Q: If a patient has lost one tooth to periodontitis and there are an additional four teeth treatment planned to be extracted due to periodontitis, do these extractions also count as being lost to periodontitis and potentially increase the patient’s stage?
A: Yes. The AAP considered that when the worst affected tooth is lost, severity may decrease. Therefore, the new guidelines incorporate current and future tooth loss attributable to periodontitis in the definition of severity,1 ensuring the patient’s stage wouldn’t regress.
The bottom line: Tooth loss due to periodontitis should include those teeth planned for extraction due to periodontitis as part of staging process. In the example above, the patient stage would increase from Stage III (<4 teeth lost due to periodontitis) to Stage IV (>5 teeth lost due to periodontitis).
- Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Periodontal.2018;89(Suppl 1):S159-S172. https://doi.org?10.1002/JPER.18-0006
About the Author
A passionate educator with 30+ years of clinical and business experience, Gabriele has revolutionized the way practices optimize client outcomes, growth, and revenue through her consultancy company, GEM Dental Experts Inc. A former practice owner, published author, dental hygiene program director, quality assurance program assessor, entrepreneur of the year, and thought leader for Crest and Oral B, Gabriele shares her innovative views on dental hygiene through her work as a public speaker, consultant, educator, and business coach for forward-thinking dental practices. Gabriele can be reached at email@example.com or visit www.gemdentalexperts.com.