Back to the Basics: Mastering Probing Techniques for Comprehensive Periodontal Assessment

Abstract

In a high-level technological world, with many innovations, instruments and techniques, as well as new clinical approaches, it is more important than ever that dental professionals develop, maintain, and enhance their clinical skills. Studies show that experienced dental professionals, new graduates, and students alike are often challenged when probing periodontal/peri-implant pockets or gingival/peri-implant sulcus. Using inadequate probing technique can lead to errors and while it is not possible to achieve a level of 100% correctness in all cases, one should expect an accuracy level of at least 85% of a highly skilled clinician. A periodontal probe (PP) is a calibrated instrument used to evaluate the health of periodontal tissues during a comprehensive periodontal exam. The PP measures the distance from the free gingival margin (or gingival margin [GM]) to the gingival sulcus base or the periodontal pocket base. This measure is referred to as periodontal pocket depth (PD).  The PP can also it can be used to measure be used to measure the distance from the cementoenamel junction (CEJ), which is a fixed-point reference, instead from the GM, to help determine the level of clinical attachment loss (CAL). Clinicians must use PPs effectively by following correct techniques while considering tip design, correct angulation, and adaptation, as well as the appropriate amount of pressure exerted. Three elements affect the accuracy of periodontal probing: tools, technique, and the patient. It is good practice to develop a standard technique for conducting periodontal probing, using the same probe type, exerting consistent pressure, and working through the same sequence every time. This promotes a consistent standard of care for every patient and helps ensure that measurements related to disease progression or current status are obtained similarly. Patients often find periodontal probing uncomfortable due to sensitivity and inflammation, making a thorough examination difficult. Always attempt to provide the most comfortable experience for the patient by being gentle and, if necessary, using anesthesia.