Are there differences between partial and total periodontal examination of the mouth?

  • Renata S Coelho Federal University of Campina Grande, Campina Grande, Paraíba, Brazil.
  • Estela S Gusmao Department of Oral Medicine, University of Pernambuco, Recife, Pernambuco, Brazil.
  • Rafael Amorim Cavalcanti de Siqueira Federal University of Pernambuco
  • Nikos Donos Unit of Periodontology, Eastman Dental Institute, London, UK.
  • Bruna Carvalho Farias Vajgel Associate Professor, Department of Prosthesis and Oral Facial Surgery, Federal University of Pernambuco, Recife, Brazil.
  • Renata Cimões Associate Professor, Department of Prosthesis and Oral Facial Surgery, Federal University of Pernambuco, Recife, Brazil.


Background: Diagnosis of periodontal disease for epidemiologic survey is difficult due to complexity of periodontal exam. The aim of this study was  to compare data from a full-mouth examination and a partial-mouth examination, observing the agreement between both methods of presenting the Community Periodontal Index (CPI).

Methods and Findings: The population comprised of male and female subjects, aged 18 years and over, attending public health centers in the city of Recife, Brazil. A total of 505 patients participated in this study. Each participant completed a form and underwent periodontal examination. Firstly, for each tooth present one of the periodontal conditions was determined: periodontal health, gingival bleeding, dental calculus, shallow periodontal pockets and deep periodontal pockets, according to CPI. Finally, partial data (10 index teeth) was recorded derived from the total version of CPI. Bivariate analysis of frequencies and means was performed. Mc Nemar test was used to calculate the level of statistical significance of the association tested. There are significant statistical differences between partial and full-mouth examination (p<0.001). According to gender, men classified as score 1 presented the same prevalence in both methods; partial recording overestimated 0.2% of women classified as score 1; percentile difference among men was higher for subjects classified as score 0. Among subjects with at least one tooth with deep periodontal pocket, percentile difference between different approaches was higher among elders (60 years and over).

Conclusions: Considering the variable age, the smaller amount of lost information refers to periodontal pockets in individuals aged 18 to 30 years of age. In older individuals classified as periodontally healthy and with gingival bleeding no loss of information was observed. Partial examination of the mouth underestimated the presence of periodontal pockets and overestimated the presence of calculus and bleeding. A high concordance between the partial and total examination was observed.


- Gjermo P, Rösing CK, Susin C, Oppermann V. Periodontal disease in Central and South America. Periodontol 2000, 2002; 29: 70-78.
2 - Vettore MV, Lamarca GA, Leão ATT, Sheiham A, Leal MC. Partial recording protocols for periodontal disease assessment in epidemiological surveys. Cad Saúde Pública 2007; 23(1): 33-42.
3 - Newman MG. Current concepts of the pathogenesis of periodontal disease. J Periodontol 1985; 56:734-9.
4 - Russell AL. A system of classification and scoring for prevalence surveys of periodontal disease. J Dent Res 1956; 35:350-9.
5 - Greene JC, Vermillion JR. The simplified oral hygiene index. J Am Dent Assoc 1964; 68:7-13.
6 - Ramfjord SP. The Periodontal Disease Index (PDI). J Periodontol 1967; 6 Suppl 38:602-10.
7 - Carlos JP, Wolfe MD, Kingman A. The extent and severity index: a simple method for use in epidemiologic studies of periodontal disease. J Clin Periodontol 1986; 13:500-5.
8 - Ainamo J, Barmes D, Beagrie G, Cutress T, Martin J, Sardo-Infirri J. Development of the World Health Organization (WHO) community periodontal index of treatment needs (CPITN). Int Dent J 1982; 32:281-91.
9 - WHO - World Health Association. Oral health surveys: basic methods. 4th ed. Geneva: ORH/EPID, 1997. 66p.
10 - Benigeri M, Brodeur JM, Payette M, Charbonneau A, Ismail AL. Community periodontal index of treatment needs and prevalence of periodontal conditions. J Clin Periodontol 2000; 27(5): 308-12.
11 - Brasil. Ministério da Saúde. Divisão Nacional de Saúde Bucal. Levantamento epidemiológico em saúde bucal: Brasil, zona urbana, 1986. Brasília: Centro de Documentação do Ministério da Saúde, 1988. 137.
12 - Gesser HC, Peres MA, Marcenes W. Condições gengivais e periodontais associadas a fatores socioeconômicos. Rev Saúde Pública 2001; 35(3): 289-93.
13 - Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Projeto SB Brasil 2003: Condições de saúde bucal da população brasileira 2002-2003: resultados principais. Brasília: Ministério da Saúde, 2004. 67p.
14 – Moimaz SAS, Saliba NA, Garbin AJI, Saliba O, Lelis RT, Santos KT. Condiciones periodontales y características socioeconómicas de jóvenes y adultos brasileños. Acta Odontol Venez 2008; 46(2).
15 - Coelho RS, Gusmão ES, Jovino-Silveira RC, Caldas Júnior AF. Profile of periodontal conditions in a Brazilian adult population. Oral Health Prev Dent 2008; 6(2): 139-45.
16 - Baelum V, Fejerskov O, Manji F, Wanzala P. Influence of CPITN partial recordings on estimates of prevalence and severity of various periodontal conditions in adults. Community Dent Oral Epidemiol 1993; 21: 354-59.
17 - Ainamo J, Ainamo A. Partial indices as indicators of the severity and prevalence of periodontal disease. Int Dent J 1985; 35:322-6.
18 - Aucott DM, Ashley FP. Assessment of the WHO partial approach in identification of individuals highly susceptible to periodontitis. Community Dent Oral Epidemiol 1986; 14:152-5.
19 - Grytten J, Holst D, Gjermo P. Validity of CPITN´s hierarchical scoring method for describing the prevalence of periodontal conditions. Community Dent Oral Epidemiol 1989; 17: 300-3.
20 - Baelum V, Papapanou PN. CPITN and the epidemiology of periodontal disease. Community Dent Oral Epidemiol 1996; 24:367-8.
21 - Dowsett SA, Eckert GJ, Kowolik MJ. The applicability of half-mouth examination to periodontal disease assessment in untreated adult populations. J Periodontol 2002; 73:975-81.
22 - Attström R. Van der Velden U. Consensus report of Session I. In: Lang NP, Karring T, eds. Proceedings of the 1st European Workshop on Periodontology. London: Quintessence Publishing Co 1994.
23 - Hansen BF, Bjertness E, Gjermo P. Changes in periodontal disease indicators in 35-year-old Oslo citizens from 1973 to 1984. J Clin Periodontol 1990: 17: 249–254.
24 - Papapanou PN. Epidemiology and natural history of periodontal disease. In: Lang NP, Karring T, eds. Proceedings of the 1st European Workshop on Periodontology. London: Quintessence Publishing Co, 1994.
25 - Gaare D, Rölla G, Aryadi FJ, Van der Ouderaa F. Improvement of gingival health by toothbrushing in individuals with large amounts of calculus. J Clin Periodontol 1990: 17: 38–41.
26 - Silness J, Roynstradt T. Partial mouth recording of plaque, gingivitis and probing depth adolescents. J Clin Periodontol 1988; 15:189-92
27 - Caldas Júnior AF, Jovino-Silveira RC, Marcenes W. The impact of restorative treatment on tooth loss prevention. Pesqui Odontol 2003; 17(2): 166-70.
28 - Jovino-Silveira RC, Caldas Ade F Jr, de Souza EH, Gusmão ES. Primary reason for tooth extraction in a Brazilian adult population. Oral Health Prev Dent. 2005;3(3):151-7.
How to Cite
COELHO, Renata S et al. Are there differences between partial and total periodontal examination of the mouth?. International Archives of Medicine, [S.l.], v. 10, sep. 2017. ISSN 1755-7682. Available at: <>. Date accessed: 19 oct. 2017. doi:
Dental Medicine