BSP Flow Chart: Implementing Periodontal Disease Classification PDF

# Implementing the 2017 Classification of Periodontal Diseases to Reach a Diagnosis in Clinical Practice ## History, Examination and Screening for Periodontal Disease * Including BPE and assessment of historic periodontitis (interdental recession) ### **Code 0/1/2** * With no obvious evidence of...

# Implementing the 2017 Classification of Periodontal Diseases to Reach a Diagnosis in Clinical Practice ## History, Examination and Screening for Periodontal Disease * Including BPE and assessment of historic periodontitis (interdental recession) ### **Code 0/1/2** * With no obvious evidence of interdental recession ### **Code 3** * With no obvious evidence of interdental recession ### **Code 4** * And/or obvious evidence of interdental recession | Bleeding on Probing | | | | |---|---|---|---| | <10% | 10-30% | >30% | | | | | | **Appropriate radiographic assessment** | | **Clinical Gingival Health** | **Localised Gingivitis** | **Generalised Gingivitis** | **Initial periodontal therapy and review in 3 months with localised 6-point pocket chart in involved sextant(s)** | | | | | **Appropriate radiographic assessment** | | | | | **Full periodontal assessment (including detailed 6-point pocket chart)** | | | | | **Molar-incisor pattern** | | | | | **<30% of teeth** | | | | | **≥30% of teeth** | | **Diagnosis should also include a comment on plaque retentive factors where a BPE code 2 is present** | | | | | | | | **No pockets ≥4mm and no radiographic evidence of bone loss due to periodontitis continue with code 0/1/2 pathway** | | | | | **Pockets ≥4mm remain and/or radiographic evidence of bone loss due to periodontitis continue with code 4 pathway** | | | | | **Periodontitis Molar-Incisor Pattern** | | | | | **Localised Periodontitis** | | | | | **Generalised Periodontitis** | | | | | **Staging and grading, current disease status and risk factor assessment (PTO)** | ## Staging | | | | | |---|---|---|---| | **<15% (or <2mm attachment loss from CEJ)** | **Coronal third of root** | **Mid third of root** | **Apical third of root** | | **Stage I (Early/Mild)** | **Stage II (Moderate)** |**Stage III (Severe)** | **Stage IV (Very Severe)** | ## Grading | | | | |---|---|---| | **Radiographic Assessment (periapicals or OPG/DPT)** | **Interproximal bone loss (use worst site of bone loss due to periodontitis)** | **% bone loss ÷ patient age (use worst site of bone loss due to periodontitis)** | | **If not clinically justified or if bytewings only available use CAL or bone loss from CEJ** | **<15% (or <2mm attachment loss from CEJ)** | **<0.5** | | **Stage I (Early/Mild)** | **Coronal third of root** | **0.5-1.0** | | **Stage II (Moderate)** | **Mid third of root** | **>1.0** | | **Stage III (Severe)** | **Apical third of root** | **Grade A (Slow rate of progression)** | | **Stage IV (Very Severe)**| **Grade B (Moderate rate of progression)** | **Grade C (Rapid rate of progression)** | | | | | | ## Assessment of Current Periodontitis Status | | | | |---|---|---| | **Currently Stable** | **Currently in Remission** | **Currently Unstable** | | * BoP <10% * | * BoP ≥10% * | * PPD ≥5mm or * | | * PPD ≤4mm * | * PPD ≤4mm * | * PPD ≥4mm & BoP * | | * No BoP at 4mm sites * | * No BoP at 4mm sites * | | ## Risk Factor Assessment * For example: * Smoking, including cigarettes/day * Sub-optimally controlled diabetes ## Diagnosis Statement: Extent - Periodontitis - Stage - Grade – Stability – Risk Factors * e.g.: Generalised Periodontitis Stage 3 Grade B – Currently Unstable – Risk(s): Smoker 15/day