Advantages and Limitations

The advantages of using the PSR system include early detection, speed, simplicity, cost-effectiveness, ease of recording, and risk management.

  • Early detection: Since all sites are evaluated, the risk of periodontal disease can be made early and appropriate treatment can be performed.
  • Speed: Once the technique of the PSR system is learned, it should take only a few minutes to perform the screening. This saves time versus a comprehensive examination.
  • Simplicity: It is easy to do and understand for patients.
  • Cost-effectiveness: It is not necessary to purchase expensive equipment since all that is needed is a ball-tipped probe.
  • Ease of recording: Only one number is recorded for an entire sextant.
  • Risk management: The dental team is monitoring and recording a patient's periodontal status to stay compliant with standards of care and for legal requirements.

There are limitations when using the PSR system. As stated earlier, it is not intended to replace a full-mouth periodontal examination. Those patients who have received treatment for periodontal diseases and/or are in a maintenance phase of care should receive comprehensive periodontal examinations routinely. There is also limited use of the PSR system in children. It is necessary to differentiate pseudo-pockets from true periodontal pockets with these younger patients. In any patient exhibiting enlarged gingiva or recession, the PSR score may give false results.14 Landry and Jean reported that since the PSR does not measure epithelial attachment, the severity of periodontal disease may be underestimated with its use.5 While a study by Rams and Loesche found a pretreatment PSR score of 4 or greater in 110 adults to be a good predictor of periodontal access surgery needs, this same study concluded after performing non-surgical periodontal therapy the score overestimated surgical access needs.13

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