If a sextant shows deeper signs after originally coded 1, what should be the clinical action?

• A. Keep monitoring only.
• B. Escalate to a higher code and consider treatment plan.
• C. Immediately extract a tooth.
• D. Do nothing.

Answer: (B)

When using PSR, the code assigned to a sextant reflects the most significant finding in that area. If a sextant was previously coded as 1 and subsequent examination reveals deeper signs (such as increased probing depths or other indicators of periodontal involvement), you should raise the code to reflect the higher level of disease and start planning appropriate treatment. This progression means the situation isn’t just monitoring anymore; it warrants a full periodontal assessment and a treatment plan (for example, scaling and root planing, radiographs if needed, and a careful reassessment). Do not opt for extraction or do nothing in response to progression; those aren’t appropriate responses to worsening signs. The idea is that higher codes guide more comprehensive management, potentially including referral to a specialist if indicated.