What are the BPE codes 0 to 4 in dentistry?

BPE codes 0–4 represent the worst periodontal finding in each of six mouth sextants, recorded using a WHO/CPITN probe. Code 0 means healthy tissues with no bleeding; code 1 means bleeding on probing without calculus or pockets; code 2 means calculus or a plaque-retentive factor; code 3 means a pocket depth of 3.5–5.5 mm (black band partially disappears); code 4 means a pocket depth greater than 5.5 mm (black band completely disappears). The asterisk (*) is added when furcation involvement is detected in any sextant.

What does the asterisk (*) mean in BPE?

The asterisk (*) indicates furcation involvement — the point at which the probe tip can be inserted horizontally into the space between the roots of a multi-rooted tooth. It is written alongside the sextant’s numeric code (for example, 4* or 3*) and is not a separate code; the BSP does not restrict the * to codes 3 or 4, so 2* is valid. Furcation involvement typically worsens the long-term prognosis and may affect treatment planning and referral.

What does "BPE 3b" or "2b" mean?

The "b" suffix on a BPE code is NOT a standard BSP BPE notation. In the published BPE system, bleeding on probing is captured by code 1 and is not separately notated at higher codes. The BSP 2019 system uses only codes 0–4 and the asterisk; no BSP, FGDP/CGDent or GDC publication defines a "b" suffix. If you encounter or use it, maintain a practice-level glossary, as records must be interpretable by any registered professional under GDC Standard 4.1.

When should a BPE be recorded?

A BPE should be recorded at every routine clinical examination for adult patients, including new patient examinations and recall visits. The BSP (2019) recommends recording it for all new patients and, for patients with codes 0–2, at every routine examination. It should also be recorded before surgical procedures, implant placement, or major restorative treatment. An examination record without a BPE is an incomplete record.

Does a BPE code 4 mean I must refer to a periodontist?

No — a code 4 requires a full-mouth periodontal chart and active periodontal treatment following the BSP’s four-step pathway. Specialist referral should be considered where there is deep residual pocketing after Steps 1 and 2, furcation involvement (code 4*), or complexity exceeding the clinician’s experience. The decision to refer or manage in-house must be documented. Referral decisions are governed by the BSP Referral Policy and Parameters of Care (2019).

How is BPE different from full periodontal charting?

BPE is a rapid sextant-based screening tool that records the worst finding per sextant, not individual pocket depths. Full periodontal charting records pocket depth (usually six sites per tooth), recession, bleeding on probing, plaque/BOP indices, furcation grade, and clinical attachment level for every tooth. Full charting is required when BPE scores 3 or 4 are recorded.

Is BPE mandatory for every adult patient in UK dentistry?

The BSP recommends recording a BPE for all new patients and, for those with codes 0–2, at every routine examination (BSP, 2019). Under the FGDP/CGDent Clinical Examination and Record Keeping guidelines (3rd edition, 2016), the absence of a BPE from an adult examination record constitutes a record-keeping deficiency that may be flagged in BSA audit, CQC inspection or a GDC complaint.

Can a dental hygienist or therapist record a BPE?

Yes. Dental hygienists and therapists are trained in periodontal assessment and are competent to carry out and record BPE as part of their clinical scope. Under direct access (introduced 1 May 2013), a hygienist or therapist is responsible for their own periodontal assessment, including BPE recording, to the same documentation standard as a dentist.

BPE Scoring Guide: Codes 0–4, the Asterisk (*), and What to Do Next

Clinically reviewed by Mohammad Noori, GDC No. 310862. Last reviewed: June 2026.

The Basic Periodontal Examination (BPE) is a rapid six-sextant screening tool used in UK dentistry to detect periodontal disease. Each sextant scores 0–4 using a WHO/CPITN probe, with an asterisk (*) added when furcation involvement is detected (BSP, 2019).

BPE codes 0–4 and the asterisk: canonical reference table

BPE Code	Probe finding	What it means	BSP-recommended clinical action
0	Black band fully visible; no bleeding; no calculus or plaque-retentive factors	Healthy periodontal tissues	No periodontal treatment; routine oral hygiene reinforcement
1	Black band fully visible; bleeding on probing; no calculus	Gingivitis without pocketing or calculus	Oral hygiene instruction (OHI)
2	Black band fully visible; calculus or plaque-retentive factor; pocket ≤3.5 mm	Calculus/restoration defect without significant pocketing	As code 1 plus removal of plaque-retentive factors and all calculus
3	Black band partially visible	Pocket depth 3.5–5.5 mm (shallow pocketing)	As code 2 plus RSD if required; 6-point pocket chart in that sextant only
4	Black band completely subgingival	Pocket depth >5.5 mm (6 mm or more)	6-point pocket chart throughout the entire dentition; OHI/RSD; periapical radiographs; consider specialist referral
*	Furcation involvement detected in a sextant	Probe tip enters the furcation of a multi-rooted tooth	Record both the number AND the * (e.g. 2, 3 or 4) — the BSP does not restrict the to codes 3/4

A BPE code 4 requires a full-mouth periodontal chart before planning treatment; specialist referral is considered for residual deep pocketing after Steps 1–2, furcation involvement (4*), or complex cases. For children under 18, a simplified BPE (sBPE) of six index teeth is used.

Last updated: June 2026

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