Presence and absence of bleeding in association with calculus in segments given Code 2 in the Community Periodontal Index of Treatment Needs (CPITN)

The periodontal status of 257 Japanese company employees aged 20-56 yr was studied to determine the number and percentage of subjects with and without bleeding after gentle probing in the sextants given a Code 2 using the CPITN. In addition to recording the presence of calculus in the conventional manner, a modification was introduced to add a Code 2+ for sextants in which bleeding after probing was found and a Code 2- where no bleeding was detected. The results indicate that 38-52% of the sextants given a Code 2 showed no bleeding after probing. Such a large percentage of sextants with no evidence of bleeding in the presence of calculus raises a question about the priority which should be accorded to provide scaling for these subjects. The results also show that of the 116 subjects aged 20-29 yr judged to be in need of periodontal treatment by the CPITN criteria 18.1% showed neither pocket formation nor bleeding. Modifications to the CPITN are suggested which should make the index more appropriate for assessing both the prevalence of periodontal disease and the need for periodontal treatment and thus make it more useful for public health planning and evaluation purposes.