Sir, in the supplement Oral Health Report (autumn 2013), Dr Amit Rai's article, Periodontal care includes the statement 'the BPE scores do not provide clinical diagnoses'. However, within Table 2 it records that BPE scores of 1 and above signify certain periodontal diseases. For example, a BPE score of 3 signifies 'mild to moderate periodontitis'. I should like to question this as BPE scores are already clearly defined and are limited on what they denote:1

BPE Signifies

0 Healthy periodontal tissues

1 Bleeding on probing

2 Plaque retentive factors such as overhanging restorations or calculus

3 Probing depths of 3.5-5.5 mm

4 Probing score of over 5.5 mm

* Furcation involvement

The scores do not indicate or signify anything more than this and so, for example, a BPE score of 3 does not necessarily signify 'mild or moderate periodontitis' as there could be false pocketing. Diagnosing periodontitis requires further special investigations, like radiographs. My point is that BPE scores do not signify other periodontal diseases nor should they be linked to certain diagnoses.

Dr Amit Rai responds: I would like to thank Dr George for his letter regarding my recent article Periodontal care – Dr Rai gives a brief review for the general dental practitioner. Being a 'review', Table 2 was in fact taken from a referenced source, the work of Professor Esmonde Corbet, which Dr George may have overlooked previously in the BDJ.2 Although Dr George justifies my assertion that BPE scores alone do not permit the diagnosis of periodontal conditions, he has misquoted me. Furthermore, he overlooks the fact that I reference Table 2 in the same sentence in which I state 'the BPE does not provide a clinical diagnosis' which I am sure was unintentional since that would otherwise inaccurately infer that my article was contradictory.

The point that Dr George makes in his letter is already identified in my article where I go on to state that Table 2 'can prove useful for record keeping and patient communication purposes'. However, I recognise his point regarding false pocketing, so in the interests of teamwork, I have highlighted Dr George's observations to Professor Corbet.