S.B.I / A.P.I and P.S.R Screening and Indices

Question 1

State when it is necessary to perform a P.S.R, how often should it occur

Answer 1

1st visit of the patient / at least once a year to screen the patient for periodontal problems

Question 2

State advantages and limitations of P.S.R

Answer 2

Advantages
• Easy detection of periodontal disease/condition
• It takes only few minutes (2-3 min)
• Simplicity
• Cost-effectiveness – WHO probe is the only equipment we need
• Ease of recording – only “the highest” score per sextant is recorded
• Risk management: The dental team (dentist/ hygienist/periodontist) is monitoring a patient’s periodontal status for legal requirements

Disadvantages
• It’s not a comprehensive exam/ doesn’t provide accurate readings

Question 3

Identify what the (*) stands for in a P.S.R

Answer 3

• An ( * ) is recorded for each section when:

1. Recession of greater than 3.5mm
2. Furcation involved teeth
3. Mucogingival problems (e.g. gingival hyperplasia)
4. Tooth mobility

• does not indicate the need for a Full mouth Periodontal Chart

Question 4

Fully explain the P.S.R codes and explain when it is necessary to move on to a full mouth Periodontal Chart

Answer 4

• Code 0: No bleeding, no calculus, black ring of W.H.O. probe is visible at DEEPEST pocket
• Code 1: Bleeding upon probing evident, no calculus,, black ring of W.H.O probe is present at DEEPEST pocket
• Code 2: Bleeding upon probing, calculus present, black ring of W.H.O probe is present at DEEPEST pocket
• Code 3: Bleeding upon probing, calculus, black ring of W.H.O PARTIALLY PRESENT at deepest pocket. Perio chart now required in this sextant only. If two code three’s = full mouth perio chart
• Code 4: Bleeding upon probing, calculus, black ring COMPLETEY DISAPPEARS at deepest pocket. Full mouth perio charting required.

Question 5

How do you perform S.B.I

Answer 5

• Rinse then dry patients mouth
• Insert the ball of the WHO probe into sulcus at the midline
• Keeping the ball in the sulcus, slide the WHO probe to the interproximal to reach the papilla

Question 6

How do you perform A.P.I?

Answer 6

• Rinse
• Dry
• Apply disclosing solution
• Rinse
• Dry
• Read
• Don’t count stained papilla
• Count stained teeth

Question 7

Know the ideal percentages range of the A.P.I we recommend for our patients

Answer 7

• <35% = good oral hygiene

* <25% = AMAZING oral hygiene

Question 8

Know the ideal percentages range of the S.B.I we recommend for our patients

Answer 8

• <25% = good oral hygiene

* <15% = AMAZING oral hygiene

Question 9

List and describe the two types of disclosing gels

Answer 9

• Erythrosine: one tone only
• GC tri colour gel: red= new biofilm/ less than 24hrs old, dark blue= mature biofilm/ greater than 48 hrs old, light blue= acidic biofilm with pH of 4.5 or less

Question 10

What is the correct sequence of performance?

Answer 10

• When All three indices (SBI, API, PSR) are needed: SBI, API, PSR
• When only API/SBI neeeded: SBI, API
• For SBI and API, you do NOT read the midline, nor do you read the 8’s with SBI
• SBI buccal of quadrant 1 and inverting with API, so SBI buccal 1 and API palatal 1, then 2 SBI palatal 2 and API buccal 2

Question 11

Calculate and record the correct reading points for S.B.I and A.P.I under different circumstances e.g. missing or replaced teeth

Answer 11

• Implants are treated as normal teeth
• Bridges/ denture: you lose a reading point
• In a normal circumstance, you have 28 reading points
• Tooth missing with space open; you still have the 28 interdental papilla to read. Thus, one tooth missing doesn’t make a difference, even if there’s a bridge/ denture.
• Two teeth missing with open space; you lose one reading point
• Three teeth missing; you lose two reading points
• Gap closed by ortho: you lose a reading point