If the B.P.E reading is 4, what should be done?

A B.P.E (Basic Periodontal Examination) reading of 4 indicates that there may be some significant periodontal disease present, often suggesting that there is attachment loss or deeper probing depth in the affected site. In this instance, the appropriate response would be to provide oral health instruction (OHI) to help the patient improve their oral hygiene practices, while also using a 6-point chart to assess the periodontal condition more meticulously across the entire dentition.

Considering the situation, the possibility of extracting a tooth may arise, especially if it is severely compromised due to periodontal issues. The decision to consider extraction stems from the understanding that if the tooth is supporting a chronic infection or is non-restorable due to the condition of the surrounding structures, removal may be necessary to prevent further complications.

This comprehensive approach ensures that the patient receives immediate guidance on maintaining their oral health and that a thorough evaluation of their periodontal status is conducted, which is critical for deciding the best treatment path moving forward, including possible extraction if warranted.