2. BPE — screen fast, then stop using it as the diagnosis
What BPE is for
The Basic Periodontal Examination is a screening tool with a WHO probe, recorded per sextant. It tells you how much further examination you need. It does not diagnose periodontitis, stage it, or prove that treatment worked. Pockets can stay even when inflammation is controlled.
Adult codes (plain language)
- 0 — no bleeding, no retentive factors, black band fully visible
- 1 — bleeding on probing
- 2 — plaque-retentive factor (calculus, overhang)
- 3 — black band partly in the pocket (typical 4–5.5 mm range)
- 4 — black band disappears (typical 6 mm or more)
- * — furcation
Record the worst code in each sextant. New dentate adults get a BPE. Codes 0–2: repeat BPE at routine exams. Codes 3 or 4: you need a proper periodontal assessment, not another BPE as your “monitor”.
After a code 3 or 4
Code 3: start Step 1-type care (oral hygiene, risk factors, remove retentive factors), then a 6-point chart in the affected sextant once the person has had time to respond. Code 4 (or a periodontitis history you can already see): full-mouth 6-point charting and appropriate radiographs — BPE is effectively redundant as the map of disease.
Radiographs
You need enough imaging to judge bone loss for staging. Selective periapicals and/or a panoramic view are chosen for the clinical picture — not a panoramic “because we always do”. Report bone loss relative to root length where you can.
Bleeding
Always record bleeding with a 6-point chart. Full-mouth bleeding percentage is something patients understand; BPE codes are not.
Children and young people
Periodontitis can start young. From about age 7 use the current BSP modified BPE for the index teeth in that age band. Adolescents use a fuller code set. This course will not freeze a 2012 table — check the current paediatric BSP note.
Already a periodontitis patient
If history, recession pattern or old radiographs already show periodontitis, do not “BPE them back to gingivitis”. Go to a periodontal assessment and classify current status on a reduced periodontium.