Periodontal treatment planning is changing


In 2017 a Global Workshop with representatives from the American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP) convened in order to develop a new classification system for Periodontal and Peri-Implant Diseases and Conditions. The aim was to overcome the limitations of the previous classifications that relied heavily on clinical attachment levels and had multiple sub categories.

The subsequent work led to a new system launched in July 2018.

This system simplifies the diagnosis and management of periodontal diseases into “Stages” and “Grades”.

The concept of staging and grading has been adopted from the management of Cancer patients.

Staging gives an indication of the patient’s status at diagnosis- patients understand that Stage 3 cancers is worse than a Stage one cancer.

In relation to periodontal diseases, Staging indicates the current levels of tissue loss – Clinical attachment, radiographic bone loss and missing teeth. Resulting in a ranking of Stage I to Stage IV.

Grading gives an indication of the future progression of the disease,  taking into account past history and risk factors such as smoking. The grade score can change with time, for instance if the risk factor is removed. Grades are ranked A, B & C for slow, moderate and rapid progression.

The American Academy of Periodontology

Has published handy tables that are designed to be laminated and used at the chair side, to view this click here >

A very useful summary of the new classification can be found by clicking here >

The British Society of Periodontology

Is due to publish guidance on the implementation of the new classification shortly and has suggested that in the mean time clinicians should continue to use the current BPE based system.

However it is likely that Periodontists will start to use the classification immediately and this may be reflected in the letters received back from specialists about referred patients. So it may be worth taking a quick look at the new system ahead of the BSP guidance.

By Jason Bedford

ByRick Craven