Periodontal Charting Guide: Probing Depths & Documentation
Complete guide to periodontal charting including six-point probing protocols, pocket depth interpretation, and documentation best practices. Master the standard of care for dental documentation.
What is Periodontal Charting?
Periodontal charting is a comprehensive assessment and documentation of the health of the periodontium—the tissues that support the teeth. It provides a detailed map of pocket depths, recession, bleeding, and other clinical findings that help diagnose and monitor periodontal disease.
Standard of Care
According to dental-legal experts, the standard of care requires a full-mouth, six-point probing with all numbers recorded. In the eyes of the law, if it's not recorded in the chart, it never happened.
Most periodontists recommend comprehensive charting at least once per year for all patients.
Six-Point Probing Protocol
The periodontal probe is placed at six specific sites around each tooth.
Mesiobuccal (MB)
Mesial aspect of the buccal/facial surface
Mid-buccal (B)
Center of the buccal/facial surface
Distobuccal (DB)
Distal aspect of the buccal/facial surface
Mesiolingual (ML)
Mesial aspect of the lingual/palatal surface
Mid-lingual (L)
Center of the lingual/palatal surface
Distolingual (DL)
Distal aspect of the lingual/palatal surface
Proper Probing Technique
Use 10-20 grams of probing force to prevent measurement distortion. Walk the probe along the sulcus, keeping it parallel to the long axis of the tooth. Document all six sites—skipping sites creates incomplete records.
Probing Depth Interpretation
Understand what different pocket depths mean for periodontal health and treatment planning.
No bleeding
Normal, healthy sulcus depth. No signs of periodontal disease.
Continue regular hygiene maintenance and preventive care.
With bleeding
Early gingival inflammation. Reversible with proper care.
Improve oral hygiene, consider antimicrobial rinse, schedule follow-up.
No bleeding
Potential for gum disease. May have some bone loss.
Scaling and root planing (SRP) recommended. Re-evaluate in 4-6 weeks.
With bleeding
Active periodontal disease with tissue inflammation.
SRP required. Consider adjunctive therapy. More frequent maintenance.
With bleeding
Significant bone loss and soft tissue damage.
Definitive periodontal treatment. Consider referral to periodontist.
With bleeding
Advanced bone loss. Risk of tooth loss.
Aggressive treatment, possible surgical intervention. Specialist referral.
Complete Documentation Elements
A thorough periodontal chart includes more than just probing depths.
Probing Depths
Distance from gingival margin to base of pocket
Measurement: Millimeters (mm)
Frequency: All 6 sites per tooth
Gingival Recession
Distance from CEJ to gingival margin
Measurement: Millimeters (mm)
Frequency: Where present
Clinical Attachment Level (CAL)
Probing depth + recession
Measurement: Millimeters (mm)
Frequency: Calculated per site
Bleeding on Probing (BOP)
Presence of bleeding after probing
Measurement: Yes/No or %
Frequency: All sites
Suppuration
Pus discharge from pocket
Measurement: Present/Absent
Frequency: When observed
Tooth Mobility
Degree of tooth movement
Measurement: Class I, II, III
Frequency: Per tooth
Furcation Involvement
Bone loss in multi-rooted teeth
Measurement: Class I, II, III
Frequency: Multi-rooted teeth
Mucogingival Defects
Inadequate attached gingiva
Measurement: Present/Description
Frequency: When observed
PSR: Periodontal Screening and Recording
PSR is a quick screening tool that can be used to identify patients needing comprehensive periodontal evaluation. The mouth is divided into sextants, and each receives a code based on the highest finding.
Colored area completely visible. No calculus, defective margins, or PD >3mm
Continue preventive care
Colored area completely visible. No calculus or defective margins. Bleeding after probing
Oral hygiene instructions, preventive care
Colored area completely visible. Supragingival or subgingival calculus and/or defective margins
Oral hygiene instructions, removal of plaque retentive factors
Colored area partially visible (PD 3.5-5.5mm)
Comprehensive periodontal assessment of sextant needed
Colored area completely disappears (PD >5.5mm)
Comprehensive periodontal assessment of entire mouth needed
Added to any code: Furcation involvement, mobility, recession >3.5mm
Additional evaluation required
Sample Periodontal Documentation
Periodontal Examination
Date: 01/19/2026 | Provider: Dr. Smith, DDS
Clinical Findings Summary:
BOP: 25% of sites (localized to posterior sextants)
Probing Depths: Generalized 2-3mm; #3 DB: 5mm with BOP; #14 ML: 6mm with BOP; #30 MB: 5mm
Recession: #6-11 facial: 1-2mm; #22-27 facial: 1mm
Mobility: All teeth Class 0-I
Furcation: #3 buccal Class I; #14 buccal Class I
Suppuration: None observed
Calculus: Moderate subgingival posterior; Light supragingular anterior
Assessment: Localized moderate chronic periodontitis, Stage II Grade B, affecting #3, #14, #30
Treatment Plan: SRP quadrants 1 and 2, with localized site-specific therapy. Re-evaluate at 4-6 weeks post-SRP. Consider periodontal maintenance q3 months.
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Frequently Asked Questions
What is periodontal charting?
Periodontal charting is a systematic documentation of gum health measurements around each tooth. It includes probing depths (the space between the gum and tooth), recession, bleeding points, tooth mobility, and furcation involvement. This data helps diagnose periodontal disease, create treatment plans, and track changes over time.
What is a normal probing depth?
Normal, healthy probing depths are 1-3mm with no bleeding on probing. At these depths, the periodontal probe remains within the gingival sulcus without reaching diseased tissue. Depths of 4-5mm may indicate early periodontal disease, while 6mm or more indicates moderate to advanced disease requiring treatment.
How often should periodontal charting be done?
Most periodontists recommend a comprehensive six-point periodontal charting at least once per year for all patients. Patients with active periodontal disease or those in periodontal maintenance may need charting every 3-6 months to monitor treatment response and disease stability.
What is the difference between probing depth and clinical attachment level?
Probing depth measures from the gingival margin to the base of the pocket. Clinical attachment level (CAL) measures from the cemento-enamel junction (CEJ) to the base of the pocket. CAL = Probing Depth + Recession. CAL is a more accurate indicator of true periodontal destruction because it accounts for gum recession.
What is PSR (Periodontal Screening and Recording)?
PSR is a simplified screening tool that divides the mouth into sextants and assigns a code (0-4) based on the highest probing depth and clinical findings in each sextant. It's faster than full-mouth charting and helps identify patients who need comprehensive periodontal evaluation. Codes 3 or 4 indicate need for full charting.
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