Title: Age of permanent maxillary canine palpation and basic periodontal examination: A retrospective audit
Abstract:
Background: Early identification of maxillary permanent canine position and timely assessment of periodontal health are critical components of paediatric dental care. The Royal College of Surgeons recommends clinical palpation of maxillary canines from age 8 to identify potential impactions, while the British Society of Periodontology advises initiating Simplified Basic Periodontal Examinations (sBPE) from age 7 to support early diagnosis and management of periodontal issues. Failure to follow these guidelines can lead to complex orthodontic and legal consequences. This audit aimed to evaluate current compliance with these guidelines in primary care and identify areas for improvement in both clinical practice and documentation.
Methods: A two-cycle, criterion-based retrospective audit was conducted at Quantock View Dental Centre. The first cycle reviewed records of 203 patients aged 8 and over who attended between January 1st and March 1st, 2025. The second cycle included 191 patients seen from April 1st to June 1st, 2025, following intervention. Data were extracted from the practice’s electronic records (EXACT) and analysed for documentation of maxillary canine palpation and sBPE, with stratification by patient age and examination date. Interventions between cycles included the distribution of guideline-based information sheets, clinician discussions, and note template modifications.
Results: In the first cycle, only 44% of patients had documentation of maxillary canine palpation, with a mean first recorded age of 10 years and 7 months. Documentation of sBPEs was noted in 40% of patients, with a mean initial age of 12 years and 2 months. Following intervention, the second cycle showed substantial improvements: 82% of patients aged 8–11 had canine palpation documented at their most recent examination, and 78% of patients aged 8–15 had a completed sBPE. Notably, palpation and sBPE documentation remained lowest in the youngest patients.
Conclusion: The audit revealed that the gold standards for early assessment of maxillary canines and periodontal health were not initially being met in primary care. However, significant improvements were achieved through clinician education and system changes. Barriers such as clinician familiarity with guidelines and variability in documentation practices persist. Continued efforts, including structured teaching and visual prompts, are recommended to sustain and improve compliance. A re-audit is planned in 12 months to assess long-term progress.
