How to do periodontal charting, step by step
Six measurements, six sites on every tooth, and a fixed order that stops you losing your place. The method is the same on paper as it is on screen.
What periodontal charting is
Periodontal charting is the record of how much support each tooth has left. You measure the same six points around every tooth, write down what you find, and repeat it at the next visit so the two visits can be compared. It is the only way to tell a mouth that is stable from one that is losing attachment, because both can look the same.
Six sites, not one number
Three points on the cheek side and three on the tongue side of each tooth. A tooth with one deep site and five shallow ones is a different problem from one that is deep all round.
A full mouth is 192 sites
Thirty-two teeth at six sites each. That is why order matters more than speed: skip a site and you cannot tell later whether it was healthy or missed.
The comparison is the point
One chart describes today. Two charts, taken the same way, show whether treatment worked. Charting that changes method between visits cannot be compared.
The six things you record
Every periodontal chart is built from these. The abbreviations are the same on paper and on screen, and international, so a chart travels between clinics.
- Pocket depth (PD)
- From the gum margin down to the base of the pocket, in millimetres. One to three is healthy. Four and above is where you start paying attention.
- Recession (REC)
- How far the gum margin sits from the cementoenamel junction. Positive when the root is exposed, negative when the gum sits above the CEJ.
- Bleeding on probing (BOP)
- Marked or not marked, per site. It is the single best sign of active inflammation, and the number that should fall first after treatment.
- Plaque (PLQ)
- Present or absent, per site. Recorded the same way as bleeding, and read together with it: plaque explains most bleeding you will find.
- Mobility (MOB)
- Graded per tooth, not per site, on a nought to three scale. It reflects how much bone is left holding the tooth rather than how deep the pocket is.
- Furcation (FURC)
- Only on multi-rooted teeth, where the roots divide. Graded by how far a probe passes between them, and often the finding that changes the plan.
How to chart a full mouth, on paper or on screen
This is the order most schools teach, and the one the tool follows. Keep it the same every time and the chart becomes comparable to the last one.
- 01
Set the sheet out first
Fill in the patient, the date and who is charting before you pick up the probe. A sheet found later with no date on it records nothing you can use.
- 02
Start in one quadrant and never jump
Upper right to upper left, then lower left to lower right, is the usual route. The route matters less than always using the same one.
- 03
Walk the probe, do not spot check
Keep the probe against the root and walk it around the tooth, recording the deepest reading in each of the three zones per side. Six numbers per tooth.
- 04
Read recession against the CEJ
Find the cementoenamel junction, then measure to the gum margin. Write it as a negative number when the gum sits above the junction rather than below it.
- 05
Mark bleeding, plaque and suppuration
Wait a few seconds after probing a sextant before you score bleeding. Scored too early it reads clean, and bleeding is the finding you least want to miss.
- 06
Finish with mobility and furcation
Both are per tooth rather than per site, so they are quicker done in one pass at the end than mixed in with the six-site readings.
- 1B1828
- 2P1828
- 3B4838
- 4L4838
Charting on paper? There is a free printable form with all six rows already ruled, in A4 and US Letter. No email address and no account.
A filled chart, read out loud
Numbers on their own teach very little. This is a charted mouth with the findings explained, and you can open the same chart and change anything in it.
- A 7 mm pocket with 2 mm of recession
- That is 9 mm of attachment lost, not 7. Recession is added to pocket depth to get clinical attachment loss, which is the number that describes the damage.
- Bleeding at a shallow site
- A 3 mm site that bleeds is inflamed today. Depth tells you what has already happened, bleeding tells you what is happening now, so read the two together.
- Grade II furcation on a lower molar
- The probe passes more than a third of the way between the roots. This usually changes the plan on its own, whatever the pocket depths around it say.
It opens in the free tool with the measurements already in it. Nothing is saved, so change whatever you like.
Practise on a blank chart, as often as you like
The free chart needs no account and saves nothing, so it is a safe place to get the sequence into your hands. Type a value and it moves to the next site by itself, which is what keeps you from losing your place.
Type, do not click
Enter a number and the chart advances. Arrow keys move by hand, Backspace clears, and typing 1 then a digit enters ten or more.
Bleeding, plaque and suppuration
B, P and S mark their own rows. Pressing the key again clears the mark, so a mis-hit costs nothing.
Either numbering system
Switch between FDI and the 1 to 32 Universal system above the chart. The export follows whichever is showing.
Using it with a class
Charting is taught by repetition, and the usual obstacle is that practice software needs licences and logins before anyone can start.
- Nothing to hand out
- The chart opens in a browser with no account, no install and no licence. A whole cohort can be charting within a minute of opening the link.
- One link, the same chart
- A worked example travels as a link. Everyone who opens it gets their own editable copy, and no changes reach anyone else.
- Paper for the bench
- The printable form is free, unwatermarked and needs no email address, so it can be copied for a class without asking anyone for anything.
The words on a chart
- Pocket depth (PD)
- The distance from the gum margin to the base of the sulcus or pocket, in millimetres. One to three millimetres is generally healthy.
- Clinical attachment loss (CAL)
- Pocket depth plus recession. It measures from a fixed landmark on the tooth rather than from the gum, so it does not move as the gum does.
- Cementoenamel junction (CEJ)
- The line where the enamel crown meets the root surface. It is the fixed reference every attachment measurement is taken from.
- Recession
- How far the gum margin has moved away from the CEJ, exposing root. Recorded as a negative number when the gum sits above the junction instead.
- Bleeding on probing (BOP)
- Whether a site bleeds after gentle probing. Recorded per site as present or absent, and the earliest sign that inflammation is active.
- Suppuration
- Pus expressed from a pocket. Recorded per site, uncommon, and a sign of active infection that outweighs a moderate pocket depth reading.
- Furcation involvement
- Bone loss between the roots of a multi-rooted tooth, graded by how far a probe passes through the space between them.
- Mobility
- How far a tooth moves under pressure, graded nought to three per tooth. It reflects remaining bone support rather than pocket depth.
Questions
- What is periodontal charting?
- It is the record of how much support each tooth has left. You measure six points around every tooth, note bleeding, plaque, mobility and furcation, and repeat it at later visits so the results can be compared. A single chart describes today; two charts show whether anything is changing.
- How do you do periodontal charting on paper?
- Fill in the patient and date first, then work quadrant by quadrant in the same order every time. Walk the probe around each tooth and record the deepest reading in each of the three zones per side, then recession against the CEJ, then bleeding and plaque, then mobility and furcation per tooth at the end. There is a free printable form on this site with all six rows already ruled.
- What do the numbers on a perio chart mean?
- The main row is pocket depth in millimetres, one to three being generally healthy and four or more warranting attention. The row beside it is recession from the cementoenamel junction. Adding the two gives clinical attachment loss, which is the figure that describes how much support has actually been lost.
- How long does a full mouth chart take?
- A full mouth is 192 sites, so the first ones you do will be slow. With a settled order and a second person recording, it usually settles at around five to ten minutes. Charting on screen removes the recording half, because each value you type moves the cursor to the next site by itself.
- Where can I practise periodontal charting?
- On the free chart on this site. It needs no account, saves nothing and can be reloaded as often as you like, so there is nothing to break. There is also a worked example on this page that you can open and edit, and a printable blank form if you would rather practise on paper.
- Do I need an account?
- Not to chart, to read the summary or to export a PDF. All of that is free and anonymous, and nothing is stored. A free account adds saved patients and lets you compare a patient's charts across visits, which the anonymous tool cannot do because it keeps nothing.
- What is a normal pocket depth?
- One to three millimetres, with no bleeding on probing, is generally taken as healthy. Four to five millimetres suggests a pocket that needs treatment, and six or more is usually described as deep. Depth alone is not the whole picture, though: a shallow site that bleeds is still inflamed.
- Is this suitable for dental hygiene students?
- Yes, and it is a common use. There is no licence, no install and no account, so a whole class can open the same worked example and edit their own copy of it. The printable form is unwatermarked and free to photocopy for benchtop practice.
Chart a mouth in the next five minutes
No account, no install, and nothing saved anywhere you did not put it.
Open the free chart