Grade 1 

Description: Gingivitis

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

Grade 2 

Description: Early periodontal disease with <25% attachment loss based on radiographs

Appropriate treatment: Grade 1 care plus locally applied antimicrobials and/or subgingival scaling if pocketing exists.

Grade 3 

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

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

Grade 4

Description: Advanced periodontal disease with >50% attachment loss based on radiographs

Appropriate care: Extraction or periodontal surgery including osseous resective or additive procedures followed by consistently performed home dental care