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Fast Facts - Historical Survey of Diagnosing Periodontal Disease

Fast Facts - Perio Edition Episode 2
[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. In this episode, we discuss the historical survey of diagnosing periodontal disease. The first iterations of us documenting the diagnosis of periodontitis comes from Orban in 1942, where we established two major forms of periodontitis. The first was simplex, which was essentially a formation of an abscess in subsequent bone loss. Versus complex, which was more degenerative.

While this was a rudimentary way of explaining acute vs. chronic periodontitis, it wasn't until 1966 that the American Academy of Periodontology developed the World Workshop, which specifically termed chronic periodontitis with no definite system for classification.
 In 1982, Page and Schroeter identified five different forms of periodontitis, and these forms were used until 1986, when the American Academy of Periodontology established our case types. Most dental hygienists are familiar with these case types:
Case Type Zero - Healthy
Case Type One - Gingivitis
Case Type Two - Mild
Case Type Three- Moderate
Case Type Four - Severe Periodontitis
However, in addition in 1989, there was an adoption of classifications of juvenile periodontitis, adult periodontitis, necrotizing ulcerative gingiva periodontitis and refractory periodontitis.
Finally, in 1999, the American Academy of Periodontology established gingival and periodontal classifications, these classifications changed the way that we looked at periodontal disease because it integrated various modalities of risk factors associated with these disease processes.
In 1999, the American Academy of Periodontology classified:
Classification Zero as Healthy
Classification One - Gingivitis
Classification Two - Chronic periodontitis
Classification Three - Aggressive periodontitis
Classification Four - Periodontitis as a manifestation of systemic disease
Classification Five - Necrotizing diseases
Classification Six - Abscesses of the periodontium
Classification Seven - Periodontitis associated with endodontic lesions
Classification Eight - Developmental or acquired deformities and conditions
This allowed the clinician to create a multifaceted approach when identifying a diagnosis and subsequent treatment plan for patients.
Finally, in 2017, published in 2018, the American Academy of Periodontology created with the World Federation, the staging and grading guidelines as we know them today.
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 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 We'll see you next week for another Fast Fact!


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