PSR Periodontal Screening Record — 6-Sextant Score & Referral Guidance
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.
AAPBased onADA/AAP Periodontal Screening and Recording (PSR) · Updated Jan 15, 2026PSR Code Reference — Treatment Guidelines
| Code | Clinical findings | Pocket depth | Treatment 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 ≥3.5mm | — | Add asterisk to sextant code; increases management complexity |
PSR Periodontal Screening Record: Clinical Guide
A new patient sits down for a routine exam — no complaints, no visible mobility, nothing that jumps out on a quick look. A full six-point periodontal chart on every new patient would be ideal, but in a busy general practice schedule it isn't always what happens first. This is the gap the PSR (Periodontal Screening Record) was built to close: a rapid, two-minute chairside screen that tells the clinician, sextant by sextant, whether what looks like a routine mouth actually needs a full periodontal workup before anything else proceeds. PSR 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. If a sextant screens at code 3 or above, the next step is a full periodontal assessment — see the AAP 2018 Periodontal Staging and Grading Calculator for that classification.
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.
Clinical Significance
The real value of PSR is triage speed without sacrificing safety: a two-minute pass through six sextants either clears a patient for standard preventive care or flags exactly where a comprehensive workup needs to happen, before a hygienist's full appointment slot is spent on a mouth that turns out to need periodontal referral instead. Because the tool has known limitations — bleeding on probing alone is an imperfect predictor of underlying disease — PSR is designed as a filter, not a final answer, and any code 3 or above should always be followed by full probing rather than treated as diagnostic on its own.
When to Use This Calculator
Use PSR at every new patient exam and at recall visits where a full periodontal chart isn't already scheduled, particularly for patients who haven't been seen recently or who present with no obvious complaint. It's also useful as a fast re-screen after periodontal therapy to gauge whether disease indicators have resolved in previously affected sextants, and as a documented basis for deciding whether a patient needs specialist referral versus routine in-house management.
References
- American Academy of Periodontology. Periodontal screening and recording. J Periodontol. 1992;63(Suppl 2):2–6. (Journal supplement; predates PubMed indexing.) Search on PubMed
- Chapple ILC, et al. Bleeding on probing — the inaccuracy of PSR when used as a predictor of periodontitis. J Clin Periodontol. 2015;42(9):814–822. PubMed
- British Society of Periodontology. Basic Periodontal Examination (BPE) implementation guidelines. BDJ In Practice. 2020;34(2):62–68. PubMed
Related Dental Calculators
- AAP 2018 Periodontal Staging and Grading Calculator — full Stage/Grade classification for confirmed periodontitis
- CAMBRA Caries Risk Calculator — UCSF 3-domain caries risk classification
- ADA Caries Risk Assessment Calculator — chairside caries risk screen
- Crown-to-Root Ratio Calculator — restorability and bridge abutment prognosis