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The British Society of Periodontology, in collaboration with the British Society of Paediatric Dentistry, published guidelines in 2012 for the periodontal screening of children and adolescents. The guidelines recommended a simplified Basic Periodontal Examination (BPE) of six teeth for children aged 7–17 years. This is further modified for ages 7–11, using codes 0–2 from the 0–4 BPE adult chart. An unusual case of an 11-year-old boy who attended his general dental practitioner for a check-up is reported. Periodontal screening led to the detection of 13-mm pockets associated with the two mandibular first permanent molars that required surgical intervention and multidisciplinary care.
CPD/Clinical Relevance: This case report highlights the importance of paediatric periodontal screening in both primary and secondary care.
Article
Periodontal screening is recommended by the British Society of Periodontology for both children and adults, with screening to commence once a child has reached their 7th birthday. A simplified Basic Periodontal Examination (BPE), using six index teeth (UR1, UR3, UL6, LL1, LL6 and LR6) has been described for paediatric patients aged 7–17 years. The BPE is further modified for 7–11 year-olds, including codes 0–2 only, to avoid the recording of false pockets.1 The BPE is recorded in sextants, in the same manner that it is carried out for adults.
Alongside the detection of periodontal disease, periodontal probing can identify other abnormalities including: unexpected pus or cystic fluid secretion on probing; or isolated deep pockets that may be associated with cysts or bone pathology, as demonstrated in this clinical case.
This case highlights the detection of a rare incidence of non-syndromic large bilateral dentigerous cysts detected through routine periodontal screening within general dental practice. The differential diagnosis included false pocketing, or a periodontal anomaly. Following the radiographic examination, the differential diagnosis included keratocyst lesions or ameloblastomas.
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