8 Importance of periodontal probing depth (PPD)
There were no oral or dental problems until around 8 months ago, when severe gingivitis localized to the upper canine teeth was noted. Three episodes of professional periodontal therapy (scaling and polishing and extraction of ‘some’ teeth) under general anaesthesia had been performed in the last 6 months and the dog had received a short course of antibiotics following each dental cleaning. The gingivae had appeared healthy for approximately 3 weeks after each cleaning and antibiotic course, and then the gingival inflammation had flared up again.
The dog was referred to us for management of recurrent gingivitis affecting the upper canine teeth. The owner did not feel that the oral inflammation was affecting the general well-being of the dog (i.e. interested in walks and eating well), but he did not appreciate the halitosis.
Figure 8.1 Dental record. All clinical findings are reported on the front page of the dental record. Remember that periodontitis is a site-specific disease. PPD is recorded on the occlusal view of the tooth on the dental record so that you can easily identify the precise site of disease. Normal periodontal probing depth (PPD) is not noted on the dental record to avoid clutter. However, when gingival recession is present, then PPDs are always recorded, so that periodontal attachment loss (PAL) can be calculated (GR + PPD) and entered on the record at its precise site in green ink. PAL is a more accurate assessment of attachment loss.
(b) Note the gingival recession on the buccal aspect of 204 and 206. The gingival draining tracts located to the buccal aspect of 204 are obvious, as is the furcation involvement at 206. The crown fracture of 208 is also obvious.
(b) The gingivae of 204 and 206 are inflamed and the gingival margin has receded apically. Three gingival drainage tracts are evident in the buccal gingiva of 204. The furcation of 206 is clearly involved in the disease process.
The radiographs of 104 and 204 confirmed the clinical diagnosis of periodontitis. There was resorption of the alveolar margin and widening of the periodontal space. The radiograph of 104 showed extensive bone loss extending beyond the apex (Fig. 8.5).