Probing is Your Future
How many veterinarians or technicians routinely use a periodontal
probe in as part of every dental prophylaxis? Why use a periodontal probe? What
information can be learned and how can this help our patients?
A periodontal probe is the primary instrument used in gingival
examination. The only accurate method of detecting and evaluating periodontal pockets, is
careful exploration with a periodontal probe. Pockets are not reliably detected or
measured by radiographic examination. Periodontal pockets are soft tissue changes.
Radiographs indicate areas of bone loss where pockets may occur, but do not show whether
pockets are present, and do not reveal pocket depth. The probe's use can give the
practitioner invaluable information concerning gingival bleeding, an important sign of
inflammation, and determine the depth, shape, and tissue characteristics of the pocket.
Design of the Probe
Probes vary in cross-sectional design and millimeter markings.
They may be rectangular (flat), oval, or round. The calibrated working end is marked in
millimeters at varying intervals to facilitate reading of depth measurements.
|The Marquis probe is color-coded by alternately colored bands which
mark 3, 6, 9, and 12 mm. This probe has a good, thin working end. Care must be taken in
estimating the millimeter readings between the markings. |
|The Williams probe is marked at 1, 2, 3, then 5, 7, 8, 9, and 10
millimeters. The spaces between 3 and 5 are important to note, because most pockets deeper
than five millimeters will need surgical care (flap procedure or extraction). Be careful
when purchasing a Williams probe because some manufacturers produce a working end which is
too thick to allow easy insertion.|
|The Michigan-O probe is marked at 3,6, and 8 millimeters. Many
veterinarians prefer this probe, because it has a very thin working end. The Michigan-O
probe can be obtained with Williams markings.|
Use of the Probe
Periodontal measurements are taken by inserting the probe under
the free gingival margin and gently moving it down to the bottom of the pocket (junctional
epithelium). Keep the probe parallel to the tooth surface to insure correct measurement.
After inserting, gently "walk" the tip along the bottom of the pocket. This
walking technique allows an accurate measurement of the level of attachment around the
tooth. The measurements are recorded at four to six points on each tooth.
Periodontal depths are measured from the base of the pocket to the margin of
the free gingiva. Normals for dogs are 2-3 mm, cats 1-2 mm. The level of attachment of the
epithelium at the base of the pocket to the cement-enamel junction (CEJ) is of greater diagnostic
significance than the probing depth of the pocket. The level of attachment is determined
by subtracting from the total depth the distance from the gingival margin to the
cement-enamel junction (CEJ). When the gingival margin coincides with the CEJ, the level
of attachment and the pocket depth are equal; when the gingival margin is located apical
to the CEJ, the loss of attachment will be greater than the pocket depth.
So how does this help the veterinarian? If all the probing depths
are normal the client is informed all is well. If there are areas of abnormal depth,
radiographs are taken and the client advised of a therapy plan (flap surgery, hemi-section
and endodontics, or extraction). The probe provides this "under the gum line"
look at dental pathology and is an essential part of every dental examination.