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

• Measurement

– Sulcus/pocket depths– Width of attached

gingiva– Bleeding – Exudate– Oral lesions– Furcations

A B C

DE

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 MeasurementMarquis Probe (3 6 9 12)‐ ‐ ‐

Healthy Sulcus Diseased Pocket

Probing Depth? 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

– 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

Maxillary Posterior Technique

Walk all theway 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 quadrantstarting @ #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. GM apical to CEJ

(recession)2. GM coronal to CEJ

(hyperplasia)3. GM level with CEJ

Accuracy of MeasurementAffected 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)