Understanding Bola's Perio Meter
The Bola Perio Meter is designed to help clinicians organize and communicate periodontal findings with clarity and efficiency. It offers a three-part summary of a patient’s gum health:
Section | Purpose |
Stage & Grade | Helps summarize disease severity and potential progression. |
Perio Score | Quantifies how much of the mouth is affected by deep pockets and bleeding. |
Odontogram (Tooth Map) | Shows exactly where findings are located—by tooth and quadrant. |
These sections are meant to support clinical workflows, patient conversations, and treatment planning. All findings should be reviewed by the provider.
Stage and Grade
The periodontal stage and grade classification system is based on American Association of Periodontology's information on Staging and Grading. It provides a standardized framework for evaluating disease severity (Stage) and progression risk (Grade).
The Stage & Grade system gives you a suggested classification based on PDs and CAL only.
If additional inputs (radiographs, progression rate, risk modifiers) are relevant to your judgment, you can override the suggested stage or grade at any time.
Concept | What it represents | Typical distribution | Can the clinician override? |
Stage | Structural damage (CAL / bone loss / tooth loss risk) | Most healthy adults with some bone loss fall into Stage II; higher stages taper off into a long tail. | Yes. Bola auto-calculates CAL and PD but you can adjust if radiographs or clinical judgment indicate otherwise. |
Grade | Rate of progression (historical data + modifiers) | Default start at Grade B; risk factors such as smoking / diabetes can shift to Grade C. | Yes. Override if longitudinal records or patient‑specific factors warrant it. |
The semi‑circular dial in the UI adds two patient‑friendly categories—Healthy and Gingivitis—before Stage I. This gives you language for early‑stage conversations without forcing a periodontal stage.
Why so many patients land in Stage II
Stage II captures attachment loss of 3–4 mm.
Epidemiological data (AAP) show this is the most common profile for adults > 30 yrs.
Think of Stage II as the tipping point: still controllable, but a clear warning sign.
What About Stage I?
It’s common to see patients labeled Stage I even when there are no obvious symptoms. This is based on the math based on the AAP guideline document: a CAL of just 1–2 mm meets the AAP threshold for Stage I.
If you feel “Healthy” or “Gingivitis” is more appropriate, you can and should override the Stage as needed.
Grade modifiers: smoking & diabetes (and more)
Bola currently surfaces Smoking and Diabetes toggles because they have the strongest evidence base and are quick to capture chairside.
Other modifiers (e.g. bone loss, heavy plaque) can be considered but are not yet hard‑coded into the calculation—use clinical judgment or manual override.
Please read the FAQ on staging and grading to understand more about how staging and grading should be calculated.
Quick Treatment Lens
Classification | First‑line action |
Stage I–II | Localized SRP. Reinforce Oral Health Instructions |
Stage III–IV | Potential referral to specialist. |
Grade B–C | Shortened recall · Tailored home care |
ℹ️ Tip: Use the Stage & Grade readout to anchor urgency. For example, “You’re Stage II, Grade C — damage is moderate but progressing quickly, so let’s shorten your recall to 3 months.”
Perio Score
Perio Score: Measuring Disease Extent
Key Idea: A single metric that summarizes how widespread the condition is — useful for tracking change and simplifying communication.
1. What the Score Looks Like
Element | What it means | Example |
Perio Score (e.g. 6 / 48) | First number = sites with PD ≥ 5 mm |
|
Second number = sites that bleed on probing | 48 bleeding sites |
|
% of Mouth Impacted | % of sites with PD ≥ 5 mm | 5 % in the screenshot above |
Bleeding % | % of sites with bleeding on probing | 25 % in the screenshot |
Target Score | Always 0 / 0 | Zero deep pockets and no bleeding |
2. Color‑Zone Logic
Even one deep pocket pushes a patient into the Yellow zone—an early warning designed to prompt timely intervention.
Zone | Affected Sites | % of Sites† | Clinical Meaning | Tooth‑Based Anchor (≈ sites) |
🟢 Green | 0 | 0 % | Healthy | 0 teeth |
🟡 Yellow | 1 – 9 | ≈ < 5 % | Early signs—monitor closely | ≈ 1–2 teeth |
🟠 Orange | 10 – 35 | ≈ 5 – 18 % | Moderate disease burden | ≈ 2–5 teeth |
🔴 Red | ≥ 36 | ≥ 18 % | Extensive—intervention needed | ≥ 6 teeth |
†Calculations are based on a typical full‑mouth chart of 168–192 sites.
These zones are not diagnostic but help patients and clinicians understand distribution and severity at a glance.
The zones correlate with Stage & Grade trends but are not a 1‑to‑1 mapping; they are intentionally simpler for patient comprehension.
3. How to Use It Chairside
Communicate extent without overwhelm: “You have 6 deep pockets—that’s in the yellow zone, an early stage we can still reverse.”
Set urgency: Color bar instantly signals if action is preventive (green/yellow) or corrective (orange/red).
Benchmark progress: Recheck the score at each recall; celebrate moves toward 0 / 0.
4. Acknowledgment
This structure is influenced by the work of Trish O’Hehir, RDH, MS, who advocated for numeric communication of perio findings.
Follow Up
Key idea: The Odontogram shows where disease exists — site-by-site and quadrant-by-quadrant — supporting precision treatment planning.
The tooth map displays all 32 teeth and their associated sites, highlighting:
Pocket depths ≥ 5 mm
Bleeding on probing
Sites that exhibit both (dual-coded)
This allows clinicians to visually identify localized patterns and tailor quadrant-specific treatment strategies.
Quadrant View
Each quadrant includes a numeric readout (e.g. "Upper Right: 6 / 48") showing:
Number of PD ≥ 5 mm sites
Number of bleeding sites
This helps:
Support insurance documentation for SRP billing
Determine whether SRP is localized or generalized
Track improvement at a regional level over time
Suggested Treatment + Note
The Follow-Up section auto-generates treatment suggestions and a clinical note based on charting data:
Antibiotic need if PD ≥ 5 mm sites exceed threshold
SRP (Localized or Generalized) by quadrant involvement
Written summary of disease findings in patient-friendly terms
💡 Clinician Tip: You can edit the autogenerated note as needed before printing or copying to your PMS.
This final section is designed to ease documentation, reinforce treatment acceptance, and standardize perio care communication.
PS: This report can be saved as a PDF and uploaded to your PMS. It can also be printed and handed to your patient — a helpful tool for reinforcing chair-side discussions and supporting treatment acceptance.
Disclaimer
This tool provides an informational summary based on periodontal charting. It does not constitute diagnosis or treatment advice. Final clinical decisions are the responsibility of the provider.