1. History taking
Listen to your patients carefully to pick up the clues that will contribute in making the diagnosis. The British Society of Periodontology (BSP) suggests asking the following questions:
- Do your gums bleed on brushing or overnight?
- Are any of your teeth loose?
- Can you chew everything you want to?
- Do you have a bad taste or smell from your mouth?
- Do you suffer from pain, swelling, gumboils or blisters?
- Do you smoke?
- Is there anything else you would like to tell me?
2. Periodontal probing
The BPE is used to screen patients for periodontal disease. It indicates the level of examination required and provides a basic guidance on treatment need. The asterisk symbol (*) should now be used to denote only the presence of a furcation, and that both the number code and the * should be recorded for each sextant where furcation involvement is found.
Appropriate radiographs are an important part of the clinical records. As a general guide, the BSP suggest that radiographs will be needed for BPE codes 3, 4 or *. Consider horizontal bitewings, vertical bitewings, paralleled periapicals or a dental panoramic.