BPE Scores Explained: Codes 0 to 4, Furcation and What to Record

BPE scores run from 0 to 4 for each of six sextants of the mouth, with an asterisk (*) added when furcation is found. A 0 means healthy gums, a 1 means bleeding, a 2 means calculus or an overhang, a 3 means a pocket of 3.5 to 5.5mm and a 4 means a pocket deeper than 5.5mm. The dentist records the highest score found in each sextant.

The Basic Periodontal Examination (BPE) is the gum screen that UK dentists carry out at almost every check-up. The rules come from the British Society of Periodontology (BSP), and this guide sets out what each score means, how the BPE should be recorded, how it works for children, and why the highest score now matters to the NHS.

It is written for practice owners, managers and the wider team who decide how the BPE is recorded in the practice. It is not clinical advice, and the clinical judgement always sits with the dentist. The guidance quoted here was checked against the BSP and NHSBSA documents in September 2026.

What is the BPE?

The BPE is a quick screening test for gum disease. The dentist walks a special probe around the teeth and gives each part of the mouth a code, and those codes tell the team how much further examination and treatment a patient needs.

The BSP is clear about its limits: its guidance says the BPE "should be used for screening only and should not be used for diagnosis". A high score is a signal to look more closely, not a diagnosis on its own. The BSP first developed the BPE in 1986, and the current version of its guidance was published in January 2019. You can read the BSP BPE guidelines (2019) in full.

How the BPE is recorded

The mouth is split into six sextants, and each sextant gets one score: the highest one found in it. The BSP defines the sextants by FDI tooth number:

• Upper right: 17 to 14
• Upper anterior: 13 to 23
• Upper left: 24 to 27
• Lower right: 47 to 44
• Lower anterior: 43 to 33
• Lower left: 34 to 37

A few rules shape the score:

• Two teeth or more. A sextant must contain at least two teeth to be scored. If it has fewer, it is left out rather than scored as 0.
• Third molars. Wisdom teeth are not included unless the first or second molars are missing.
• The probe. A WHO BPE probe is used. It has a 0.5mm ball end and a black band from 3.5mm to 5.5mm, and light force should be used.
• Every site. The probe is walked around all the teeth in a sextant, so the highest score is found before moving on.

The result is usually written as a grid of six boxes, three for the upper jaw and three for the lower. An excluded sextant is shown with a dash or an X rather than a number.

BPE scores 0 to 4 explained

These are the codes as the BSP defines them:

• Code 0: pockets under 3.5mm, no calculus or overhangs, and no bleeding on probing. The black band stays fully visible.
• Code 1: pockets under 3.5mm and no calculus or overhangs, but there is bleeding on probing.
• Code 2: pockets under 3.5mm, with calculus above or below the gum, or an overhanging filling.
• Code 3: a probing depth of 3.5 to 5.5mm. The black band is only partly visible.
• Code 4: a probing depth over 5.5mm. The black band disappears, showing a pocket of 6mm or more.
• Code *: furcation involvement, where gum disease has reached the area between the roots of a multi-rooted tooth.

The asterisk is added to the number rather than used instead of it, so a score of 3* means a pocket of 3.5 to 5.5mm plus furcation in that sextant. The BSP says both the number and the * should be recorded.

What each BPE score means for treatment

The BSP gives general guidance on what each code implies. In summary:

• 0: no need for periodontal treatment.
• 1: oral hygiene instruction.
• 2: as for 1, plus removal of plaque-retentive factors, including all calculus above and below the gum.
• 3: as for 2, plus root surface debridement if needed. After initial therapy, a 6-point pocket chart is recorded in that sextant.
• 4: oral hygiene instruction and root surface debridement, and an assessment of whether more complex treatment or a specialist referral is needed. A 4 in any sextant means a 6-point pocket chart of the whole mouth.

The BSP also says radiographs should be available for every code 3 and code 4 sextant. Codes 0 to 2 need no more than oral hygiene advice and, for a 2, removing calculus and other plaque-retentive factors, and the BPE is simply repeated at each routine examination. Detailed 6-point charting is only required for codes 3 and 4. The BPE is a screening tool, not a diagnosis: the BSP's implementation of the 2017 classification (Dietrich et al., British Dental Journal, 2019) sets out how a diagnosis is reached. The dentist still weighs other factors, such as smoking, diabetes and the patient's history, before deciding what to do.

BPE scores for children and teenagers

Children are screened with a simpler version called the simplified BPE (sBPE). It is set out in joint guidance from the BSP and the British Society of Paediatric Dentistry. It looks at six index teeth only, to avoid false pockets around erupting teeth: the four first permanent molars plus the upper right and lower left central incisors. In FDI terms, those are 16, 11, 26, 36, 31 and 46.

The codes used depend on age:

• Ages 7 to 11: codes 0 to 2 only. At this age the screen looks for bleeding and calculus.
• Ages 12 to 17: the full range of codes 0 to 4, plus * for furcation.

The BSP and BSPD summary on the simplified BPE for under-18s sets this out. From 18, the adult BPE applies.

How often should a BPE be recorded?

The BSP guidance gives three simple rules:

• Every new patient should have a BPE recorded.
• For patients scoring 0, 1 or 2, the BPE should be recorded at every routine examination.
• For patients scoring 3 or 4, more detailed periodontal charting is needed.

The BPE cannot be used to measure how a patient responds to gum treatment. It does not show how individual sites change within a sextant. For that, the BSP recommends a 6-point pocket chart before and after treatment. It also advises against using the BPE around implants.

How BPE scores feed the FP17

Since 1 October 2022, the highest BPE sextant score has been a required field on NHS claims in England. The NHSBSA says it is mandatory on all adult claims for Bands 1, 2 and 3 where the date of acceptance is on or after 1 October 2022. It stays optional for patients under 18. When a BPE cannot be carried out, a hyphen is used.

This is where good recording pays off. If the BPE is charted properly at each check-up, the highest score for a course of treatment is already on the record. Nobody has to rebuild it from free-text notes at claim time. Our guide to the FP17 clinical data set covers the BPE field alongside decayed teeth and the recall interval.

Recording BPE scores in software: what to check

A paper grid is easy to fill in and just as easy to get wrong, especially when an empty sextant is written down as a 0. When you compare practice management systems, check that the BPE screen can:

• Record all six sextants in one exam, not six separate entries.
• Store furcation next to the code, so 3* never becomes a plain 3.
• Mark a sextant as excluded, instead of forcing a 0 that claims healthy gums.
• Apply the age rules from the patient's date of birth on the exam date.
• Keep every past exam, so you can see the trend.

DentiPoint's dental charting software works this way. All six sextants are recorded together, with codes 0 to 4 and furcation. A sextant with fewer than two teeth is recorded as X, never as 0. Age is worked out from the date of birth on the exam date: there is no BPE under 7, the six index teeth are used from 7 to 17, and codes stop at 2 for ages 7 to 11. Every past exam stays on the patient record, with the highest sextant highlighted, so the score a claim needs is already recorded. DentiPoint does not submit FP17 claims; they still go to the NHSBSA through your existing route.

Frequently asked questions

What do BPE scores mean?

They show the gum health in each of six sextants: 0 is healthy, 1 is bleeding, 2 is calculus or an overhang, 3 is a pocket of 3.5 to 5.5mm and 4 is a pocket over 5.5mm, with an asterisk to show furcation.

Is a BPE score of 2 bad?

It means calculus or an overhanging filling was found, but pockets are under 3.5mm. Under BSP guidance it does not call for detailed pocket charting, which is only needed for codes 3 and 4. The usual response is oral hygiene advice and removing the calculus.

What does a BPE score of 3 mean?

A pocket of 3.5 to 5.5mm in that sextant, for which the BSP recommends initial therapy, then a 6-point pocket chart of that sextant.

What does a BPE score of 4 mean?

A pocket deeper than 5.5mm, and a 4 in any sextant means a full-mouth 6-point pocket chart, and the dentist considers whether a referral is needed.

What does X mean on a BPE chart?

The sextant has fewer than two teeth, so it is not scored, which is different from a 0, which means the gums were checked and found healthy.

At what age is a BPE done?

From age 7: children aged 7 to 11 are screened on six index teeth with codes 0 to 2. Teenagers aged 12 to 17 use the same teeth with the full range of codes.

The BPE takes minutes, but it drives treatment decisions, specialist referrals and, since October 2022, NHS claim data, so recording it consistently at every examination is the easiest improvement a practice can make. If you want to see a BPE grid that handles exclusions and age rules for you, get started with DentiPoint or see every feature on the features page.