This screen asks for measurements based on the condition of the patient’s mouth on the date of the exam.

Deepest Pocket Per Sextant:

(Also called probing depth or sulcus depth). Only the deepest pocket in the sextant should be used to determine your response for each input value. In other words, you can quickly observe each sextant and note only whatever the deepest pocket depth is in each sextant.

Choose the single greatest measurement of pocket depth per sextant (do not take an average of all measurements in that sextant).

The four choices for pocket depth are: No Teeth, <5mm, 5-7mm, and >7mm.

Time-saving tip: Remember, for you only need to indicate the deepest pocket for each sextant. The range of choices allows you to make a single, simple choice for each sextant, rather than having to enter a precise measurement for each tooth in the mouth.

Pocket depth measurements are from the gingival margin to the base of the pocket. Measurements are taken at:

• Facial -- at the mesio-distal midpoint on the facial
• Lingual -- at the mesio-distal midpoint on the lingual
• Mesial -- at the facio-lingual midpoint from the facial and lingual
• Distal -- at the facio-lingual midpoint from the facial and lingual

Note that a Risk Assessment requires at least one pocket depth value other than "No Teeth."

Radiographic bone height from the CEJ:

The greatest distance in each sextant from the CEJ to the radiographic bone crest is used.

Choose the single greatest measurement of bone height from the CEJ per sextant (do not take an average of all measurements in that sextant).

Note that in the case where there is a is a vertical bone lesion, the greatest distance is at the base or apical extent of the bone lesion, which might not be interpreted as the bone crest. In any case, you should indicate the greatest distance in each sextant from the CEJ to the most apical level of bone that is evident on the radiograph.

It is acceptable to use radiographs that have been taken within 5 years of the examination. This is marginally adequate since bone height generally does not change enough in 5 years to affect the risk score.

However, the most accurate assessment requires radiographs taken the day of the assessment, which can be accomplished with as few as four bitewing radiographs. The use of only four posterior bitewing radiographs will not permit the bone height measurement for the upper anterior or lower anterior, and hence the risk and periodontal health scores could be inaccurate. This is unlikely to be significant for the patient whose diagnosis is health, gingivitis or beginning periodontitis (Periodontal disease state<=10). Radiographs of all teeth are indicated for patients with severe periodontitis (Periodontal disease state>=37) to calculate accurate risk scores and disease states.

Restorations and crowns may obscure the CEJ. In this situation, the clinician should use previous records and his or her best judgment to determine the radiographic bone height from the CEJ.

Note that a Risk Assessment requires at least one radiographic bone height value other than "No Teeth" and "No X-ray."