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Rather than a single disease entity, periodontal disease is a combination of multiple disease processes that share a common clinical manifestation. The cause includes both local and systemic factors. The disease consists of a chronic inflammation associated with loss of alveolar bone. Advanced disease features include pus and exudates.
The primary purpose of periodontal charting is to evaluate periodontal health, detect early signs of disease, monitor disease progression, and guide treatment planning. It enables clinicians to identify conditions such as gingivitis and periodontitis, assess the effectiveness of interventions, and tailor patient-specific periodontal therapy.
Universal numbering system. This is a dental practitioner view, so tooth number 1, the rear upper tooth on the patient's right, appears on the left of the chart. The Universal Numbering System, sometimes called the "American System", is a dental notation system commonly used in the United States. [1] [2]
Using the periodontal six/four point chart, if more than 30% of sites are involved then a diagnosis of generalised disease is given. If less than 30% of sites are involved, then the type of periodontitis is localized. To complete the diagnosis, the extent of the disease must be assessed.
Wisdom teeth are not included because pericoronitis and tooth impaction may cause isolated periodontal defects which do not represent the general periodontal condition of the rest of the mouth. At least 2 teeth must be present in a sextant for it to be scored. If only 1 tooth is present in a sextant, the tooth is included in the adjoining sextant.
The system uses two numbers to define each tooth. One to specify the quadrant, and one to specify the tooth within that quadrant. Orientation of the chart is traditionally "dentist's view", i.e. patient's right corresponds to notation chart left. The designations "left" and "right" on the chart below correspond to the patient's left and right.
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Gingivitis is a non-destructive disease that causes inflammation of the gums; [1] ulitis is an alternative term. [2] The most common form of gingivitis, and the most common form of periodontal disease overall, is in response to bacterial biofilms (also called plaque) that are attached to tooth surfaces, termed plaque-induced gingivitis.