AAP Periodontal Disease Classification Animation – Sponsored by J&J

American Academy of Periodontology (AAP)

16 Dec 202005:06

EducationalLearning

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TLDRThe Centers for Disease Control and Prevention, along with the American Academy of Periodontology, report that nearly half of American adults suffer from periodontitis. In response, a new evidence-based classification system for periodontal diseases was introduced in 2018, which includes a multi-dimensional staging and grading system. This system accounts for disease severity, treatment complexity, tooth loss, rate of progression, and risk factors, emphasizing the individualized nature of the disease. The process involves three steps: assessing the level of disease through clinical examination, establishing the stage based on disease severity and complexity, and grading the rate of progression and response to treatment. The grading system categorizes patients into grades A, B, or C, based on the rate of disease progression, with adjustments for factors like smoking habits and glycemic control. The script underscores the importance of clinical judgment and a holistic approach to patient care for personalized treatment strategies.

Takeaways

🦷 Almost half of American adults have some form of periodontitis, according to the CDC and the American Academy of Periodontology.
📈 A new classification system for periodontal diseases was introduced in 2018, which includes a multi-dimensional staging and grading system.
🔍 The system assesses severity, treatment complexity, tooth loss, rate of disease progression, and risk factors.
📝 Clinical examination involves full mouth probing depths, clinical attachment loss, and radiographs to measure the severity of periodontitis.
📊 Stage 1 is incipient periodontitis with minimal bone loss and probing depths ≤ 4mm, while Stage 2 shows more bone loss and probing depths ≤ 5mm.
🦴 Stages 3 and 4 indicate severe periodontitis, with the distinction based on tooth loss or treatment complexity.
🌟 Stage 4 cases often require extensive rehabilitation due to a greater extent of tooth loss.
⏱️ Grading indicates the rate of periodontitis progression, responsiveness to therapy, and potential impact on systemic health.
🔢 A patient's grade can be determined by the ratio of percent bone loss to patient's age at the most affected site.
🚫 Grade modifiers such as smoking habits and glycemic control should be considered as they influence disease progression and severity.
🧐 Clinical judgment and a holistic assessment are essential for accurate classification and personalized patient care.
📈 The staging and grading process should be dynamic, considering the patient's specific needs for a comprehensive treatment strategy.

Q & A

What is the prevalence of periodontitis among American adults according to the CDC and the American Academy of Periodontology?
-Almost half of American adults have some form of periodontitis.
When was the new evidence-based classification system for periodontal diseases introduced?
-The new classification system was introduced in 2018 following a consensus conference of global leaders in periodontology.
What does the new multi-dimensional staging and grading system for periodontitis consider?
-The system considers severity, treatment complexity, tooth loss due to periodontitis, rate of disease progression, and risk factors.
What are the three steps involved in staging and grading a patient with periodontitis?
-Step one is to assess the level of disease, step two is to establish the stage based on disease severity and complexity, and step three is to establish the grade indicating the rate of progression, responsiveness to therapy, and impact on systemic health.
What does the clinical examination for assessing the level of disease in periodontitis include?
-The clinical examination includes full mouth probing depths, clinical attachment loss, full mouth radiographs, and missing teeth due to periodontitis.
How is the stage of periodontitis determined?
-The stage is assigned based on the severity and complexity of the disease at the most affected site, with stages 1 and 2 indicating mild to moderate periodontitis and stages 3 and 4 indicating severe periodontitis.
What does stage 1 of periodontitis represent?
-Stage 1 is incipient periodontitis, with bone loss within the coronal 15% of the root and probing depths equal to or less than 4 millimeters.
What are the characteristics of stage 2 periodontitis?
-Stage 2 represents progression beyond incipient periodontitis, exhibiting bone loss within 15 to 33% of the root and probing depths equal to or less than five millimeters.
What factors determine the distinction between stage 3 and 4 periodontitis?
-The distinction between stage 3 and 4 is determined by the extent of tooth loss due to periodontitis or by assessing the complexity of the periodontal and overall treatment required.
How is the grade of periodontitis determined?
-Grading indicates the rate of periodontitis progression, anticipated responsiveness to standard therapy, and potential impact on systemic health. The grade can be assigned using the ratio of percent bone loss to patient's age at the most affected site and considering grade modifiers such as smoking habits and glycemic control.
What is the significance of grading in the context of periodontitis treatment?
-Grading helps in understanding the rate of disease progression and the patient's anticipated response to treatment, which aids in developing a personalized approach to patient care and a comprehensive treatment strategy.
Why is it important to use clinical judgment and a holistic assessment when staging and grading a patient with periodontitis?
-Using clinical judgment and a holistic assessment ensures that the classification of the patient's condition is reasonably accurate, taking into account multiple variables and the individualized nature of the disease, rather than relying on a single factor.

Outlines

00:00

🦷 Introduction to Periodontitis Classification

This paragraph discusses the prevalence of periodontitis among American adults and introduces a new evidence-based classification system for periodontal diseases established in 2018. The system is multi-dimensional, considering factors like severity, treatment complexity, tooth loss, rate of disease progression, and risk factors. It emphasizes the individualized nature of the disease and its response to treatment. The process for staging and grading a patient involves three steps: assessing the level of disease, establishing the stage based on severity and complexity, and determining the grade which indicates the rate of progression and response to therapy.

Mindmap

Keywords

💡Periodontitis

Periodontitis is a severe gum infection that can lead to the destruction of the soft tissue and bone that support the teeth. In the video's context, it is the main disease being discussed, with a focus on its classification and treatment. The script mentions that almost half of American adults have some form of periodontitis, highlighting its prevalence.

💡Classification System

A classification system is a method of categorizing things into different groups based on shared characteristics. In this video, the classification system introduced in 2018 for periodontal diseases is discussed. It is multi-dimensional, considering various factors such as severity, treatment complexity, and risk factors. The system is crucial for understanding the video's theme as it provides a framework for staging and grading periodontitis.

💡Staging

Staging in the context of the video refers to the assignment of a stage to a patient based on the severity and complexity of their periodontitis. It is a key step in the new classification system. The stages range from 1 to 4, with 1 and 2 indicating mild to moderate periodontitis and 3 and 4 indicating severe periodontitis. Staging is vital for determining the appropriate treatment strategy for each patient.

💡Grading

Grading in this video pertains to the evaluation of the rate of periodontitis progression, the patient's responsiveness to standard therapy, and the potential impact on systemic health. It is another critical step in the classification system. Grades A, B, and C are used to denote slow, moderate, and rapid rates of progression, respectively. Grading helps in tailoring the treatment approach to the individual patient's needs.

💡Clinical Attachment Loss

Clinical attachment loss refers to the loss of the connection between the tooth and the surrounding gum tissue. It is a significant clinical parameter for measuring the severity of periodontitis. The video emphasizes its relevance in the staging process, where it is used in conjunction with probing depths and radiographic evidence of bone loss to assess disease severity.

💡Probing Depths

Probing depths are measurements taken by a dental professional using a periodontal probe to assess the depth of the pockets around the teeth. In the video, probing depths are used in the clinical examination as part of the staging process to determine the level of periodontal disease. Probing depths equal to or less than 4 millimeters are indicative of incipient periodontitis, while deeper measurements suggest more advanced stages.

💡Bone Loss

Bone loss is the deterioration of the jawbone that supports the teeth, often a result of periodontal disease. The video discusses how radiographic evidence of bone loss, particularly in combination with probing depths, can be used to assess the severity of periodontitis. The extent of bone loss is categorized into different stages, with more significant loss corresponding to later stages of the disease.

💡Tooth Loss

Tooth loss refers to the permanent loss of natural teeth, which can occur due to periodontitis. In the video, tooth loss is a factor in distinguishing between different stages of periodontitis, particularly between stages 1 and 2, where no teeth are lost, and stages 3 and 4, where tooth loss has occurred. The extent of tooth loss also influences the complexity of treatment and rehabilitation required.

💡Risk Factors

Risk factors are attributes, conditions, or behaviors that increase the likelihood of developing a disease. In the context of the video, risk factors are considered in the new classification system for periodontal diseases. They highlight the individualized nature of the disease and can include smoking habits, glycemic control, and other systemic health conditions that may influence disease progression and treatment response.

💡Dental Biofilm

Dental biofilm, also known as plaque, is a bacterial colony that forms on the teeth and can contribute to periodontal disease if not properly controlled. The video mentions that some cases of periodontitis may require more intensive control of the dental biofilm and inflammation. Effective biofilm management is essential in the treatment and prevention of periodontal diseases.

💡Holistic Assessment

A holistic assessment involves considering the whole person, including their physical, emotional, and social aspects, when making a diagnosis or treatment plan. In the video, it is emphasized that staging and grading a patient should not be based on a single variable but should involve a holistic assessment. This approach allows for personalized patient care and comprehensive treatment strategies that address the patient's specific needs.

Highlights

Almost half of American adults have some form of periodontitis according to the CDC and the American Academy of Periodontology.

A new evidence-based classification system for periodontal diseases was introduced in 2018 following a global consensus conference.

The new system uses a multi-dimensional staging and grading system for periodontitis, similar to those used in medicine.

The system considers severity, treatment complexity, tooth loss due to periodontitis, rate of disease progression, and risk factors.

The classification framework highlights the individualized and complex nature of periodontal disease in each patient.

There are three steps to staging and grading a patient: assessing the level of disease, establishing the stage, and establishing the grade.

Clinical examination includes full mouth probing depths, clinical attachment loss, and full mouth radiographs.

Stage 1 and 2 indicate mild to moderate periodontitis without tooth loss, while stages 3 and 4 indicate severe periodontitis.

Stage 1 is incipient periodontitis with bone loss within the coronal 15% of the root and probing depths ≤ 4mm.

Stage 2 represents progression beyond incipient periodontitis with bone loss within 15-33% of the root and probing depths ≤ 5mm.

Stage 3 or 4 is assigned if teeth were lost or planned to be removed due to periodontitis or if deep defects are present.

The distinction between stage 3 and 4 is determined by the extent of tooth loss or the complexity of the required treatment.

In stage 4 cases, a greater extent of tooth loss requires extensive rehabilitation.

Grading indicates the rate of periodontitis progression, the anticipated responsiveness to therapy, and potential impact on systemic health.

Grade A signifies a slow rate of progression, grade B a moderate rate, and grade C a rapid rate.

A patient's grade can change over time based on their clinical history or risk profile.

A practical approach to assign the grade is to use the ratio of percent bone loss to patient's age at the most affected site.

Grade modifiers such as smoking habits and glycemic control can influence disease progression and severity.

Staging and grading should not be based solely on a single variable and should involve a holistic assessment using clinical judgment.

Personalized patient care and comprehensive treatment strategy are developed based on the patient's specific needs.

Transcripts

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AAP Periodontal Disease Classification Animation – Sponsored by J&J

Takeaways

Q & A

What is the prevalence of periodontitis among American adults according to the CDC and the American Academy of Periodontology?

When was the new evidence-based classification system for periodontal diseases introduced?

What does the new multi-dimensional staging and grading system for periodontitis consider?

What are the three steps involved in staging and grading a patient with periodontitis?

What does the clinical examination for assessing the level of disease in periodontitis include?

How is the stage of periodontitis determined?

What does stage 1 of periodontitis represent?

What are the characteristics of stage 2 periodontitis?

What factors determine the distinction between stage 3 and 4 periodontitis?

How is the grade of periodontitis determined?

What is the significance of grading in the context of periodontitis treatment?

Why is it important to use clinical judgment and a holistic assessment when staging and grading a patient with periodontitis?