Anatomy and Basic Periodontal Examination
- Enamel
- Dentin
- Junctional epithelium
- Connective tissue
- Alveolar bone
- Division of dentition into six sextants
- Use of World Health Organization (WHO) Probe
- Running the probe around gingival pockets
- Scoring codes range from 0 to 4
- More detailed charting for BPE scores of codes 3 and 4
- Sextant division: Upper Right, Upper Anterior, Upper Left, Lower Right, Lower Anterior, Lower Left
- Recording the highest score in each sextant
- Radiographs for teeth or sextants with BPE codes 3 or 4

Timing of Examination
- BPE recorded for all new patients
- BPE recorded for patients with code 0, 1, and 2 at least once annually

Guidance on Interpretation of BPE Scores
- Score 0: No need for periodontal treatment
- Score 1: Provide patient with oral hygiene instruction (OHI)
- Score 2: Provide patient with OHI and remove plaque retentive factors
- Score 3: Provide patient with OHI and root surface debridement (RSD)
- Score 4: Provide patient with OHI, RSD, and evaluate for more complex treatment

Microbiology
- The environment of the gingival sulcus is unique within the mouth.
- The gingival sulcus becomes a periodontal pocket in the presence of periodontal disease.
- Gingival crevicular fluid (GCF) increases significantly during gingivitis and periodontitis.
- Gingival crevicular fluid provides defense mechanisms against microbial insult.
- Bacterial metabolism in the gingival sulcus is supported by proteins and glycoproteins present in GCF.

Pathology
- Chronic excess of sulcular depth can lead to inadequate cleansing and accumulation of food debris and microbes.
- Dental biofilm can form in the sulcus, posing a danger to periodontal ligament fibers.
- If microbes remain undisturbed, they can penetrate and destroy soft tissue and periodontal attachment fibers.
- Untreated periodontal disease may result in deepening of the sulcus, recession, and tooth loss.
- A periodontal pocket indicates an abnormally deepened gingival sulcus.

Gingival sulcus (Wikipedia)

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Main article: Gingival and periodontal pockets

The gingival sulcus is an area of potential space between a tooth and the surrounding gingival tissue and is lined by sulcular epithelium. The depth of the sulcus (Latin for groove) is bounded by two entities: apically by the gingival fibers of the connective tissue attachment and coronally by the free gingival margin. A healthy sulcular depth is three millimeters or less, which is readily self-cleansable with a properly used toothbrush or the supplemental use of other oral hygiene aids.^{[citation needed]}

Gingival sulcus
Gingival sulcus (G). Other letters: A, crown of the tooth, covered by enamel. B, root of the tooth, covered by cementum. C, alveolar bone. D, subepithelial connective tissue. E, oral epithelium. F, free gingival margin. H, principal gingival fibers. I, alveolar crest fibers of the PDL. J, horizontal fibers of the PDL. K, oblique fibers of the PDL.
Details
Identifiers
Latin	sulcus gingivalis
TA98	A05.1.01.111
TA2	2793
FMA	74580
Anatomical terminology [edit on Wikidata]