Impact of the 2018 periodontal classification on diagnosis, treatment strategies, and assessment of prognosis by dental hygienists in Swedish general dental care
Objective To investigate the impact of the 2018 periodontal classification on diagnostic assessments, treatment strategies, and prognostic assessments made by dental hygienists in general dentistry, compared with the 1999 classification. Materials and Methods A questionnaire comprising five patient cases was administered to dental hygienists in Sweden on two separate occasions. For each case, diagnoses, treatment plans, and prognostic assessments were proposed, first using the 1999 and subsequently the 2018 classification. Cases ranged from no marginal bone loss attributed to periodontitis and few (<10%) bleeding sites to marginal bone loss >30% and generalized inflammation (>30%). Answers from the two occasions were compared. Results A total of 142 dental hygienists completed both questionnaires. Diagnostic assessments changed significantly in three of the five cases when using the 2018 classification (p < 0.05). In four cases, fewer treatment sessions were recommended, and more optimistic prognostic assessments were made when using the 2018 classification (p < 0.05). Conclusion The 2018 classification resulted in greater variation in proposed diagnoses in cases without clear attachment loss and was associated with fewer recommended treatment sessions and more optimistic prognostic assessments. However, it appeared at least as effective as the 1999 classification in identifying cases with periodontitis.