Fast Facts: Perio Edition – AAP 2017 Classification System – Introduction to Staging

Fast Facts: Perio Edition Episode 47
 
[Andrew Johnston, RDH]
Welcome back everyone! You are listening to another episode of Fast Facts- Perio Edition brought to you by A Tale of Two Hygienists in partnership with DentistRX. And now, please welcome your host, Katrina Sanders.
 
[Katrina Sanders, RDH]
Hello, and welcome to Fast Facts: Perio Edition. Oh, my gosh, you guys, can you believe it? We’re going to start the conversation about AAP staging Woohoo, so awesome and one of my favorite topics! So buckle up if you’re in your car or even if you’re not in your car, still buckle up because it’s going to be amazing. Today we’re going to be talking about the AAP staging guidelines. We’re going to do an overview today, and then in the coming weeks, we’re going to look at stage one, two, three, and four periodontitis and how the AAP has come to classify periodontitis, of course, based on these stages.
 
Now, I want to first begin by saying that the AAP in 2017 had quite a massive undertaking. They had to essentially redefine periodontitis based on what we understand to be true and so to clarify, the AAP has defined periodontitis in this way: “periodontitis is characterized by microbially associated host mediated inflammation that results in loss of periodontal attachment. This is detected as clinical attachment loss by circumferential assessment of the erupted dentition with a standardized periodontal probe with reference to the cemento enamel junction.” Do you guys like my radio voice?
 
The idea being that the AAP understood that there can be some clinical conditions other than periodontitis where the patient will present with clinical attachment loss. We acknowledge that there can be some exposure of the CEJ, and in some of these cases, those are patients that haven’t experienced the sequelle of periodontitis. To note, when we talk specifically about staging and grading our patients, we are talking about patients that present with an activity of periodontitis. And so it’s important for us to know that when the AAP looked at the objectives around this case definition system, they wanted us to first and foremost, identify a patient as a Perio case, meaning the definition in subsequent diagnosis is periodontitis. Then the descriptor that’s going to be your stage one, stage two, stage three and stage four, and those descriptors are going to allow us to identify what will be effective clinical management, prognosis or other influences, either oral or systemically, that could be involved based on the extent of the patient’s stage.
 
To be very clear, the AAP has indicated that a patient is a periodontitis case in the clinical context, if there’s interdental clinical attachment loss that is detectable at two or more non adjacent teeth, or if there is buccal or oral clinical attachment loss of three or more millimeters with pocketing that is greater than 3 mm detected at at least last two or more teeth. These, we all, of course, understand, are going to be single definitions in helping to identify if the patient is truly considered an active Perio case.
 
Stay tuned next week as we talk about stage one, two, three and four periodontitis.
 
This has been another episode of Fast Facts – Perio Edition with Katrina Sanders, RDH. Please feel free to reach me on Instagram @thedentalwinegenist or on my website www.KatrinaSanders.com Cheers.
 
[Andrew Johnston, RDH]
Thank you for listening to another episode of Fast Facts – Perio Edition, brought to you in part by DentistRX makers of the InteliSonic line of power brushes. Find out more by visiting their website at www.dentistrx.com. We’ll see you next week for another Fast Fact!