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Apr 03
Pick up that probe

A number of recent complaints have emphasized the absolute necessity for periodontal probing as a routine component of a diagnostic workup.

In one case, without benefit of periodontal probing, the dentist replaced a crown for a symptomatic tooth. There was significant expense to the patient. When the patient returned within two months with no resolution of their symptoms, periodontal probing revealed the presence of a 9mm isolated plunging mesio-lingual pocket. Comparison of pre- and post-treatment radiographs confirmed the radiographic appearance of a pre-existing periodontal defect. The mesio-lingual root was confirmed fractured and the tooth extracted. The patient was understandably angry when she realized the treatment was based on an erroneous diagnosis.

In another case, a dentist provided a “prescription” treatment when she placed four maxillary anterior implants for a patient who was a patient of record in another practice to which she returned after the surgical phase of treatment. She did not provide a pre-operative comprehensive examination and did not assess the patient’s periodontal status. The patient suffered from poorly controlled moderate periodontitis. Within a two-to-three-year period all four implants were lost as a result of severe peri-implantitis and the associated bone loss. The patient suffered a serious clinical failure and significant financial loss. A full periodontal assessment would have contraindicated the treatment provided which would have protected both the patient and the dentist from such a negative outcome.

Periodontal probing is an imperative component of clinical practice. It is an important component of case selection. Not only is it indispensable as a diagnostic tool, it is an important measure of therapeutic efficacy.

Meticulous, evidence-based diagnoses, based on all the available information, will protect you and your patients from poor decisions leading to avoidable clinical failures.

The expectation of the College is that documentation of periodontal probing is included in all patient records as well as in comprehensive or new patient examinations.

From the desk of Dr. Meredith Moores (mmoores@cdsbc.org)

Posted 3 April 2017

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