Do the math on a full perio chart. A patient with 28 teeth has 168 probing sites. Record a pocket depth and a gingival margin at each one and you are past 330 numbers before you have touched bleeding points, mobility, or furcations. You cannot probe and type at the same time, so the standard workaround is to borrow a second person: you read numbers out loud, an assistant keys them into Open Dental.
The problem is that the second person usually has a job already. So the full chart quietly becomes optional.
Why the six-site chart gets skipped
Almost nobody skips perio charting because they think it does not matter. It gets skipped because of two very practical constraints.
- Time. A complete six-site exam with all the secondary findings takes a meaningful bite out of a hygiene appointment that already has to cover radiographs, scaling, polishing, exam, and patient conversation. When the schedule is tight, the perio chart is the part that flexes.
- A second person. Calling numbers to an assistant is the fastest traditional method, but it means pulling someone off room turnover or their own column. If nobody is free, the choice becomes probe-and-peck at the keyboard with wet gloves, or shrink the exam.
So the exam shrinks. Hygienists commonly describe the fallback patterns: spot probing, charting only the pockets over 4 millimeters, running a quick screening instead of a full chart, or carrying "perio charting due" forward to the next recall, and then the one after that.
What a complete chart actually requires
A defensible periodontal evaluation is more than pocket depths. Per tooth, at six sites, a complete chart records:
- Probing depth at mesiobuccal, buccal, distobuccal, mesiolingual, lingual, and distolingual sites.
- Gingival margin position, which captures recession.
- Clinical attachment level, calculated from probing depth and gingival margin. CAL, not pocket depth alone, is what the current classification system is built on.
- Bleeding on probing and suppuration by site.
- Plaque and calculus indicators.
- Mucogingival junction measurements where attached gingiva is in question.
- Mobility per tooth and furcation involvement on multi-rooted teeth.
Then the chart has to become a diagnosis. The AAP and EFP replaced the old mild-moderate-severe language at the 2017 World Workshop with staging and grading. Stage comes from interdental CAL at the worst site, radiographic bone loss, tooth loss from periodontitis, and case complexity. Grade estimates progression risk from the bone loss to age ratio, adjusted for smoking and diabetes. It is a better system, and it is also more arithmetic on top of an exam that was already losing the race against the clock.
This is not a corner-case exam
If perio charting only mattered for the occasional referral-out case, skipping it would be a smaller problem. It is not a corner case. CDC researchers analyzing NHANES data from 2009 to 2014 found that 42.2 percent of US adults age 30 or older have periodontitis, including 7.8 percent with severe disease. That is not a specialty population. That is roughly two out of every five adults in your hygiene column.
Without a current full-mouth chart, that disease is easy to watch and hard to treat. You cannot stage what you have not measured. You cannot show a patient the difference between last year's chart and this one if last year's chart is three numbers and a note. And when you do diagnose and treat, the claim narrative for scaling and root planing leans on exactly the documentation that got skipped.
Charting by voice, while you probe
Molaris takes the read-numbers-out-loud workflow that already works and removes the person on the keyboard. A floating recorder sits on top of Open Dental. You probe the way you always have and call out what you see: depths site by site, recession, a bleeding point, a class II furcation, mobility on the lower anteriors. The six-site chart fills itself as you speak.
Everything a complete exam needs is charted by voice: pocket depths, gingival margin and recession, bleeding, suppuration, plaque, calculus, MGJ, mobility, and furcation. Clinical attachment level is computed automatically from the depths and margins you called out, so nobody is doing subtraction chairside. When the exam is done, Molaris computes AAP and EFP 2017 staging and grading from the chart itself, so the diagnosis language on the note matches the numbers behind it.
The part that matters for your records: saved exams file directly into Open Dental's own Perio Chart module. Not a PDF attachment, not a separate portal your front desk has to remember exists. The exam lands where every previous perio chart in your practice already lives, so recall comparisons work the way they should.
And your assistant stays wherever the schedule actually needs them.
The exam you already do, minus the bottleneck
Six-site charting was never clinically controversial. It was operationally expensive: one exam, two people, and a keyboard nobody could reach with gloves on. Voice charting removes the second person and the typing, and keeps everything else, including the probe in your hand and your eyes on the tissue.
If you want to see what that does to a hygiene day, run your own numbers at getmolaris.com/roi, or book a 15-minute demo at cal.com/molvo/molaris. Bring your most overdue perio patient in mind. That is the chart worth filling first.