When calculating Clinical Attachment Level (CAL) with gingival overgrowth, what should be done?

When calculating the Clinical Attachment Level (CAL) in the presence of gingival overgrowth, it is essential to adjust the measurements accurately to reflect the true attachment level of the periodontal tissue. CAL is determined by measuring the distance from the cementoenamel junction (CEJ) to the bottom of the periodontal pocket, which is typically assessed through probing depth measurements.

In cases of gingival overgrowth, the probing depth will include the added thickness of the excess gingival tissue. Therefore, to obtain an accurate measure of the CAL, the probing depth must be adjusted by subtracting that depth from the total measurement. This adjustment accounts for the gingival tissue that has moved coronally due to the overgrowth and ensures that the CAL reflects the actual attachment status of the tooth. Thus, subtracting the probing depth when calculating CAL provides a more accurate representation of periodontal health under these circumstances.