Periodontal Screening Index

By collecting the Periodontal Screening Index (PSI), dentists can easily determine the severity of periodontitis (inflammation of the periodontium) as part of routine examinations and initiate therapeutic measures at an early stage if treatment is needed. The PSI was developed in the 1990s. While it has been a mandatory part of every routine dental examination in the Netherlands for a number of years, in Germany it has been included in the catalog of statutory health insurance schemes since 2004 and can be collected at two-year intervals for children and adults.

Indications (areas of application)

• Routine screening of periodontal health status of all patients.
• For early initiation of periodontal therapy.
• For progress monitoring after successful periodontal therapy in the context of supportive periodontal therapy (UPT).
• For early detection of a relapse (a recurrence of periodontal disease).

Contraindications

• None

The procedures

I. Adults

• To survey the PSI, each jaw is first divided into three sections: both posterior regions and the anterior region. For the entire dentition, this results in six sections, called sextants:

Sextant	Jaw section
S1	Upper right molars
S2	Top anterior region
S3	Upper left molars
S4	Molar teeth lower left
S5	Lower anterior region
S6	Molar teeth lower right

• On each tooth, the probing depth of the gingival pocket is determined by carefully probing at up to six points with a WHO probe (World Health Organization probe: rounded at the tip and provided with a special scale), and the bleeding tendency is ascertained by gently stroking in the gingival sulcus (depression running circularly around the tooth between the tooth and gum).
• For each sextant, only the worst value is entered in a special findings chart:

PSI code	Probing depth	Bleeding tendency	Tartar or Biofilm (plaque) or Defective restoration margins	Therapy
0	< 3.5 mm	none	none	Recall (regular control)
1	<3.5 mm	Bleeding	None	Motivation Oral hygiene guide Recall
2	<3.5 mm	possibly	present	Professional dental cleaning (PZR) Contouring of filling margins, if necessary. Motivation Oral hygiene guide Recall
3	> 3.5 mm to < 5.5 mm			Suspected mild to moderate periodontitis, therefore: Survey of a detailed periodontal findings. Professional teeth cleaning Oral hygiene guide If necessary, systematic periodontal therapy
4	> 5.5 mm			Suspected moderate to severe periodontitis, therefore: Collection of a detailed periodontal findings. Professional teeth cleaning Oral hygiene guide Systematic periodontal therapy

II. children

Periodontal disease (disease of the periodontium) may occur as early as childhood. Because this early form of periodontitis begins on the first molars (first posterior molars, six-year molars) and incisivi (incisors), measurement in children is limited to teeth 11, 31, and the six-year molars.

According to the procedure

After the PSI has been obtained, further therapeutic measures are initiated if the findings are appropriate.

Possible complications

• None