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Classification of Periodontal Disease


Posted on 6/3/2024 by Dr. Gopin
a close up of a mouth with inflamed gumsIn 2014, the American Academy of Periodontology introduced a new categorization of periodontal disease. This categorization identified three types of the disease, each with its own set of crucial considerations, including attachment levels, chronic versus aggressive periodontitis, and localized versus generalized periodontitis.

Further advancements were made in 2018 to better capture the severity and progression of the disease. These changes introduced the staging and grading approach in the classification of periodontal disease, taking into account the past disease experience of the patient and the complexity of treatments needed. This approach provides a more comprehensive understanding of the disease. The staging approach resulted in the following classification:

Stages I and II


Stage I of periodontal disease is defined as periodontal disease that has caused between 1 and 2 clinical attachment losses, has not resulted in tooth loss, has a 4mm probing depth, and has less than 15 percent bone loss. Stage II of periodontal disease is also called the moderate stage. It is identified by a 3-4 mm clinical attachment level, has between 15-33 percent bone loss, and a probing depth of 5mm or less.

Stage III


The third stage of periodontitis is also considered severe, with a potential for more tooth loss. This stage is identifiable by a 5mm or more clinical attachment level, more than 33 percent bone loss, the loss of about four teeth or less, and complexities such as more than 6mm or more of probing depth. These complexities could include deep gum pockets that are difficult to clean or severe gum recession.

Stage IV


The fourth stage of periodontal disease has more than 5mm of clinical attachment level, more than 33 percent bone loss, and the loss of more than four teeth. It also has other additional features, such as severe ridge defects, bite collapse, less than 20 remaining teeth or ten opposing pairs, and tooth migration. These additional features often require complex rehabilitation.

Call Us Today


The grading system is designed to show the rate at which the disease is progressing and your ability to respond to standard therapy. A periodontist should also determine the potential systemic impact posed by a certain class of periodontitis. Visit us today and have our periodontist examine your teeth for periodontal disease progression.



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