Hi Jill! I always enjoy reading your articles...I have had many occasions to go to my Dimensions of Dental Hygiene magazine for perspectives and reliable information. I am interested in finding some documentation on the recommended frequency of perio charting for the adult patient. I have researched the American Academy of Periodontology, the Journal of Periodontology, ADHA, and ADA and have found useful information for the periodontal patient. Now I would like to find some written guidelines for the adult prophy patient. I work in a community health center and we have 9 dental clinics in our organization and 13 hygienists. We are trying to find some consistency within our dental clinics. Most of our hygienists believe in the need to complete an annual periodontal chart. A few of our hygienists do not feel it is important to complete the periodontal chart on a regular basis. Please let me know if you have any written documentation regarding the recommended frequency for which periodontal charting should be completed in the adult prophy patient.
Thanks for your kind words! Your question is a great one because while there are guidelines for patients who have been diagnosed with a periodontal condition, it's difficult to find such criteria for the "healthy" adult patient (in other words, one that only requires a prophylaxis. This means someone who has never been diagnosed with periodontitis.) While many adult patients have exhibited some type of periodontal condition by the time they reach adulthood, there are some who have not. Keep in mind that even a past history of periodontitis means that the individual is susceptible to a future periodontal condition….even if his or her current state is deemed to be stable. It's also important to consider not just oral health but overall health and systemic conditions that may predispose a person to periodontitis (e.g. diabetes, smoking and more.) So while there may not be a cut-and-dried perio charting guideline for so-called healthy adults, a once-yearly regimen makes sense. This charting is not only to determine probing depths but to observe bleeding on probing. While bleeding does not predict future breakdown, lack of bleeding does indicate no inflammation, and thus sites that are healthy (in non-smokers.) So that takes us back to the "healthy" adult periodontal patient…a rare person indeed! If you've decided that this truly is the condition, based on all oral and systemic criteria, then you could likely go a little longer than the once-yearly suggestion. However, it's always best to err on the side of caution and perform perio charting more often than less often.