Simplified basic periodontal examination (BPE) in children and adolescents: a guide for general dental practitioners

Dental plaque-induced periodontal diseases are common in both children and adults.1 plaque-induced periodontal diseases have two common manifestations, gingivitis and periodontitis. Gingivitis is a reversible disease and can be defined as the presence of gingival inflammation without loss of connective tissue attachment.2 Periodontitis can be defined as the presence of gingival inflammation at sites where there has been a pathological detachment of collagen fibres from cementum and the junctional epithelium has migrated apically.2 It is considered that gingivitis and periodontitis are a continuum of the same disease, however, there is a wide range in an individual's susceptibility and thus not all patients with gingivitis will progress to periodontitis.3^,4

The Child Dental Health Survey 20031 showed that, in three of the four age groups (5, 8, 12 years of age), levels of gingival inflammation and plaque accumulation had increased since the previous survey in 1993.5 However, the level of gingivitis for 15-year-olds remained similar to previous surveys, with 43% of 15-year-olds demonstrating gingivitis.1 This survey did not examine periodontal pocketing and thus levels of periodontitis were not measured. However, a study by Clerehugh et al found that 3% of 14-year-olds had attachment loss of at least 1 mm on at least one of the incisors, molars and premolars. The prevalence of attachment loss rose to 37% at age 16 and 77% at 19.6