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Staging and Grading of Periodontitis: What You Need to Know

March 25, 2020

The new periodontal classification system emerged from the 2017 World workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. The classification includes systemic modifying factors thus recognizing the role of factors such as diabetes and smoking on the onset and progression of periodontal disease. This article is written to give you a brief overview of the classification. For detailed information, please refer to all the related full text articles on www.perio.org/2017wwdc.

The previous classification system of periodontitis was mainly based only on the severity of the periodontal disease. For example: Mild, Moderate and Severe Periodontitis. The previous classification failed to capture factors of the disease such as complexity that influences approach to therapy (ex: furcations, mobility etc.). The New Periodontal classification system has a staging and grading system - instead of the previously used Case Types or descriptive severity.

Staging is utilized to classify the severity and extent of an individual based on currently measurable extent of destroyed and damaged tissue attributable to periodontitis. Staging also assesses complexity that may determine the complexity of the controlling current disease and managing long term function and esthetics of the patient’s dentition. Please refer to table 2 below for a detailed breakdown of the factors taken in to consideration while staging a patient.

Grading the periodontitis patient is to estimate future risk of progression in periodontitis. Grading also helps estimate the potential impact of periodontitis on systemic disease and the reverse to guide systemic monitoring and co-therapy with medical colleagues. Please refer to table 3 below for a detailed breakdown of the factors taken in to consideration while grading a patient.

The diagnosis for Periodontitis is now reported as a stage and grade. For example: What was previously reported as generalized moderate periodontitis is now reported as Generalized Stage II periodontitis; Grade A, B, or C.

Table 1: Framework for the new classification1

Table 2: Staging of Periodontitis1

While clinical attachment loss (CAL) is a primary determining factor of the staging, radiographic bone loss (RBL) can be used in the absence of clinical attachment loss. The presence of a complexity factor moves the staging to a higher stage. Patients who have been treated for periodontitis should be staged frequently to monitor them.

 

Table 3: Grading of Periodontitis1

Clinical implications:

The diagnosis for Periodontitis is now reported as a stage and grade. For example: What was previously reported as generalized moderate periodontitis is now reported as Generalized Stage II periodontitis; Grade A, B, or C.  If the patient is diabetic with HbA1c of 8.o%, then the diagnosis is Stage II Grade C Periodontitis. In the absence of smoking or diabetes, the progression of the case is assessed to determine grading. Please refer to table 3.

 

References:

1 - Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Periodontology. 2018;89(Suppl 1):S159– S172. https://doi.org/10.1002/JPER.18-0006

Thanks to Satheesh Keerthana DDS MS, Chair, Department of Periodontics, UMKC for her contributions to this article.

Save the Date

March 25, 2020

Avoid Coding Errors and Excel in Insurance Administration

Presented by Dr. Charles Blair

Kansas City Area - September 24, 2020

Wichita Area - September 25, 2020

More information to come!

 

Delta Dental of Kansas Annual Membership Meeting

All Participating Dentists are invited to attend Delta Dental of Kansas' (DDKS) Annual Membership Meeting on Saturday, August 15, 2020 at 8:30 a.m. Due to possible meeting restrictions as a result of COVID-19, the meeting is being held virtually this year. Details will be released soon.

 

View and Register for Upcoming Events

DDKS is closely monitoring the CDC's recommendations to do our part in stopping the spread of COVID-19. We will keep you informed on any changes to our 2020 events schedule due to the COVID-19 outbreak. Please bookmark DeltaDentalKS.com/Register for the most up-to-date information on our events schedule.

Meet Our Team

March 25, 2020

We have some additions to our Professional Relations team here at Delta Dental of Kansas! You may speak with these individuals on the phone, or see them at our events.

Meet Natalee Dye, Professional Relations CoordinatorMeet Natalee Dye, Professional Relations Coordinator

Delta Dental of Kansas (DDKS) is pleased to welcome Natalee Dye as the Professional Relations Coordinator. Natalee has spent most of her life in the dental field. Over the past 8 years, she has worked in both insurance coordinating and office management roles. Natalee also holds a Bachelor’s degree in the Modern French Language which she obtained from Wichita State University. With her extensive dental experience, Natalee is already proving to be a wonderful asset to the PR team in helping your dental office’s staff. We look forward to your office becoming familiar with a new voice to help you with your insurance business needs.

Meet Sydney Tuttle, Professional Relations Administrative Assistant

Sydney joined Delta Dental of Kansas as the Professional Relations Administrative Assistant in April of 2019. Sydney is from the Wichita area and comes to DDKS with many years of experience in office management, project supervision and administrative responsibilities. In addition to her administrative duties, Sydney is an additional contact to assist dental office staff with setting providers up in one or more of our networks as well as direct deposit. Sydney’s attention to detail and customer service makes her an excellent addition to the DDKS Professional Relations Team.

Happy Office Acknowledgment Program Reminder

March 25, 2020

Help us recognize great work!

The Professional Relations team rewards DDKS Customer Service team members who have provided dental offices with excellent customer service through the Happy Office Acknowledgment Program.

You can nominate a Customer Service team member by telling us about your great customer service experience with DDKS.

Please send an email to pr@deltadentalks.com with the name of the DDKS team member, the date and time of your call, your name and dentist/office name.

Pre-Determinations: Don’t forget this helpful tool!

March 25, 2020

A pre-determination of benefits is a helpful tool that allows you and your patient to know in advance what procedures are covered by insurance, the amount the patient's dental plan will pay toward the treatment, and what the patient's financial responsibility will be.

Depending on a patient's plan, a predetermination may be required before certain treatments are performed. We encourage pre-determinations for extensive treatments like dentures, implants, TMJ, orthodontics, crowns, etc.

Requests for pre-determinations are made by submitting a proposed treatment the same way you would a regular claim - just omit the dates of service and the dentist's signature. You can also easily submit a Pre-determination online through your dentist account. Pre-determinations are valid for 6 months - you can easily extend their expiration date by calling or emailing our Customer Service team to request an extension at 800.234.3375 or customerservice@deltadentalks.com.

If you have questions about pre-determinations, contact your Professional Relations Representative or email pr@deltadentalks.com.

End of Year Updates

December 20, 2019

Delta Dental of Kansas (DDKS) Participating Dentist Handbook

The dentist handbook is an extension of the Participating Dentist Agreement and is designed to provide important information related to the general processing policies and guidelines for all ADA CDT procedure codes, along with other helpful information such as definitions, submitting claims, appeals and using electronic services.

The 2020 Dentist Handbook will be available online shortly. To access, log in to your dentist account at DeltaDentalKS.com/Dentist and click on the Documents & Dentist Handbook section.

Log in to your dentist account to view the 2020 Dentist Handbook

Delta Dental PPOTM Fee Schedule

Delta Dental of Kansas wishes to thank you for your continued participation in our Delta Dental Premier® and/or Delta Dental PPOTM  networks.

Please consider this an official notification that the 2020 Delta Dental PPO Fee Schedule will be available online by December 23, 2019. To access the schedule, log in to your dentist account at DeltaDentalKS.com/Dentist and click on the Documents & Dentist Handbook section. You may also access your Detailed Dentist Snapshot (DDS Report) in the reporting section of the Kansas Provider Toolkit

There are no changes to the 2020 Delta Dental Premier nor the Delta Dental PPO fee schedules with the exception of these 3 procedure codes: D4346, D9945 and D9946. As you have previously been informed, several enhancements were introduced designed to benefit DDKS members (your patients) that will become effective upon employer group renewal starting January 1, 2020 for risk (fully-insured) groups that choose them. (Please review those enhancements here). 

Please note Delta Dental’s PPO program is an optional network for Participating Dentists who signed a supplemental agreement. Contact your local Professional Relations Representative if you would like to participate in and/or learn more about the PPO Network or send an email requesting information to pr@deltadentalks.com.

Log in to your dentist account to view the 2020 PPO Fee Schedule

CDT Code Additions, Revisions & Deletions

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Delta Dental of Kansas (DDKS) Processing Policy Changes

The American Dental Association has published the new procedure codes for 2020. Changes include: 37 new codes, 6 deleted codes, 5 revised nomenclatures/descriptors and 15 editorial actions that clarify without changing the CDT code entry's purpose or scope.

To order CDT 2020 items, visit adacatalog.org or contact the ADA at 800.947.4746.

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Delta Dental Individual & FamilyTM Dental Plans - 2020 Plan Updates

What's Changing?

  • Platinum plan rates are changing
  • All four plan options will include the new Right Start 4 KidsSM program
  • Pre-determinations are no longer required

2020 brochures for our individual and family plans have been mailed out to all Participating dental offices. These updated brochures have the rates for 2020. Please use the 2020 brochures and discard the old brochures.

Any enrollee who enrolls AFTER November 25, 2019 will have a 1-1-20 start date, and will have the 2020 rates.

To order more brochures, please contact pr@deltadentalks.com.

Click here for more information on DDKS' Individual and Family plans

Keeping Your Informed: Noteworthy Group Dental Plan Changes Beginning 1-1-20

December 20, 2019

Please verify patient coverage and benefits each time your patient seeks treatment at your office. You can easily check by logging in to your dentist account at DeltaDentalKS.com/Dentist. While we’ve included many of our large group benefit changes on the linked flyer, not all groups with dental plan changes have been listed.

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Contact Us

For more information on becoming a Delta Dental participating dentist, contact Delta Dental of Kansas’ Professional Relations team at 800-733-5823, email PR@deltadentalks.com, or fill out the form below.

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