Various types of periodontal probes can be used to measure pocket depths. Most clinicians use their own personal preferences in determining which probe to use.
Types of Probes
|Figure 2. Dental Probes|
|Probes shown (from top to bottom):|
1. Traditional Probe; 2. Naber's Probe; 3. Color Coded Probe.
Color coded probe has color on the shank for ease in reading.
|Photo courtesy of Hu-Friedy Mfg. Co., Chicago|
Most traditional probes are marked with 1-millimeter increments with the 4 and 6 mm marking absent. Many dental hygiene clinical boards require proficiencies with a probe reading 1, 2, 3, 5, 7, 8, 9, and 10 mm. Some probes have a black band indicating the 3, 5, 9, and 10-mm markings. Other probes are marked at 3mm. Some clinicians prefer probes that are color coded because they are easier to read.
The Naber’s probe or the Furcation probe is a blunt ended instrument that is used buccally and lingually on the periodontal structure to locate possible furcation involvement.
Periodontal Probing Guidelines
Since periodontal probing is such an important aspect of the periodontal examination, the technique must be systematic and consistent. The operator, when probing, will:
Use a lateral “walking” approach
Use only one brand of probe to achieve standardization
Dictate findings to the dental assistant who will chart data on a form that allows comparison of readings over time
Record six regions around each tooth
The probe is placed under the contact area between the line angles; making sure it is located at the interproximal area of the tooth.
The shank is rested between the teeth against the contact and the probe is angled under the contact area – always watching the angulation.
Round up to the next highest reading if the numbers on the probe are between one another.
Record the deepest reading in each segment.
Use all three measurements on the buccal and all three measurements on the lingual for accuracy.
Use radiographs to verify the level of bone and the presence of bone loss.
Forcing the probe can penetrate the periodontal tissues, resulting in inaccurate pocket depths and discomfort for the patient.
Periodontal Probing Guidelines
Even though periodontal probing is one of the best diagnostic tools we have to assess periodontal disease, there are also certain pitfalls to avoid:
Subgingival calculus can interfere with accurate readings.
In an area with elevated inflammation, the attachment is easily perforated.
The pocket may be too tight to probe.
The patient may present with hypersensitivity making accurate probing difficult.
Visibility is another extremely important factor in accurate probing. It is important that the probe be clearly visible to obtain accurate results. The skillful use by the dental assistant of the air/water syringe and the evacuation system will help keep the probing areas visible.
Bleeding at the gingival margin or sulcus is often the first indicator of gingivitis or periodontitis. Bleeding, pocket depths, and radiographs are used together to determine periodontal condition. These measurements are significant for two different types of periodontal disease and their future treatment.