Periodontal disease staging

Periodontal disease (PD) staging is most accurate when performed in an unconscious patient after intraoral radiographs and periodontal probing.

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Stage 1 -- (PD1)

Description:
Gingivitis

Appropriate treatment:
Dental scaling, polishing, irrigation, home dental care

Stage 2 -- (PD2)

Description:
Early periodontal disease with <25% attachment loss

Appropriate treatment:
PD1 care plus locally applied antimicrobials and/or subgingivial scaling if pocketing exists.

Stage 3 -- (PD3)

Description:
Established periodontal disease with 25–50% attachment loss

Appropriate care:
Periodontal therapy* including periodontal surgery will only be successful if the client is committed to consistently administering home dental care. Extraction indicated if client and patient will not commit to daily home oral hygiene.

*Periodontal therapy: closed- or open-root planing ± locally applied antimicrobials or advanced periodontal treatment such as guided tissue regeneration.

Stage 4 -- (PD4)

Description:
Advanced periodontal disease with >50% attachment loss

Appropriate care:
Extraction or periodontal surgery including osseous resective or additive procedures followed by consistently performed home dental care; prognosis is considered guarded.

These guidelines are supported by generous educational grants from
Boehringer Ingelheim Animal Health USA Inc., CareCredit, Hill’s ® Pet Nutrition Inc., and Midmark