We are constantly bombarded by the media with messages that periodontal disease is a very important disease, and we also espouse it to our patients every day. Most issues of JADA contain an article or two about periodontal disease. Millions of dollars are spent on diagnosis and treatment every year. Yet, we have no standard diagnostic criteria as to what constitutes periodontal disease, and we have no staging system.
A standard is needed for epidemiologists and researchers. How can we tell if periodontal disease is improving in the general population or getting worse? How can we know if certain medical diseases contribute to the development of periodontal disease, or if periodontal disease is a risk factor for developing certain medical conditions? Would the Centers for Disease Control and Prevention monitor periodontal disease if there was a standard?
Other medical diseases (lupus, for example) are classified by certain criteria. Maybe we should classify periodontal disease in this way.
I propose moderate periodontal disease as having two of the following: 30 percent bone loss on one arch; two or more mobile teeth (2 mobility or greater); probing depth of 6 millimeters or more on six or more teeth; or Class II furcations on two or more teeth.
I propose advanced periodontal disease as having at least two of the following: 50 percent bone loss on one arch; two or more mobile teeth (3 mobility); or Class III furcation on two or more teeth; or probing depth of 8 mm or more on six or more teeth.
I believe the study of periodontal disease would be greatly enhanced by a standard diagnostic and staging system.
