Dental Hygiene I Probing

Uses of probes

- Measure sulcus and pocket depths - Measure clinical attachment levels - Determine the width of the attached gingiva - Assess for the presence of bleeding - Measure the size of oral lesions

color-coded probe

-Marked in bands with each band being several millimeters in width This example is marked at 3, 6, 9, and 12 mm

probe depth in a healthy sulcus

-Probe inserted into a healthy gingival sulcus -In health, the probing depth should be from 1 to 3 mm in depth -touches the tooth near the CEJ

2 steps for interproximal readings

-TOUCH THE CONTACT AREA walk the probe between the teeth until it touches the contact area -TILT THE PROBE slant the probe slightly so that the tip reaches under the contact area. In this position, gently press downward to touch the soft tissue base

probe depth in a periodontal pocket

-a probing depth deeper than 3 mm indicates a periodontal pocket -probe tip touches the root somewhere below the CEJ

what is used to calculate CAL?

-gingival margin readings -probing depth

how to measure width of attached gingiva

-measure the total width of the gingiva from the gingival margin to the mucogingival junction -measure the probing depth Width of gingiva 4 mm -Probing depth is 2 mm -Calculate: 4 - 2 mm = 2 mm of attached gingiva

factors that can affect accuracy of probing measurements:

-position of gingival margin -interference from calculus deposits, overhanging restorations -amount of pressure applied -misread probe calibrations

how to determine how far gingival margin is coronal to its normal level

-position the tip of the probe at a 45-degree angle to the tooth. -slowly move the probe tip along the tooth until you detect the CEJ. -record the distance between the gingival margin and the CEJ

if the gingival margin is NOT in the normal position, the bone support must be calculated by using two measurements which are

-probing depth -gingival margin level

damage with loss of attachment

-relocation of the junctional epithelium -Destruction of gingival fibers -Destruction of periodontal ligament -Loss of alveolar bone support

the position of the gingival margin can change with

-swelling -overgrowth -recession

clinical attachment level provides and estimate of

-tooth's stability -loss of bone support

the level of the gingival margin can change in response to

-trauma -medications -disease

gingival margin measurements

0= margin at normal level (-)= significantly covers CEJ (+)= gingival recession

probe tip

1-2 mm of the side of the probe

probing measurements are recorded for

6 sites or zones on each tooth

gingival pocket

A deepening of the gingival sulcus as a result of swelling or enlargement of the gingival tissue

Calculate width of gingival attachment: width of gingiva = 4mm probing depth = 2 mm

ANSWER: 4mm - 2mm = 2mm Attached gingiva = 2 mm

periodontal probe

Marked in millimeter increments -Used to evaluate the health of the periodontal tissues

Nabers probe N1 and N2

N1: assesses medial and distal furcation areas N2: assesses facial and lingual furcation areas

attached gingiva

Part of the gingiva that is tightly connected to the cementum on the root and to the connective tissue cover of the alveolar bone

interdental gingiva

Portion of the gingiva that fills the area between two adjacent teeth apical to the contact area

probing depth

The distance in millimeters from the gingival margin to the base of the sulcus or periodontal pocket as measured with a probe

gingival sulcus

The v-shaped space between the free gingiva and the tooth surface

free gingiva

Unattached gingiva surrounds the tooth

Design of the probe working end

Working-end is blunt and rod shaped -Cross section may be circular or rectangular -Calibrated with millimeter markings

periodontal pocket

a gingival sulcus that has been deepened by disease; depth is greater than 3mm; orms from apical migration of the junctional epithelium and destruction of periodontal fibers and bone

stroke pressure

a pressure exerted with the probe tip against the soft tissue base of the sulcus or pocket should be between 10 and 20 grams

probe walking stroke

a series of bobbing strokes that are made within the sulcus or pocket while keeping the probe tip against and in alignment with the root surface

if the gingiva in an area is receded, then the _________________ has also been lost

alveolar bone

the probe should NOT be held

away from the tooth

classification of tooth mobility

class 1: slight; < 1mm of horizontal (facial/lingual direction) class 2: <1mm but < 2mm horizontal (facial/lingual direction) class 3: <2mm horizontal (facial/lingual direction OR vertical mobility)

CAL

clinical attachment level

furcation involvement in mandibular molars is detected more frequently by

clinical examination

these probes are marked in bands

color-coded probes

Florida probe

computer-assisted probe; connected to a computer which created a computerized dental chart

the __________________ reading is used to record the probing depth

deepest

why should you use caution when using a probe to measure?

do not assume all probes have the same patter of millimeter marking

walking strokes are used to cover the ______________________

entire circumference of the sulcus

proximal surfaces are assessed from the

facial and lingual

causes of gingival margin that significantly covers the CEJ

gingivitis medications

UNC 15 probe

has millimeter markings at 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, and 15 mm

probing depth readings accurately indicate the level of the bone ONLY if the gingival margin is

in its normal position, slightly above the CEJ

to remain in the oral cavity, a tooth must be attached by:

junctional epithelium fibers of the gingiva periodontal ligament fibers alveolar bone

furcation involvement

loss of bone and fibers between multi-rooted teeth

how to measure gingival recession

measure distance from gingival margin to the CEJ

a probing depth is not enough information to tell you if a tooth has

normal bone support or bone loss

it is common for the depth of a pocket to be deeper in _____________

one place

the probe must be positioned ________________ to the long axis of the root surface

parallel

in addition to bone support, we really need to know the location of the

periodontal attachment

causes of gingival margin that is apical to CEJ

periodontitis

correct adaptation of probe tip

probe tip is kept in contact with the tooth surface throughout the walking stroke

furcation involvement in maxillary molars is detected more frequently by

radiographs

probing maxillary molars

reposition the instrument handle to the side of the patient's face to reach the distal surfaces of the maxillary molars

probing

the act of walking the tip of a probe along the base of a sulcus or pocket for the purpose of assessing the health status of the periodontal tissues

clinical attachment level (CAL)

the estimated position of the structures that support the tooth as measured with a periodontal probe

junctional epithelium

tissue that forms base of the sulcus

Repeatedly removing the probe can

traumatize the tissue