • 3 =Total bone loss with through and through an opening of furcation
    • 4 = Grade 3 with gingival recession exposing the furcation to view.

  • When it comes to BOP and SUP, you can select, and the marking will appear on the chart.
  • Bleeding on Probing (BOP): BOP refers to bleeding that is induced by gentle manipulation of the tissue at the depth of the gingival sulcus or interfaces between the gingiva and a tooth. BOP is a sign of periodontal inflammation and indicates some sort of destruction.

  • Plaque (PL): A sticky film that coats teeth and contains bacteria. Dental plaque or Calculus can damage a tooth and lead to tooth decay or tooth loss. 
    • Select the teeth and enter the value on either FACIAL or LINGUAL section.

  • Suppuration (SUP): The production or discharge of PUS.

Description of Conditions of a Tooth

  • Missing: Marks the tooth as missing
  • Impacted: Marks the tooth as impacted.
  • Hide 3rd molar: Hides the 3rd molar from Maxilla and Mandible region. 
  • Interproximal bleeding: Conversion of bleeding to a non-bleeding state.
  • Bleeding: Marks one tooth is in Bleeding
  • Bleeding All: Marks complete tooth set as Bleeding

You can also check out the Overview of Perio Chart to know more information on how to configure Perio Chart at a system/user level.

Bleeding and Plaque, Numeric Chart, Perio Graph, and Numeric Comparison

Watch this video for a concise summary.

  • Bleeding and Plaque, Numeric Chart, Perio Graph, and Numeric Graph are extensions of Perio Chart.
  • The changes that are made on perio chart will be reflected in these areas.

Bleeding and Plaque

  • Bleeding and Plaque include periodontal factors that impact patients' oral health. To learn more, click here.

Numeric Chart

  • In the Numeric Chart, you will only be able to see the numeric entries made.

Perio Graph

  • The Perio Graph will show you the progression of different values of a patient's tooth condition through a graph that depicts the tooth set.
  • There are five different readings, such as Pocket Depth, Gingival Margin, Clinical Attachment Level, Mucogingival Junction, and Mobility.
  • Select each to read the different states of the tooth.
  • You can set dates for the three exams, and the related chart will show up to compare progress for each value.

Numeric Comparison

  • Numeric Comparison can be used to understand the progression of the patient's treatment, you can compare the value that is given during each examination based on dates and determine if the patient's oral health is improving. 
  • There are five different readings, such as Pocket Depth, Gingival Margin, Clinical Attachment Level, Mucogingival Junction, and Mobility.

Practices can use this resourceful guide to learn and explore the Perio Charting process in CareStack.

 

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