Periodontal Screening · ADA/AAP · BPE Equivalent · 6 Sextants

PSR Periodontal Screening Record

ADA/AAP Periodontal Screening Record (PSR) — equivalent to the BPE. Enter WHO probe codes 0–4 for all 6 sextants, add furcation/asterisk modifiers, and generate treatment need classification and specialist referral recommendation.

NMClinically reviewed byDr. Nikhil Mahajan, PT, MPT  ·  Jan 15, 2026
0–1HealthyOHI only
|
2GingivitisScale + OHI
|
3Early/Mod. PerioFull assessment
|
4Severe PerioSpecialist referral
|
*ModifierFurcation / recession
Highest Code
Sextants Scored0 / 6
Asterisk (*)None
Overall Severity
PSR / BPE Code Reference
0
No disease
None required — preventive care
1
Bleeding on probing
Oral hygiene instruction (OHI)
2
Calculus detected
Scale and polish + OHI
3
Early/moderate periodontitis
Comprehensive periodontal assessment
4
Severe periodontitis
Specialist referral recommended
Score each sextant (record highest code found in that sextant)
UR Upper right (17–14)
UA Upper anterior (13–23)
UL Upper left (24–27)
LR Lower right (47–44)
LA Lower anterior (43–33)
LL Lower left (34–37)

PSR Code Reference — Treatment Guidelines

CodeClinical findingsPocket depthTreatment need
0 No bleeding, no calculus, pockets <3.5mm. Black band fully visible. <3.5mm (health) None required — preventive care
1 Bleeding after gentle probing. No calculus, pockets <3.5mm. <3.5mm (health) Oral hygiene instruction (OHI)
2 Supra or subgingival calculus present. Pockets <3.5mm. <3.5mm (health) Scale and polish + OHI
3 Pockets 3.5–5.5mm. Black band partially visible. <3.5mm (health) Comprehensive periodontal assessment
4 Pockets >5.5mm. Black band completely subgingival. <3.5mm (health) Specialist referral recommended
*Furcation involvement OR recession ≥3.5mmAdd asterisk to sextant code; increases management complexity

PSR Periodontal Screening Record: Clinical Guide

The PSR (Periodontal Screening Record) was developed jointly by the American Dental Association (ADA) and the American Academy of Periodontology (AAP) as a rapid chairside screening tool for periodontal disease in general dental practice. It is functionally equivalent to the Basic Periodontal Examination (BPE) used in the UK and Europe, both using the WHO Community Periodontal Index probe with its 3.5–5.5mm black band.

How PSR Is Administered

The dentition is divided into six sextants: upper right, upper anterior, upper left, lower right, lower anterior, lower left. Each sextant must contain at least two teeth to be scored — edentulous sextants are excluded. The WHO probe is walked around each tooth in the sextant. The highest code found in that sextant is recorded. The asterisk (*) modifier is added to any sextant code where furcation involvement is detected or gingival recession of 3.5mm or more is present.

PSR vs Full Periodontal Chart

The PSR is a screening tool only — it does not replace a full periodontal chart with 6-point probing depths, recession measurements, furcation grading, and mobility scores. Any sextant scoring 3 or above (or any asterisk) requires a comprehensive periodontal assessment with a full-mouth periodontal chart before treatment planning. PSR guides the clinician to whether a full chart is needed — it does not provide the full chart itself.

NM
Dr. Nikhil Mahajan, PT, MPTReviewed January 15, 2026 · View credentials

Frequently Asked Questions

Is PSR the same as BPE?
Functionally yes — the PSR (US: ADA/AAP) and BPE (UK/Europe: BSP) use the same WHO probe, the same 6-sextant division, and the same 0–4 coding system with an asterisk modifier. The main difference is in management guidelines: BSP guidelines (2019) have more detailed prescriptive management protocols for each BPE code, while PSR guidelines are less prescriptive. Both are equivalent screening tools.
What does the asterisk (*) modifier mean on the PSR?
The asterisk (*) is added to a sextant code when: (1) furcation involvement is detected in any tooth within that sextant, or (2) gingival recession of 3.5mm or more is present. The asterisk increases the complexity of that sextant's management regardless of the numerical code. A Code 2* requires more complex management than Code 2 alone.
When should I refer to a periodontist based on PSR?
Code 4 in any sextant warrants specialist periodontal referral. Code 3* (code 3 with asterisk) in any sextant also generally warrants specialist assessment. Multiple sextants scoring code 3 may also benefit from specialist assessment for complex treatment planning. The AAP guidelines recommend referral whenever the clinical presentation is beyond the competency or resources of the general practice.