Classification of Periodontal Diseases in Infants, Children, Adolescents, and Individuals with Special Health Care Needs

Abstract

This best practice familiarizes clinicians with new classifications of periodontal and peri-implant diseases/conditions to improve their diagnoses. Three major determinants of periodontal health include microbiological determinants (e.g., plaque and biofilm), host determinants, and environmental determinants (e.g., smoking, medications, stress, and nutrition). Gingival diseases are categorized as dental plaque biofilminduced gingivitis or non-dental plaque-induced gingival diseases. Periodontal disease can be grouped as periodontitis, necrotizing periodontitis, and periodontitis as a manifestation of systemic conditions. An assessment of the periodontal status of pediatric patients should be part of a routine dental visit and oral examination. Bleeding on probing remains the best parameter to monitor gingival health or inflammation longitudinally, and the practice of probing should be initiated once permanent first molars are fully erupted and the child is cooperative. While destructive periodontal disease may be uncommon among children and adolescents, nearly half of all children will experience gingivitis in their later preschool years, and nearly all will by puberty.

This document was developed through a collaborative effort of the American Academy of Pediatric Dentistry Councils on Clinical Affairs and Scientific Affairs to offer updated information and guidance regarding the classification of periodontal diseases in infants, children, adolescents, and individuals with special health care needs.

^{KEYWORDS: PERIODONTAL DISEASES, GINGIVAL DISEASES, PERIODONTITIS, ORAL DIAGNOSES, BLEEDING ON PROBING, GINGIVAL}