Dental Charting Guide

• When conducting a BPE, do not include 3rd molars unless 1st and 2nd molars are missing.
• BPE Code 0:

  • No pockets over 3.5mm depth
  • Healthy tissue, no bleeding, no calculus or overhangs
  • Black band fully visible
  • No periodontal treatment needed
• BPE Code 1:

  • No pockets over 3.5mm in depth
  • Bleeding on gentle probing, no calculus/overhangs
  • Black band remains fully visible
  • OHI indicated
• BPE Code 2:

  • No pockets over 3.5mm in depth
  • Supra or subgingival calculus/defective restoration present
  • Black band remains fully visible
  • OHI, scaling and polishing, and removal of hardened plaque and calculus indicated
• BPE Code 3:

  • 3.5-5.5mm pocket
  • Black band partly disappears (indicating a pocket of 4-5mm)
  • Maybe bleeding following probing
  • OHI and root planing/sub-gingival debridement + removal of dead infected cementum indicated
• BPE Code 4:

  • 5.5mm pocket depth or more
  • Black band not visible (indicating a pocket of 6mm or more)
  • Periodontitis
  • OHI assess need for more complex treatment + removal of diseased tissue + clean and smooth root surfaces
• Include * for furcation involvement when recording BPE - treat as BPE 4.
• Careful assessment of the periodontal tissues is an essential component of patient management. The BPE is a simple and rapid screening tool that is used to indicate the level of further examination needed and provide basic guidance on treatment needed. These (BSP British Society of Periodontology) BPE guidelines are not prescriptive but represent a minimum standard of care for initial periodontal assessment. BPE should be used for screening only and should not be used for diagnosis.
• For a sextant to qualify for BPE recording, it must have 2 teeth.
• A World Health Organisation (WHO) BPE probe is used. This has a 'ball end' 0.5mm in diameter and a black band from 3.5mm to 5.5mm. Light probing force should be used (20-25 grams).
• The probe should be 'walked around' the teeth in each sextant. All sites should be examined to ensure that the highest score in the sextant is recorded before moving on to the next sextant. If a code 4 is identified in a sextant, continue to examine all sites in the sextant. This will help to gain a fuller understanding of the periodontal condition and will make sure that furcation involvements are not missed.
• All new patients should have the BPE recorded.
• For patients with codes 0, 1 or 2, the BPE should be recorded at every routine examination.
• For patients with BPE codes of 3 or 4, more detailed periodontal charting is required.

  • Code 3: Initial therapy including self-care advice (oral hygiene instruction and risk factor control) then, post-initial therapy, record a 6-point pocket chart in that sextant only
• For patients with BPE codes of 3 or 4, more detailed periodontal charting is required.

  • Code 3: Initial therapy including self-care advice (oral hygiene instruction and risk factor control) then, post-initial therapy, record a 6-point pocket chart in that sextant only
  • Code 4: If there is a Code 4 in any sextant then record a 6-point pocket chart throughout the entire dentition
• BPE cannot be used to monitor the response to periodontal therapy because it does not provide information about how sites within a sextant change after treatment. To assess the response to treatment, a 6-point pocket chart should be recorded pre- and post-treatment.
• For patients who have undergone initial therapy for periodontitis, and who are now in the maintenance phase of care, then full probing depths throughout the entire dentition should be recorded at least annually.
• BPE should not be used around implants (4 or 6-point pocket charting should be used).
• Radiographs should be available for all Code 3 and Code 4 sextants. The type of radiograph used is a matter of clinical judgement but crestal bone levels should be visible. Many clinicians would regard periapical views as essential for Code 4 sextants to allow assessment of bone loss as a percentage of root length and visualisation of the periapical tissues.
• When a 6-point pocket chart is indicated it is only necessary to record sites of 4mm and above (although 6 sites per tooth should be measured).
• Bleeding on probing should always be recorded in conjunction with a 6-point pocket chart.