BPE and Your Periodontal (Gum) Health

What is a BPE, and what does it mean to your gum health?

Have you ever wondered about the numbers that your dentist reads out to his nurse when they are probing around your gums, and wanted to understand what they might mean? They are scores called a Basic Periodontal Examination (BPE) and are the UK’s equivalent of a World Health Organisation programme that began in the 1980’s called the Community Periodontal Index of Treatment Needs (CPITN).

This examination uses a special probe that has coloured depth bands and a ball-ended tip so that it should not hurt when it is placed into the space between your gum and tooth, which is called a pocket.

The depth that this probe can enter your gum is measured. Put simply, the deeper the pocket the more gum disease you have. The ball tip can detect calculus (tartar) below the gum. Removal of this calculus by your dentist or hygienist is an important part of controlling gum disease. The other part is your personal responsibility, based on how well you control your plaque every day using your toothbrush, and if you use the correct interdental brushes to clean the spaces between your gums and teeth.

How does the BPE work?

The BPE uses six numbers, one in each of three sections of your mouth comprising molars and premolars on each side, and incisors and canines as the central number. This applies to both the upper and the lower jaw making six scores in all. Each score is called a sextant. The severity of periodontal disease is graded from 0 to 4*. The maximum score in each sextant is recorded.

What do the scores mean?

0: There are no gum problems in that part of your mouth and all your pockets are within the normal range of up to 3mm.

1: Your gums bleed on probing. This is a local inflammation called gingivitis and if left can progress and cause your teeth to become loose. It is caused by poor plaque control in that part of your mouth.

2: Calculus. This could be both above or below the gums and needs to be removed by scaling your teeth.

3: Pockets of 3.5 to 5.5mm. This is called early periodontal breakdown and means that some of the bone that supports your teeth has been lost to gum disease.

4: Pockets of 5.5 to 8.5mm. This is called moderately severe periodontal breakdown and means that up to half of the bone that supports your teeth has been lost to gum disease.

4*: Pockets greater than 8.5mm. This is severe periodontal breakdown and means that most of the bone that supported your teeth has been lost. Some of these teeth may need extracting.

What do I need to know?

You should ask for your BPE scores each time you visit your dentist. It is your legal right to have them. Write down what they are and keep your records. You should expect the scores to come down with treatment. Your eventual aim is to have a zero score in each sextant.

What if my scores don’t change?

You need to ask your dentist or hygienist why this is happening. It may be:

• Further scaling or other treatments may be required.
• You are not controlling your plaque in that area with your toothbrush
• You need to use the correct size of interspace brush. When you use these brushes there should be slight resistance as you push the brush back and forwards two or three times in the space.
• If you are diabetic, you are at greater risk of developing gum disease. If you have high blood sugar levels this can make your gum disease harder to treat.