{"id":6103,"date":"2020-03-27T12:00:42","date_gmt":"2020-03-27T17:00:42","guid":{"rendered":"https:\/\/www.oraldna.com\/trends-in-salivary-testing\/?p=6103"},"modified":"2021-05-20T16:05:31","modified_gmt":"2021-05-20T21:05:31","slug":"aap-classifications-simplified-part-1","status":"publish","type":"post","link":"https:\/\/www.oraldna.com\/trends-in-salivary-testing\/index.php\/2020\/03\/27\/aap-classifications-simplified-part-1\/","title":{"rendered":"AAP Classifications Simplified: Part 1"},"content":{"rendered":"

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How the heck are we supposed to implement the new American Academy of Periodontology (AAP) Staging and Grading Periodontitis classifications into practice?\u00a0 This new system seems so complicated, right??\u00a0 Actually, it can be simplified and once that is done, the new system is extremely valuable!\u00a0 As hygienists, we know that periodontal disease is multifactorial.\u00a0 It is affected by systemic health, habits, occlusion, and more.\u00a0 We know that it is just as much about the host response as it is about bacteria.\u00a0 The new classifications help us categorize these factors in a comprehensive way.\u00a0 Once you understand it, you will love it!<\/p>\n

The previous classifications were last updated in 1999.\u00a0 These only looked at the severity of past destruction.\u00a0 The new classifications were updated by AAP and the European Federation of Periodontology (EFP) at the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Disease and Conditions. \u00a0The new guidelines look at severity of past destruction as well as missing teeth, complexity of managing the case, future risk of progression, likelihood of responding to standard therapy, and potential influence of periodontitis on systemic health.<\/p>\n

The new system can seem daunting, but there is a manageable way to approach it that makes it much easier.\u00a0 First, the classifications are divided into 3 buckets.\u00a0 1. Health and Gingival disease, 2. Periodontitis, and 3. Implant health and disease conditions. \u00a0A big difference to note here, is that Gingivitis is no longer Stage 1.\u00a0 It is simply gingivitis caused by biofilm, or gingivitis not caused by biofilm. Implants are considered separate from natural teeth. \u00a0Their classifications are peri-implant health, peri-implant mucositis, peri-implantitis and peri-implant hard and soft tissue deficiencies.\u00a0 The hard and soft tissue deficiencies are considered to be due to improper placement of the implant.<\/p>\n

In order to classify periodontitis, follow these three steps.\u00a0 Establish a stage, determine a grade, and decide on a distribution.\u00a0 When determining the stage and grade, always base your diagnosis on the worst site<\/strong> in the patient\u2019s mouth.<\/p>\n

Let\u2019s start with Staging.<\/strong>\u00a0 The Stages are divided into 4 categories: Stage 1-Mild, Stage 2-Moderate, Stage 3-Severe with the potential for tooth loss, and Stage 4-Severe with the potential for dentition loss.\u00a0 The AAP recommends starting by choosing either between Stages 1 and 2, or between Stages 3 and 4.\u00a0 Ask yourself, has this patient lost any teeth, or do they have the potential to lose any teeth due to periodontitis?\u00a0 If the answer is no, then you will place them in either Stage 1 or 2.\u00a0 If yes, then they will be in either 3 or 4.<\/p>\n

Stage 1 presents with pocketing <<\/u>4mm and 1-2mm of clinical attachment loss (CAL) and radiographic bone loss <15%.\u00a0 Stage 2 presents with pocketing <<\/u>5mm and 3-4mm of CAL with radiographic bone loss from 15-33% and potentially redness, swelling, bleeding on probing, and mostly horizontal bone loss with no mobility, furcations, or missing teeth.<\/p>\n

Stage 3 and Stage 4 depend on missing teeth. \u00a0Stage 3 presents with up to 4 missing teeth.\u00a0 Stage 4 presents with 5 or more missing teeth resulting in masticatory dysfunction.\u00a0 There will likely be secondary occlusal trauma, severe ridge defects, mobility of 2 or more, bite collapse, drifting, flaring and less than 20 teeth or 10 opposing pairs.\u00a0 Both stages present with radiographic bone loss >33%, redness, swelling, BOP, possible mobility, furcation involvement, and vertical bone loss.<\/p>\n

Staging is only one aspect of the new AAP guidelines.\u00a0 Stay tuned to next week\u2019s blog where we discuss grading and distribution making the AAP Classification simplified.<\/p>\n

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Reference: The 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions was co-presented by the American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP). Tables from Tonetti, Greenwell, Kornman. J Periodontol 2018;89 (Suppl 1): S159-S172<\/p>\n

For more information on how to become an OralDNA Provider \u2013 scan HERE:\u00a0\"\"<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

The new classifications were updated by AAP and the European Federation of Periodontology (EFP) at the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Disease and Conditions. The new guidelines look at severity of past destruction as well as missing teeth, complexity of managing the case, future risk of progression, likelihood of responding to standard therapy, and potential influence of periodontitis on systemic health.<\/p>\n","protected":false},"author":105,"featured_media":6306,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[108,10],"tags":[112,76],"class_list":["post-6103","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-patient-education","category-periodontal-disease","tag-patient-education","tag-periodontal-disease"],"jetpack_featured_media_url":"https:\/\/www.oraldna.com\/trends-in-salivary-testing\/wp-content\/uploads\/2020\/03\/adha-minnesota.jpeg","jetpack_sharing_enabled":false,"jetpack_shortlink":"https:\/\/wp.me\/p7W16z-1Ar","_links":{"self":[{"href":"https:\/\/www.oraldna.com\/trends-in-salivary-testing\/index.php\/wp-json\/wp\/v2\/posts\/6103"}],"collection":[{"href":"https:\/\/www.oraldna.com\/trends-in-salivary-testing\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.oraldna.com\/trends-in-salivary-testing\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.oraldna.com\/trends-in-salivary-testing\/index.php\/wp-json\/wp\/v2\/users\/105"}],"replies":[{"embeddable":true,"href":"https:\/\/www.oraldna.com\/trends-in-salivary-testing\/index.php\/wp-json\/wp\/v2\/comments?post=6103"}],"version-history":[{"count":13,"href":"https:\/\/www.oraldna.com\/trends-in-salivary-testing\/index.php\/wp-json\/wp\/v2\/posts\/6103\/revisions"}],"predecessor-version":[{"id":27198,"href":"https:\/\/www.oraldna.com\/trends-in-salivary-testing\/index.php\/wp-json\/wp\/v2\/posts\/6103\/revisions\/27198"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.oraldna.com\/trends-in-salivary-testing\/index.php\/wp-json\/wp\/v2\/media\/6306"}],"wp:attachment":[{"href":"https:\/\/www.oraldna.com\/trends-in-salivary-testing\/index.php\/wp-json\/wp\/v2\/media?parent=6103"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.oraldna.com\/trends-in-salivary-testing\/index.php\/wp-json\/wp\/v2\/categories?post=6103"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.oraldna.com\/trends-in-salivary-testing\/index.php\/wp-json\/wp\/v2\/tags?post=6103"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}