Periodontal Diagnosis for Oral Health Therapists: Classification System

Introduction

• Focus on the classification system developed in 1999.
• Recommended resources:
  • Armitage's article on My Uni
  • Textbook: "The Wolf Book" for dental hygiene and periodontology.

Periodontal Diagnostic Statement

1. Locality: Generalized or localized
   • Greater than 30% of surfaces affected indicates generalized.
   • Less than 30% indicates localized.
2. Severity: Mild, moderate, or severe (sometimes referred to as advanced).
3. Form: Acute or chronic
   • Diagnostic statement structure: Locality → Severity → Form

Classification of Gingival Diseases (Gingivitis)

Types of Gingival Conditions

• Plaque-Induced Gingivitis: Caused by bacterial accumulation.
• Non-Plaque-Induced Gingivitis: Often related to systemic disorders like:
  • Lichen planus
  • Allergic reactions
  • Viral infections
  • Typically referred to a dentist or periodontal specialist for diagnosis.

Distinguishing Gingivitis from Periodontal Disease

• Both have the presence of inflammation.
• Gingivitis: No loss of attachment.
• Periodontitis:
  • Loss of attachment
  • Apical migration of the junctional epithelium
  • Loss of alveolar bone
  • Diagnosis supported by radiographs to confirm bone loss and epithelium migration.

Classification of Plaque-Induced Gingival Diseases

1. Plaque-Induced Gingival Disease without Local Contributing Factors
   • Caused solely by plaque accumulation.
2. Plaque-Induced Gingival Disease with Local Contributing Factors
   • Local factors such as rotated teeth may exacerbate the condition.
3. Necrotizing Ulcerative Gingivitis
   • Acute and painful condition associated with fever.
4. Hormonal-Associated Gingivitis
   • Conditions like pregnancy and puberty can worsen gingivitis.
5. Diabetes-Associated Gingivitis
   • Particularly in diabetics with poor sugar control.
6. Drug-Influenced Gingivitis
   • Certain drugs (e.g., anti-epileptics) can cause hyperplasia.
7. Vitamin C Deficiency Gingivitis

Summary

• Chronic Forms: All but necrotizing ulcerative gingivitis which is acute.
• Systemic Conditioning Factors: Hormones, systemic conditions (diabetes), drug influences, vitamin deficiencies.
• Role of Oral Health Therapists: Diagnose plaque-induced gingival diseases.

Homework Exercise

• Create a mind map elaborating on:
  • Local contributing factors
  • Hormonal conditions affecting plaque-induced gingivitis
  • Drugs influencing gingivitis progression

Ensure to have these concepts clear for the next class discussion.