Preventing Periodontal Disease: A Guide for the Professional

The 2017 classification of periodontitis stages and grades, modifiable and non-modifiable risk factors, and why prevention always costs less than treating advanced-stage disease.

In 2017 the American Academy of Periodontology and the European Federation of Periodontology published a new classification of periodontal diseases, replacing the previous 1999 system. Periodontitis is now described along two independent axes: stage (I-IV), reflecting the severity and complexity of the case based mainly on clinical attachment loss and radiographic bone level, and grade (A-C), estimating the rate of disease progression and future risk, taking into account factors like smoking and uncontrolled diabetes.

This classification has immediate practical value: two patients with the same disease stage can have very different risk grades, and this significantly changes the intensity of recall and preventive measures to adopt. A grade C patient, for example, requires much closer monitoring than a grade A patient, even with the same amount of existing periodontal damage.

Periodontitis risk factors are divided into modifiable and non-modifiable. Non-modifiable ones include genetic predisposition and age; among modifiable factors, those prevention can actually affect, the most relevant are smoking — which besides promoting disease onset significantly worsens response to treatment — uncontrolled diabetes mellitus, which has a well-documented bidirectional relationship with periodontitis, and naturally the patient's daily bacterial plaque control.

Primary prevention rests mainly on patient education and periodic professional check-ups, able to catch gingivitis before it progresses into irreversible attachment loss. Early diagnosis, supported by a complete, regular periodontal probing, allows intervention while damage is still reversible — a principle that applies to any professional, regardless of career stage.

On Oralzon you'll find all the diagnostic and therapeutic instrumentation for preventing and treating periodontal disease, from graduated periodontal probes to instruments for supportive non-surgical therapy.