Periodontal Charting – It’s Not Just Pocket Depth
When we talk about periodontal charting we think pocket depth. Pocket depth is an important part of the periodontal exam but it’s obviously not everything. In fact, as a stand alone diagnostic, it’s almost meaningless. Why do I say this? Because pocket depth is relative. We talk pocket depth but what we really mean to get at is loss of attachment. If the gingival margin is at the CEJ and we measure a 6mm pocket we are faced with about 6mm of attachment loss. If we measure a 6mm pocket in the presence of 6mm of recession we have 12mm of attachment loss. Same pocket depth but a much more advanced problem to deal with.
In order to get an accurate assessment of a patient’s periodontal status we need to know the pocket depth and the degree of recession. Usually we chart both. We also chart furcation involvement and mobility. We also look at many other factors such as the quality of calculus, degree of inflammation and so on.
My point is, there is a lot of effort that goes into periodontal charting and, frankly, there’s not much of it that I get a kick out of doing. So, I simplify when I can. One thing I do, or I should say one thing I don’t do is chart recession. I take intra-oral photographs. Good intra-oral photographs along with pocket measurements give me the information I need. Not only does it simplify charting I find it a more accurate assessment!