Periodontal disease usually develops gradually. It can take decades before manifest periodontitis is diagnosed -  and treated. As the authors of the latest Barmer Dental Report (2017) found, periodontitis is treated so late in many patients that even adequate treatment can no longer prevent tooth loss.

One of the reasons for this is the diagnostic procedure: Until now, the focus has been on the extent of degeneration (probing depth, bleeding on probing, etc.), but not on the onset of collagenolytic destruction of the periodontal tissue.

With the introduction of the new, globally standardized periodontitis classification on June 21, 2018, the focus will be placed more on the development and progression of periodontitis:
The comprehensive classification is based on the latest evidence and is based on the classifications commonly used by the WHO, e.g. for cancer (Caton et al. 2018). For periodontitis, this includes a decision matrix with a "staging and grading" system (Tonetti et al. 2018).

The extent of the periodontitis is defined in staging
The staging comprises four stages from stage 1 (minor periodontal disease) to stage 4 (severe periodontal disease).

The stage of periodontitis is determined by clinical and radiographic findings, such as clinical attachment loss, radiographic bone loss, probing depths, vertical defects and furcation involvement, tooth mobility and tooth loss.

The progression of periodontitis is defined in grading
The risk of disease and the degree of progression are divided into three levels, from level A (lowest risk or slow progression) to level C (highest risk or rapid progression). Risk factors such as smoking and concomitant diseases, e.g. diabetes, can be taken into account. 

The new staging and grading matrix, which replaces the previous classification into "aggressive" and "chronic" periodontitis, offers great advantages in terms of individualized diagnosis and therefore also treatment. If it is possible to identify at-risk patients reliably and at an early stage, this simple but effective approach can be a great opportunity to reduce the prevalence of periodontal disease.