Dental probes and explorers—musts for examination

Dental probes and explorers—musts for examination

Tips for these handy dental tools
Jul 01, 2011

Dental probing and exploring should be part of every professional oral hygiene visit. Here are some tips on what instruments to use and what to look for in your canine and feline patients.

Periodontal probe

A periodontal probe is used to measure the depth of the gingival sulcus and periodontal pockets in millimeters to help evaluate the extent of periodontal support. The probe is often referred as the "stethoscope and dipstick" of tooth support.

Probes vary in cross-sectional design (rectangular/flat, oval, or round) and in millimeter markings at the calibrated working end. Some probes are marked in 1-mm bands (Photo 1A), while others are marked every 3 mm (Photo 1B). I prefer the thin Williams probe (a round, conical-shaped probe with markings at 1, 2, 3, 5, 7, 8, 9, and 10 mm) to help evaluate dog and cats (Photo 1C).

Probing depth

Every professional oral hygiene procedure conducted while a patient is anesthetized should include probing and charting. Probing involves inserting the periodontal probe into the gingival sulcus or periodontal pocket and recording the depth in millimeters. The clinical or probing depth is the distance between the base of the sulcus or pocket and the gingival margin.

With gentle pressure, the probe will stop where the gingiva is attached to the tooth. Cats normally have probing depths less than 1 mm, while dogs have depths between 2 and 4 mm, depending on the area sampled and dog's size (Photos 2A and 2B). Greater depths indicate loss of attachment, a sign of periodontal disease requiring further evaluation and treatment (Photos 3A-3C).

Photo 4: An abnormal 7-mm probing depth noted palatally on the left maxillary fourth premolar.
There are two methods of probing—spot and circumferential. Spot probing involves inserting and withdrawing the probe at a single area per tooth (Photo 4). Because single areas do not represent the entire tooth, an inaccurate assessment may be obtained. Circumferential probing involves inserting the probe in the sulcus or pocket in at least four places (two buccal and two lingual or palatal) around the tooth. This method compensates for inaccurate readings when subgingival calculus or isolated areas of vertical bone loss are present.

The percentage of support loss, plus clinical and intraoral examination findings, contribute to the creation of a treatment plan. Depending on the client's ability to provide daily plaque control and the patient's willingness to accept such measures, those teeth affected by periodontal pockets composing less than 25 percent of the root height (stage 2 periodontal disease) can be treated with a locally applied antimicrobial or antibiotic. Teeth affected by 25 to 50 percent pocket probing depths (stage 3 periodontal disease) can be treated with extraction or open flap surgery to clean the accessible root surface and, hopefully, save the tooth. Teeth affected by more than 50 percent support loss should be extracted.