October 22, 2021
by Gabriele Maycher, CEO, GEM Dental Experts Inc. BSc, PID, dip DH, RDH.
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: If a patient has lost one tooth to periodontitis and there are an additional four teeth treatment planned to be extracted due to periodontitis, do these extractions also count as being lost to periodontitis and potentially increase the patient’s stage?
A: Yes. The AAP considered that when the worst affected tooth is lost, severity may decrease. Therefore, the new guidelines incorporate current and future tooth loss attributable to periodontitis in the definition of severity,1 ensuring the patient’s stage wouldn’t regress.
The bottom line: Tooth loss due to periodontitis should include those teeth planned for extraction due to periodontitis as part of staging process. In the example above, the patient stage would increase from Stage III (<4 teeth lost due to periodontitis) to Stage IV (>5 teeth lost due to periodontitis).
- Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Periodontal.2018;89(Suppl 1):S159-S172. https://doi.org?10.1002/JPER.18-0006