The purpose of perio charting is to show the health of a patient’s mouth in terms of bone loss, swollen tissue, bleeding, and so forth. To gain insurance approval for root planing and scaling procedures, you need to show that there is a loss of bone or loss of attached gingival tissue, and not just the pocket depth.
You can chart the following on the Perio tab:
Pocket depth
Mucogingival junction (MGJ)
Free gingival margin (FGM)
Furcation grades
You can also indicate:
Mobility
Plaque
Calculus
You can view charted data in a numerical format. The measurement from the cementoenamel junction (CEJ) to where the loose edge of the gum tissue begins is called the free gingival margin (FGM).
In a healthy mouth, the loose edge of the gum tissue extends beyond the CEJ to the visible part of the tooth. The bone and the PDL come right to the CEJ. Your probe would measure a pocket depth of less than 2 millimeters and an FGM value of 0. The charting module calculates an attachment level equal to the pocket depth. Insurance companies generally accept as healthy pocket depth or attachment levels of less than 3 millimeters.
If there is recession, there is bone loss. The gum tissue might be healthy and tight to the tooth, but it is below the CEJ, not on the visible part of the tooth. The perio probe is going to measure a pocket depth of less than 2, but the FGM value is the number of millimeters the edge of the tissue is from the CEJ—perhaps 3 or 4 millimeters. The charting module adds pocket depth to FGM value and calculates the attachment at 4 or 5 millimeters below the CEJ. The insurance company would then know that there is bone loss in that area.
Swollen tissue may be due to pregnancy or medication with no loss of attachment. This is sometimes called a pseudo-pocket. If the measurement from the CEJ to the bottom of the pocket is less than 1 millimeter, there is no bone loss.
The measurement from the CEJ to the point where the gingival tissue meets the inside lip or cheek tissue is the MGJ. This measurement is meaningless by itself; it will be a static number regardless of the patient’s periodontal health. If there is severe recession, the MGJ measurement minus the pocket depth measurement indicates the attachment level. The attachment level indicates to an insurance company if there is a severe loss of attachment.
Important: The SoftDent charting module does not perform any math on MGJ measurements.
Creating Custom Charting Paths
Using Auto Advance for Charting