Aligning the Dental Hygiene Diagnosis with the 2018 AAP Classification of Periodontal and Peri‑implant Diseases
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Course Author(s): Marianne Dryer, RDH, Med


  1. Highlights from the 2018 AAP Classifications Update proceedings include all of the following EXCEPT:
  1. The new classification, which introduces the concept of Staging, supports a multidimensional view of periodontitis, incorporating all the following EXCEPT:
  1. Grading incorporates the presence and control of risk factors such as smoking and diabetes. Direct or indirect evidence of bone loss clinically and/or radiographically is also incorporated into grading decisions.
  1. Overall, the new classification is based on the oncology system of ‘staging’ and ‘grading’ of disease; ‘extent and distribution’ are also integrated into the ‘staging’ system as descriptors.
  1. There is no longer a distinction between chronic and aggressive periodontitis. These conditions were thought to be the result of iatrogenic factors.
  1. A patient classified as a Generalized Periodontitis Stage IV, Grade C would likely present with the following periodontal characteristics:
  1. Staging and Grading help to do all the following EXCEPT:
  1. The updated classification system includes a component developed for peri-implant conditions and diseases. Dental implants will be staged in the same way the natural dentition is done.
  1. Bleeding on probing is the primary parameter to set thresholds for gingivitis. If a patient presents with less than 10% bleeding sites, they are considered to have incipient gingivitis.
  1. The updated AAP/EFP classification system more closely aligns itself with the principles of individualized patient care incorporating multifactorial etiology. This revised system allows the RDH to stratify patients into the appropriate classifications which may enhance provision of optimal care and improve our prognosis for the periodontally involved patient.