Technically Speaking: Tips for Implementing the 2018 AAP Periodontal Classification (Part 5)

Still confused about the 2018 AAP Periodontal Classification? Never fear! The next few monthly columns will review some of the most important updates made to the industry’s global periodontal guidelines. Please feel free to send in your questions!

Q: Do you stage and grade a patient with a reduced periodontium due to non-periodontitis causes?

A: No, the only reduced periodontium you stage and grade is in a patient with a reduced periodontium due to periodontitis. If a patient has a reduced periodontium due to non-periodontitis causes—including recession due to cervical restorations, ortho forces, extractions, and open contacts, etc.—using the following documentation to describe the periodontal condition(s) may be helpful amongst clinicians:

• Healthy gingiva on a reduced periodontium due to ortho forces, or
• Health gingiva. Generalized reduced periodontium as evidenced by slight HBL due to ortho forces.
• Generalized moderate gingivitis on a reduced periodontium due to ortho forces, or
• Generalized moderate gingivitis. Generalized reduced periodontium as evidenced by slight HBL due to ortho forces.

Decide as a team how you want to document a reduced periodontium due to non-periodontitis causes. The more specific the documentation, the less chance the next clinician will have to guess why it’s reduced. If you have localized areas of reduced periodontium (i.e., vertical defects due to extractions), then indicate where the areas are as well. For example: Localized reduced periodontium on #1.7 and #1.8 as evidenced by vertical bone loss due to extractions of 8s.