Classifying Periodontal Conditions

Healthy and Gingivitis conditions

• Intact periodontium, Reduced Periodontium (non-periodontitis patient) → prophy, 6 month recall

• Reduced Periodontium (stable periodontitis patient) → prophy, 3 month recall

• Gingivitis with plaque → prophy, 6 month recall

• Gingivitis without plaque → prophy, 3 month recall

• Necrotizing Gingivitis and Periodontitis → Immediate specialist referral
  
  

Periodontitis: Must classify Stage, Extent, Progression

Stage 1:1–2 mm clinical attachment loss, < 15% bone loss around root, no tooth loss due to periodontal disease, probing depth 4 mm or less, mostly horizontal BL
Tx: First treatment followed by second visit, full mouth root planing, then re-evaluation possibly at 3 month recall
Stage 2: 3–4 mm CAL, 15%–33% BL, tooth loss, PD 5 mm or less, mostly horizontal BL
Tx: First treatment followed by two more visit for half mouth root planing, re-evaluation
then 3 month recall
Stage 3: 5 mm or more CAL, BL beyond 33%, tooth loss of four teeth or less, with complex issues such as PD 6 mm or more, vertical BL 3 mm or more, Class II–III furcations, and/or moderate ridge defects
Tx: First visit followed by as many as 4 visits for quadrant root planing, re-evaluation, +then 3 month recall
Stage 4: Encompasses all of Stage III with additional features that will require the need for complex rehabilitation due to masticatory dysfunction, secondary occlusal trauma, severe ridge defects, bite collapse, pathologic migration of teeth, less than 20 remaining teeth (10 opposing pairs)

Tx: First visit followed by consult with other specialists