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Automated staging and grading for periodontitis

Oct. 19, 2021
Dr. Richard Nagelberg describes the use of the new MyPerioHealth app, which streamlines the data collection process and automates the staging and grading calculation for periodontitis.
The American Academy of Periodontology (AAP) Staging and Grading Guidelines, established in 2018, describe the severity, extent, rate of progression, responsiveness to therapy, and potential impact on systemic health for patients with periodontitis. Staging and grading is only applied to patients with periodontitis—not those who are periodontally healthy or who have gingivitis. What this means is that prior to determining the stage and grade of the disease, a diagnosis of periodontitis must be made based on a comprehensive periodontal evaluation and radiographs, as we have always done. The 2018 staging and grading guidelines replace the 1999 guidelines that classified periodontitis as chronic, aggressive, necrotizing, or manifestation of systemic disease.

Determining the stage and grade requires the collection of various pieces of clinical data, such as pocket depth, bone loss, and furcation involvement, and for the first time includes the systemic parameters of age, smoking status, and diabetes. There is also the calculation of percentage of bone loss divided by the patient’s age. The stage and grade facilitate treatment planning, recall intervals, and enhance patient communication. Each data point is placed in the appropriate column of the staging and grading grids.1 It can be challenging to accurately apply all the data points and come up with the correct stage and grade. Add to that the need to use a calculator for the determination of percentage of bone loss divided by age, and we can begin to understand why many dental practices have not gotten on board…until now.

A recently released app, MyPerioHealth, streamlines the data collection process and automates the staging and grading calculation. The patient is involved in the entire process, which should take just two to three minutes to complete. It’s much faster than staging and grading manually.

Ideally, the app is used on a barrier-covered tablet or cell phone with the patient inputting the information during the hygiene visit with the assistance of the hygienist or doctor. Patient participation in the process facilitates communication and enhances understanding of their case of periodontitis.

The MyPerioHealth app was developed to serve as an educational resource for the profession by OraPharma and is a free download available in the Apple App Store, Google Play Store, and Amazon App Store. A web-based version is also available at

The staging and grading guidelines were well-thought-out and well-executed, and the individuals who undertook this initiative deserve recognition. It was a massive effort requiring input from many esteemed individuals. Now their vision can be completed quickly and accurately with the MyPerioHealth app.


  1. Tonetti MZ, Greenwell H, Kornman KS. Staging and grading periodontitis. J Periodontol. 2018;89(Suppl 1):S159-S172.

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Editor’s note: This article first appeared in Through the Loupes newsletter, a publication of the Endeavor Business Media Dental Group. Read more articles and subscribe to Through the Loupes.

Richard H. Nagelberg, DDS, has practiced general dentistry in suburban Philadelphia for more than 30 years. He is a speaker, advisory board member, consultant, and key opinion leader for several dental companies and organizations. He lectures on a variety of topics centered on understanding the impact dental professionals have beyond the oral cavity. Contact Dr. Nagelberg at [email protected].