Advantages and Limitations

The advantages of using the PSR system include early detection, speed, simplicity, cost-effectiveness, ease of recording, and risk management.

• Early detection: Since all sites are evaluated, the risk of periodontal disease can be made early and appropriate treatment can be performed.

• Speed: Once the technique of the PSR system is learned, it should take only a few minutes to perform the screening. This saves time versus a comprehensive examination.

• Simplicity: It is easy to do and understand for patients.

• Cost-effectiveness: It is not necessary to purchase expensive equipment since all that is needed is a ball-tipped probe.

• Ease of recording: Only one number is recorded for an entire sextant.

• Risk management: The dental team is monitoring and recording a patient's periodontal status to stay compliant with standards of care and for legal requirements.

There are limitations when using the PSR system. As stated earlier, it is not intended to replace a full-mouth periodontal examination. Those patients who have received treatment for periodontal diseases and/or are in a maintenance phase of care should receive comprehensive periodontal examinations routinely. There is also limited use of the PSR system in children. It is necessary to differentiate pseudo-pockets from true periodontal pockets with these younger patients. In any patient exhibiting enlarged gingiva or recession, the PSR score may give false results.¹⁴ Landry and Jean reported that since the PSR does not measure epithelial attachment, the severity of periodontal disease may be underestimated with its use.⁵ While a study by Rams and Loesche found a pretreatment PSR score of 4 or greater in 110 adults to be a good predictor of periodontal access surgery needs, this same study concluded after performing non-surgical periodontal therapy the score overestimated surgical access needs.¹³