The Periodontal Probe
Presented by:
Mellissa Boyd, RDH, BSDH
Calibrated Probe
• Assessment
instrument
• Determine health
of periodontal
tissues
Working-End
•
•
•
•
•
Blunt
Rod-shaped
Millimeter markings
Color coded
Cross-section
– Round
– Rectangular
Purpose
A
B
C
• Measurement
– Sulcus/pocket depths
– Width of attached
gingiva
– Bleeding
– Exudate
– Oral lesions
– Furcations
E
D
Sulcus vs. Pocket
• Sulcus
– Space between free
gingiva and tooth
– 1-3mm
• Pocket
– Sulcus deepened
because of disease
– 4mm+
– Gingival vs.
periodontal
Probing Depth
• Entire sulcus probed
• Six sites per tooth
– 3 buccal
– 3 lingual
• Record deepest reading
per site
• Depth rounded up to
nearest mm
Basic Technique
• Insert tip to JE, feel slight
resistance
• Gentle walking strokes
– 10 – 20 grams pressure
– Digital motion
– Close together
• 1-2 mm
• Not out of sulcus
Probe Position ‐ Healthy Tissue
Sulcus
• Space between free
gingiva and tooth
• Healthy sulcus =
1 to 3 mm
• Probe tip touches
tooth near the CEJ
Probe Position – Diseased Tissue
Pocket
• Sulcus deepened
because of disease
• 4mm+
• Bleeding
• Probe tip touches root
at point apical of CEJ
Comparison Measurement
Marquis Probe (3‐6‐9‐12)
Healthy Sulcus
Probing Depth?
Diseased Pocket
Probing Depth?
Need CPE to get the full story
Measurements Recorded
• 6 sites per tooth
• Record deepest reading
Insertion of Probe Tip
• Keep side of tip against
tooth surface
– Tip = 1-2mm of probe
• Observe enamel contour
near CEJ
• Tip parallel to tooth
surface, keep constant
contact with tooth surface
Incorrect Insertion
• Probe tip should NOT
be held away from
tooth
• Inaccurate
measurement
• PAIN
Adaptation
Parallel to long axis of tooth
Inaccurate measurement
Probe Walking Stroke
• Gently insert to base of
sulcus
• Walking Stroke
– Series of light bobbing
strokes
– Made within
sulcus/pocket while
keeping side of probe tip
against tooth surface
Maxillary Posterior Technique
– Extraoral fulcrum
– Begin at DB line angle
of maxillary right most
posterior tooth (1, 2,
etc)
• Insert & walk probe
into distal “area”
• Record deepest
measurement from DB
line angle to D of tooth
Walk all the
way to the
direct Distal
Maxillary Posterior Technique
• Remove and reinsert probe
@ DB line angle
• Walk probe across B surface
• Walk probe around MB line
angle and touch M contact
• Slant probe under contact
(col)
• Take measurement under M
contact in col area
Maxillary Anterior Technique
• NOTE:
– When you reach midline, walking sequence will reverse
for max L quadrant …starting @ #9 you will walk probe
from MF line angle into M
– Touch contact and slant probe very slightly to access col
reading (anterior teeth are thinner so don’t over tilt)
– Remove & reinsert at MF line angle, probe across M
around DF line angle (continue sequence for max L quad)
– Probe Lingual surfaces from #15, 16, etc. back across arch
Max vs. Mand – who wins?
Mandibular Technique
• Posterior
– Begin at DB line angle of mandibular right most posterior tooth
(32, 31, etc)
• Anterior
– At midline walking sequence will reverse for mand L quadrant
starting @ #24 you will walk probe from MF line angle into M
– Touch contact and slant probe very slightly to access col
reading (anterior teeth are thinner so don’t over tilt)
– Remove & reinsert at MF line angle, probe across M around DF
line angle (continue sequence for mand L quad)
– Probe Lingual surfaces from #17, 18, etc. back across arch
Furcation Involvement
• Bone loss in area of furcation
• Result of periodontal disease
• Furcation probe or
periodontal probe
• Access
– Mandibular molars
– Maxillary molars
– Maxillary 1st premolar
Oral Lesions or Deviations
• Document with
measurement
• Use anatomical references
– anterior-posterior (front
to back)
– superior-inferior (top to
bottom)
Mucogingival Examination
• Attached Gingiva
– Area from base of sulcus
to mucogingival junction
(MGJ)
– Attached to the
cementum of tooth and
alveolar bone by
collagenous fibers
Mucogingival Examination
• Alveolar mucosa
– located apical to the
MGJ
– deeper red color than
attached
– Shiny and loosely
attached to underlying
bone
• MG defect
– Recession near MGJ or
into alveolar mucosa
Clinical Attachment Level
•
Measurement from the CEJ to
JE
•
Most accurate measure of
attachment loss
•
Three possible relationships:
1.
2.
3.
GM apical to CEJ
(recession)
GM coronal to CEJ
(hyperplasia)
GM level with CEJ
Accuracy of Measurement
Affected by:
• Size & design of probe
• Technique
• Tissue health
• Adaptation of probe tip against side of tooth
• Walking stroke control
• Avoiding excessive pressure
• Correct angulation into “col” area
Charting Practice
•
Typodont
•
William’s probe
•
Probe and record
1. Mandibular right first
molar, facial aspect
(Nield p 233 –235)
2. Mandibular left
canine, facial aspect
(Nield pp 236-237)