The acronym PSR stands for Periodontal Screening and Recording, a quick, standardized method used by dental professionals to assess the health of a patient’s gums and supporting structures. This screening tool efficiently detects early signs of periodontal disease, often called gum disease, which is a common inflammatory condition. Since periodontal disease can progress silently without pain, the PSR system allows for routine, rapid assessment during checkups. Early detection and intervention are crucial for successful management and preserving the long-term health of the teeth and bone.
What is Periodontal Screening and Recording?
The Periodontal Screening and Recording system acts as a preliminary risk assessment tool, providing a snapshot of a patient’s periodontal condition. The results determine whether a patient requires a more comprehensive, time-intensive periodontal charting, a full, tooth-by-tooth evaluation. The PSR is a fundamental part of a routine examination, serving as a filter to identify individuals who need specialized attention or a more in-depth treatment plan.
The system was developed jointly by the American Academy of Periodontology and the American Dental Association to establish a simple, standardized method for tracking periodontal health. The PSR is not intended to replace a full periodontal examination but rather to streamline the process of identifying at-risk patients. It is a cost-effective and fast procedure, suitable for annual use on all patients to monitor changes in gum health over time.
How the Screening Examination is Performed
The PSR examination is performed using a specialized instrument known as a periodontal probe. This probe has a small, blunt, ball-shaped tip designed to enhance patient comfort and help detect calculus or overhanging restorations. The probe features a colored band, typically extending from 3.5 millimeters to 5.5 millimeters from the tip, which acts as a visual guide for measuring pocket depths. The entire mouth is divided into six distinct sections, known as sextants, to organize data collection.
The dental professional gently inserts the probe into the gingival sulcus, the shallow space between the gum and the tooth surface, to measure pocket depth. The probe is walked around six sites on each tooth within the sextant to check for the deepest measurement. The clinician observes whether the gums bleed upon probing, a sign of inflammation, and notes the presence of calculus (tartar). The highest score found within any tooth in a given sextant is the single score recorded for that section.
Understanding the PSR Score Codes
The PSR system uses a simple set of numerical codes, ranging from 0 to 4, to communicate the status of gum health in each of the six sextants. Code 0 is the ideal result, indicating the colored band on the probe is completely visible, with no bleeding upon probing, calculus, or defective margins detected. Code 1 means the colored band is visible, but bleeding occurs when the area is gently probed, suggesting mild gingival inflammation. Code 2 is assigned if the colored band is visible, but the clinician detects calculus or finds a defective margin on a restoration.
When Code 3 is recorded, it signifies that the deepest pocket in the sextant measures between 3.5 and 5.5 millimeters, meaning the colored band is only partially visible. This score suggests moderate periodontal disease and requires a full periodontal charting of that specific sextant to determine the extent of attachment loss. Code 4 is the most concerning result, meaning the probing depth is greater than 5.5 millimeters, causing the colored band to completely disappear. This finding indicates advanced periodontal disease and necessitates a comprehensive, full-mouth periodontal examination, including radiographic analysis, to formulate a treatment plan.
In addition to the numerical codes, a single asterisk () symbol can be added next to any score from 0 to 4 to indicate specific complicating factors within that sextant. This supplemental code alerts the clinician to the presence of abnormalities such as tooth mobility, furcation involvement (bone loss between molar roots), or significant gingival recession measuring 3.5 millimeters or more. The presence of a Code 3 or 4 in two or more sextants, or any single Code 4, strongly suggests the patient has periodontitis and requires treatment beyond a routine cleaning.