Periodontitis (Stage I–III)
Inflammation with attachment loss. Stage by interdental CAL and bone loss; grade by progression rate. Proceed with the four-step protocol.
GPDental HygienistPeriodontist
Stages I–III follow the same four-step protocol. Stage IV (severe with potential tooth loss) follows a separate guideline and is not covered here.
Evidence Guidelines & evidence
- EFP S3 R3.1
In patients with periodontitis, we recommend a stepwise approach to treatment.
Source ↗ - 2018 World Workshop Stage Definition
Stage I: incipient periodontitis (CAL 1–2 mm, ≤ 15% bone loss). Stage II: established (CAL 3–4 mm, 15–33% bone loss). Stage III: severe with potential for tooth loss (CAL ≥ 5 mm, ≥ 33% bone loss extending to mid-third of root).
1 Confirm periodontitis & finalise stage/grade
Interdental CAL ≥ 1 mm at 2+ non-adjacent teeth or buccal/oral CAL ≥ 3 mm + PD > 3 mm at 2+ teeth. Stage (I/II/III) determines treatment complexity. Grade (A/B/C) determines recall frequency.
Illustration · Step 1
2 What happens next
Four sequential steps per the EFP S3 guideline: (1) behaviour change + supragingival; (2) subgingival instrumentation; (3) surgery for residual pockets; (4) lifelong supportive periodontal therapy. Click Continue to choose the patient's journey.
Illustration · Step 2
Expert perspectives
“Staging and grading at the first visit determines everything that follows. Without it, treatment intensity is a guess.”
Prof. Mariano Sanz
Chair, Periodontology, Complutense University Madrid