The advantages of using the PSR system include early detection, speed, simplicity, cost-effectiveness, ease of recording, and risk management.
There are limitations when using the PSR system. As stated earlier, it is not intended to replace a full-mouth periodontal examination. Those patients who have received treatment for periodontal diseases and/or are in a maintenance phase of care should receive comprehensive periodontal examinations routinely. There is also limited use of the PSR system in children. It is necessary to differentiate pseudo-pockets from true periodontal pockets with these younger patients. In any patient exhibiting enlarged gingiva or recession, the PSR score may give false results.14 Landry and Jean reported that since the PSR does not measure epithelial attachment, the severity of periodontal disease may be underestimated with its use.5 While a study by Rams and Loesche found a pretreatment PSR score of 4 or greater in 110 adults to be a good predictor of periodontal access surgery needs, this same study concluded after performing non-surgical periodontal therapy the score overestimated surgical access needs.13