ADA 2019: New perio classifications help improve patient care

Periodontal disease
Under the new guidelines, periodontal disease is defined as the following:

• Periodontitis (formerly aggressive and chronic)
• Necrotizing periodontitis
• Periodontitis as a manifestation of systemic conditions

The key consensus was that bleeding on gentle probing is a sign of gingival inflammation, Dr. Jepsen noted. Bleeding of more than 10% is considered abnormal.

Dentists also must consider a patient’s overall health status and some of the following risk factors before making a diagnosis:

• Smoking
• Nutritional factors, such as a vitamin C deficiency
• Hormone changes, such as puberty
• Diabetes

“You do not have to populate every single cell of the grid before arriving at an assessment of stage and grade,” Dr. Jepsen said.

Though staging cannot be revised, grading can be revised after assessing initial treatment responses, compliance and risk-factor control, he added.

“A stage 4 patient can never be a stage 3 patient, but grading can improve,” Jepsen said.