Periodontal screening test (PSR)
Free version, no sign-up. We do not store any patient data: whatever you enter is seen only by you and disappears as soon as you close the tab. To keep the result, print the forms or save them as PDF.
Patient details
Optional — they only appear on the forms.
PSR codes
For each sextant, enter the highest code found among all its teeth. Select a sextant and press 0–4, «-» for an edentulous one or «*» for special problems.
How to perform PSR
For whom: every new patient, and patients at a check-up whose previous PSR codes were «0», «1» or «2».
Probe every tooth of the sextant at six sites with a periodontal probe carrying a coloured band (its edges mark 3.5 and 5.5 mm), keeping the probe parallel to the tooth's long axis. Record the highest code found in the sextant: the first code «4» lets you move on to the next sextant. If a sextant has only one tooth, assess it together with the neighbouring sextant and mark this one edentulous.
- 0
- the probe's coloured band is fully visible; no bleeding and no calculus
- 1
- the band is fully visible; bleeding on probing; no calculus or overhanging margins
- 2
- the band is fully visible; supra- or subgingival calculus and/or overhanging restoration margins
- 3
- the band is partly visible — probing depth 3.5–5.5 mm
- 4
- the band disappears completely — probing depth over 5.5 mm
- *
- special problems: furcation involvement, gingival recession over 3 mm, tooth mobility
- —
- edentulous sextant
Instructions prepared by Oksana Shekera.
Result
Fill in all six sextants to see the result.
© 2026 UAPeriO. All rights reserved. The test's code, images and design may not be copied or published on other websites without the association's written permission.