Technically Speaking: Tips for Implementing the 2018 AAP Periodontal Classification (Part 6)

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 to help hygiene teams achieve the highest level of care. Once we have exhausted this topic we will move onto other questions about the process of care. If you have any specific questions, you would like answers to, please let me know.

Q: When considering nonsurgical periodontal therapy as a treatment modality, how prevalent is periodontal disease?

A: Periodontal disease is the most widespread disease in adults which makes it a public health concern and periodontitis makes up a huge portion of your patients that have periodontal disease.  Here are the statistics:^1,2,3

1. Patients with Gingivitis – 95% of the population
2. Patients with Periodontitis

• 13 – <30 years of age – 13% of the population have grade C periodontitis c.
• 30 – <65 years of age – 47.2% of population have grade B periodontitis

Stage I (mild/slight) – 8.7%

Stage II (moderate) – 30%

Stage III-IV (advanced to severe) – 8.5%

• >65 years age – up to 70.1% of the population have grade B periodontitis, with 64% having Stage II to Stage IV
• 11% of patients worldwide have Stage IV periodontitis.
• Periodontitis is more prevalent in Men (56.4%) vs. Women (38.4%), highest in Mexican American’s 66.7%.

To put this into perspective, 9.5 out every 10 patients will at minimum have gingivitis requiring nonsurgical periodontal therapy (NSPT). Up to 7 out of every 10 patients will have periodontitis (depending on the demographics of your practice) requiring NSPT and potentially surgical periodontal therapy (SPT). Remember, once a periodontitis patient, always a periodontitis patient, and although long periods of stability may be achieved with maintenance, periodontitis patients will go through NSPT many times throughout their lifetime.

 References:

1. Lang NP, Bartold PM. Periodontal health. J Periodontol. 2018;89(Suppl 1): S9–S16. https://doi.org/10.1002/JPER.16-0517
2. Eke PI, Dye BA, Wei L, Thornton-Evans GO, Genco RJ; CDC Periodontal Disease Surveillance workgroup: James Beck GDRP. Prevalence of periodontitis in adults in the United States: 2009 and 2010. J Dent Res. 2012;91 (10):914-920.
3. Holtfreter B, Schwahn C, Biffar R, Kocher T. Epidemiology of periodontal diseases in the Study of Health in Pomerania. J Clin Periodontol. 2009;36:114–123. [PubMed] [Google Scholar][Ref list.