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Comprehensive Periodontal Evaluation

 

A clinician performs a Comprehensive Periodontal Evaluation (CPE) to assess a patient’s oral health by examining six key areas: 1) the teeth, 2) plaque, 3) the gums, 4) the bite, 5) bone structure, and 6) patient’s risk factors.

 

Why is a CPE Necessary?

 

Oral health is a good indicator of the health of the rest of the body. Research has shown a link between periodontal health and other chronic inflammatory conditions—namely, heart disease, diabetes, and respiratory diseases.

 

The clinician will evaluate:

  • If there are lumps or abnormalities in the mouth (gum, cheek or tongue color changes).

 

Possible causes: infection or oral cancer

 

  • If there are loose or missing teeth, and the degree of looseness.

 

Possible causes: periodontal disease, bite issues, bruxism (tooth-grinding)

 

  • The color, texture, size and shape of the gums.

 

Firm and pink gums are healthy. Diseased gums: are reddish in color and swollen, or bleed easily.

 

  • Fillings, crowns, bridges, dentures or implants

 

  • The extent of plaque build-up on the teeth

 

  • The space between the teeth and the gums.

 

Known as the sulcus, the place where the teeth meet the gums should not be more than 4 mm deep. If the space is more than 4 mm, it is termed a “pocket” and means that the gums are diseased and indicates periodontitis. The sulcus or pocket is measured with a periodontal probe, a thin utensil with a millimeter ruler on the tip. The tip is inserted into the gum line to measure the amount of space between the gum line and where the tooth and gum finally meet.

 

  • If the gums bleed after probing—an indicator of inflammation and gum disease.

 

  • If the gums have receded.

Possible causes: inflammation, badly positioned teeth, or hard brushing.

  • If the roots are exposed.

 

Teeth with exposed roots can be sensitive to temperature changes, have an increased risk of decay, and look long and unattractive.

 

  • The occlusion.

 

The way the teeth come together in the patient’s bite can affect the teeth and gums, particularly if they meet with too much force. The patient may also grind or clench his or her jaw.

Besides the examination, you also will take annual x-rays of the patient’s teeth. A periapical x-ray helps in showing the extent and pattern of bone loss by showing the entire tooth, from the crown to the end of the root.

The CPE is a critical part of a patient’s oral healthcare—by identifying risk factors or catching gum disease in its onset, the clinician can help the patient be better aware of the situation and its ramifications so that preventive and reparative measures can be taken at home as well as in the dentist chair.

 

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