As a registered dental hygienist, I probe a patient's teeth and gums at every cleaning and periodontal maintenance appointment. Probing the oral structures allows us to detect and measure periodontal pocketing and defects, attachment loss, location of calculus buildup, and recession.
Measuring pocket depths at every recall appointment can also help with diagnosing and treating systemic changes and conditions before expensive or invasive solutions are necessary. This allows hygienists to make a positive difference in the lives of our patients, and also make a difference in the practice as well, by treating and educating the patient.
Generational differences
Manual probes are considered first- and second-generation probes. The first probe, invented in 1936 by Charles H.M. Williams, has thin markings at graduated levels that allow the clinician to easily measure pockets and other structures.
However, the use of a manual probe has its limitations. Generally, a hygienist will need a second person to write down the pocket depths. This takes an assistant or a front-desk person away from his or her other duties. In addition, different practitioners probe at different angles and pressures, creating the possibility of differing or conflicting probing depths. Also, a first-generation probe is not pressure-sensitive, while second-generation probes were created to fix this problem. However, neither first- nor second-generation probes could fix reading or calculation errors.
The third-generation probes, known as automated probes, were developed to prevent such discrepancies. Examples of these probes and their related systems follow.
- The Florida Probe
- GoProbe
- Probe One (Interprobe)
- Dental R.A.T.
I have had the opportunity to try each of these products, with the exception of the GoProbe.
The Florida Probe keeps a consistent pressure of 15gm for accuracy and patient comfort. It can record missing teeth, recession, pocket depth, bleeding, suppuration, furcation involvement, mobility, and plaque assessment, just by pressing the foot pedal. The data is automatically transferred to the computer.
The Florida Probe now has a disposable handpiece called the Dolphin, which exerts the same 15gm of pressure. One of the advantages of using the Florida Probe is increased productivity—because the Florida Probe uses its own software and foot pedal, no second person is needed to record measurements. Also, there is no need to read the small lines on the probe; once the operator presses the foot pedal, the number is recorded and repeated aloud so both the operator and the patient can hear it.
The exam charts are customizable to record all or some of the following information:
- Dentition
- Medical history
- Risk assessment
- Recession and hyperplasia
- Gingival attachment
- Pocket depth
- Bleeding
- Suppuration
- Furcation
- Plaque
- Mobility
- Mucogingival junction
- Diagnosis
The chart also provides a great clinical and treatment map for patients and provides documentation for your protection as a practitioner. The disadvantage with the Florida Probe is the operator may underestimate the deep probing depths due to the loss of tactile sensitivity.
Being thorough
The Florida Probe Corporation has also developed the GoProbe System. This system uses the Florida Probe's software, but can be used with any probe. A wireless keypad serves as a handy input device for charting and record creation. As with the Florida Probe, there is no need to have an assistant or other team member helping to record the data. GoProbe is a great tool for documentation and treatment planning for the periodontal needs of your patients.
The measurements are repeated to both the clinician and the patient. The colorful chart creates a great visual for you to better educate your patients so they better understand their condition and any necessary treatment.
The Probe One is another periodontal charting system that connects to your computer via USB. Also known as the Gentle Probe, this system's flexible probe tip curves right along the tooth as you explore the pocket area. The optical encoder handpiece uses a consistent 15gm of pressure to measure pocket depths.
This charting and probing system provides the documentation necessary to present treatment, and its audio capabilities enable your patients to hear the measurements. Probe One also gives you the option to print a colorful chart for patient education and case acceptance.
The Dental R.A.T., a foot-operated mouse, offers a hands-free option to periodontal charting. It also can be used for intraoral photos and X-rays, freeing up an assistant or front-desk person for other duties. The nice part about the Dental R.A.T. is that the foot pedal is USB-based and can be easily plugged in and used with your periodontal charting system.
The foot pedal is designed to record certain numbers based on how you step—it has four input buttons for easy entry of charting numbers one through eight, and a right-click option. A heel button serves as the left click, and a toe button moves the arrow on the computer screen, just like a regular mouse. The Dental R.A.T. also provides audio feedback, repeating the numbers through computer speakers or headset when entered.
All of the systems above are great for periodontal charting in your dental practice. It is just a matter of determining what meets the needs of your practice and your budget.
References
- https://www.dentalaegis.com/cced/2011/03/periodontal-probing-systems-a-review-of-available-equipment
- http://dentalrat.com
- http://www.probeone.com
- http://www.floridaprobe.com/index.htm
Jill Coon is a registered dental hygienist and a dental virtual office manager who has been in the dental field since 1985. She provides consulting administrative support to dental teams. She works behind the scenes to help increase production collections.
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