Abstract
Gingivitis and chronic periodontitis are highly prevalent chronic inflammatory diseases. Gingivitis affects the majority of people, and advanced periodontitis is estimated to affect 5-15% of adults. The detection and diagnosis of these common diseases is a fundamentally important component of oral health care. All patients should undergo periodontal assessment as part of routine oral examination. Periodontal screening using methods such as the Basic Periodontal Examination/Community Periodontal Index or Periodontal Screening Record should be performed for all new patients, and also on a regular basis as part of ongoing oral health care. If periodontitis is identified, full periodontal assessment is required, involving recording of full mouth probing and bleeding data, together with assessment of other relevant parameters such as plaque levels, furcation involvement, recession and tooth mobility. Radiographic assessment of alveolar bone levels is driven by the clinical situation, and is required to assess bone destruction in patients with periodontitis. Risk assessment (such as assessing diabetes status and smoking) and risk management (such as promoting smoking cessation) should form a central component of periodontal therapy. This article provides guidance to the oral health care team regarding methods and frequencies of appropriate clinical and radiographic examinations to assess periodontal status, to enable appropriate detection and diagnosis of periodontal conditions.
Highlights
Periodontal diseases are highly prevalent chronic inflammatory conditions that affect the supporting tissues of the teeth
Periodontal screening using methods such as the Basic Periodontal Examination/Community Periodontal Index or Periodontal Screening Record should be performed for all new patients, and on a regular basis as part of ongoing oral health care
This paper will review the methods for detection and diagnosis of gingivitis and chronic periodontitis, these being periodontal lesions that are amenable to prevention, and will take the form of a narrative review
Summary
Periodontal diseases are highly prevalent chronic inflammatory conditions that affect the supporting tissues of the teeth. In a patient with a past history of periodontitis that has been treated and stabilised, and who is in the maintenance phase of periodontal care, if there is no evidence of disease progression (e.g. as evidenced by increasing probing depths), there is no indication to take further radiographs for periodontal assessment Regarding radiation dose, this appears to be less (when using modern panoramic machines) with a panoramic radiograph plus a small number of supplementary periapical radiographs (taken according to the clinical situation), compared to a full-mouth series of periapical radiographs [42]. Radiographic bone loss is useful for assigning descriptors to indicate severity of periodontitis: 1⁄2 bone loss = severe It is important, to always take into consideration the full clinical picture when applying such descriptors, such as the age of the patient, presence of risk factors, degree of inflammation, probing depths, and pattern of bone loss (e.g. horizontal vs vertical bone defects). It is useful to list the teeth affected by mild, moderate or severe disease, as this information, combined with the radiographic examination, will help to inform treatment decisions
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