Basic Periodontal Examination (BPE)

• Basic Periodontal Examination (BPE) is part of Foundations in Clinical Skills and Practice.

Intended Learning Outcomes:

• Explain the key features and considerations for BPE.
• Limitations of the BPE
• Explain the features found on a WHO probe and relate to usage.
• Demonstrate usage of criteria associated with the BPE index.
• Describe clinical findings and treatment needs associated with each BPE code.

British Society of Periodontology Guidance 2019:

• The BPE was first developed by the British Society of Periodontology in 1986.
• Previous versions of this document were produced in 1986, 1994, 2000, 2011 and 2016.
• Next review is scheduled for 2024.
• It stemmed from CPITN (Community Periodontal Index of Treatment Needs).
• It is also known as PSR and PEPE.

Periodontal Screening Tool:

• BPE is a simple and rapid screening tool that indicates the level of further examination needed.
• It provides basic guidance on treatment needed.
• Not prescriptive, but represents a minimum standard of care for initial periodontal assessment.
• BPE should be used for screening only and should not be used for diagnosis.

Limitations of BPE:

• BPE is not for monitoring patients.
• BPE is not a treatment outcome measure.
• BPE does not provide a diagnosis.

What is taken into account

• Calculus
• Bleeding
• Overhangs
• Pocket Depths

WHO/BPE Probe:

• Considers ball height, ball features and rationale.
• The base of the 1st black band and top of the 1st black band.
• Considers what pressure to use and how to move the probe.

Recording a BPE:

• The mouth is divided into sextants.
• UR (17-14), UA (13-23), UL (24-27), LR (47-44), LA (43-33), LL (34-37).
• A sextant must contain at least 2 teeth.
• All teeth are included except 8's UNLESS the first and/or second molar is missing.
• If there are no teeth, code is "-".
• If there is furcation, a '*' is added to the code.

Summary chart of BPE scoring

• Code 0: Pockets <3.5mm, no calculus/overhangs, no bleeding on probing, black band is entirely visible, no pockets >3.5mm.
• Code 1: Pockets <3.5mm, no calculus/overhangs, bleeding on probing, black band is entirely visible.
• Code 2: Pockets <3.5mm, supra or subgingival calculus/overhangs, black band is entirely visible.
• Code 3: Probing depth 3.5-5.5mm, black band partially visible, indicating pocket of 4-5mm.
• Code 4: Probing depth >5.5mm, black band disappears, indicating a pocket of 6mm or more.
• Furcation involvement.

CODE O Treatment Indicated:

• No treatment needed.
• Encourage to continue.

CODE 1 Treatment Indicated:

• Bleeding after probing.

CODE 2 Treatment Indicated:

• Calculus (supra or sub) or overhangs.

CODE 3 Treatment:

• Initial Phase Therapy.

CODE 4 Treatment:

• Probing depth >5.5mm.