Understanding periodontitis and the latest classification system


  Posted by: Dental Design      16th November 2022

This year’s British Dental Conference and Dentistry Show (BDCDS) brought us a range of exciting and informative sessions from many internationally and nationally renowned speakers. As always, the event was a fantastic opportunity to immerse yourself in dentistry, to have an informative and enjoyable experience.

In the BDA Theatre, Dr Amit Patel set out to discuss periodontitis in the UK, exploring the new classification system, and explaining the ways in which dentists can aid their patients in reducing levels of periodontitis going forward. An important topic all year round, we look again at some of the subjects discussed.

Periodontitis and its risk factors

Periodontitis is a major health concern, so it’s important to fully understand the affects that periodontitis has on the natural tissues, and the warning signs and risk factors associated with the disease. There are several factors which make a person more at risk, including plaque build-up, smoking, alcohol, diabetes, and even some medications.[i] The national lockdowns in place during the COVID-19 pandemic also had a noticeable impact – with many people experiencing weight gain as a result, going on to increase the risk of developing periodontitis.

It’s important that patients do all they can to prevent gingivitis and later periodontitis, which means patients should strive to get any risk factors under control. Patients should aim to reduce the risk of developing this chronic disease by practising good plaque removal, avoiding tobacco, and reducing alcohol intake.i

In 2017, the American Academy of Periodontology and the European Federation of Periodontology set out to replace the previous (Armitage) classification system with a new classification, which is now in use.

Gingival recession, also known as receding gums, is the exposure in the roots of the teeth caused by a loss of gum tissue and/or retraction of the gingival margin from the crown of the teeth.

Disease progression and impact

To understand the importance of the disease, it is important to establish a view of current periodontal health in the UK. Periodontitis affects over half of the adult population in this country,i a worrying figure, and the disease costs the NHS £7.5 billion per year. Further afield, the CDC estimates that 47.2% of people aged 30 and over have some form of periodontal disease.[ii] It is also worth noting that litigation is a risk when it comes to periodontitis, with some patients making dental negligence claims based on issues caused by this disease, which are allowed to develop as a result of a missed disease diagnosis.

While it’s important to have a foundational understanding of the impact of periodontitis on the wider community and the country, it is vital to understand disease progression. Initially, patient and dentist may notice gingival tissue inflammation and the bleeding that follows. Then, as the disease progresses, the infection will spread and periodontal pockets will begin to form. And finally, you’ll see the eventual consequences of periodontitis, including bone loss and tooth loss.

Advice for patient assessment

For dentists to properly assess patients’ periodontal health, as a Periodontal Specialist, Amit offers useful suggestions as to the tools you should consider using. These essentials include a basic periodontal examination (BPE) probe, a Williams probe, and a Nabers furcation probe. By using this equipment, you will be able to assess pocket depth in each patient’s oral cavity with accuracy.

This precision is essential when classifying patients’ periodontitis. The new classification system, now in use, consists of three grading levels. Grade A meaning low risk, grade B, moderate risk, and grade C indicating high risk for disease progression. The new system simplifies classification, helping clinicians to produce treatment plans for their patients more consistently. 

Patient compliance and understanding

When discussing disease prevention. It is important not to understate the part that patients play in maintaining their own oral health. Developing a good oral hygiene routine is key to reducing plaque build-up.

Amit also advises that, in order to motivate patients to maintain their oral hygiene, dentists should clearly explain the importance of oral hygiene for preventing disease. One of the best ways to encourage compliance is through clear communication. When it comes to dental jargon, many patients won’t immediately understand the importance of what you’re saying. For example, if you describe patients’ plaque build-up, they may not know what this means, or why it’s bad for their oral health. However, if you use different language when talking to patients, such as bacteria, it becomes immediately obvious that this is harmful for their teeth and gums. Using language that your patients connect with, and have an emotional reaction to, is far more likely to encourage compliance and good oral hygiene.

Don’t miss the latest updates in all dental disciplines at the next BDCDS in 2023, and save the dates in your diary today.


The British Dental Conference and Dentistry Show 2023 will be held on Friday 12th and Saturday 13th May, NEC Birmingham, co-located with DTS.


For more information, visit birmingham.dentistryshow.co.uk, or email dentistry@closerstillmedia.com


[i] https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention/chapter-5-periodontal-diseases

[ii] Centers for Disease Control and Prevention. Periodontal Disease. Link: https://www.cdc.gov/oralhealth/conditions/periodontal-disease.html#:~:text=47.2%25%20of%20adults%20aged%2030,some%20form%20of%20periodontal%20disease. [Last accessed July 22].

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