The classification of periodontal diseases has always been a controversial entity. There are more than 25 classification systems (old and new) that can be found in periodontal literature. Every new classification system that has been proposed for periodontal diseases has changed the name of disease. Sometimes in a decade we had 4 classification systems proposed (1989-1999) and the last classification system, which was proposed by American Academy of Periodontology (AAP) in 1999, lasted for almost 20 years. There have been innumerable articles published in last 20 years on the difficulties with the application of 1999 classification system.
My question is, why do the names of the diseases require a change so frequently? Changing of disease names creates confusion among clinicians who are from different time periods of classifications, among clinicians of other specialities, and most importantly among the media-savvy general public, who intents to research about disease on internet search engines and gain knowledge about it. The multiplicity of names for the same disease creates confusion among the public.
A huge amount of research has (much more than periodontal field) is being carried out on various systemic diseases like diabetes, cardiovascular diseases, respiratory diseases, endocrinal disorders etc. But have you ever heard any change of names for the disease entity. Diabetes has remained diabetes for longest period of time. Hypertension is hypertension till date. Stroke is stroke and myocardial infarction is called the same. Do you think research has not been done in these fields?
The best part of periodontal diseases is that whether it is chronic or aggressive periodontitis or periodontitis as a manifestation of systemic disease, the clinical features remain the same: gingival inflammation, bleeding on probing, pocket formation, clinical attachment loss, gingival recession, furcation involvement, mobility, exudation etc. The only difference will be severity and time factor and in few cases etiology.
There should be changes in classification system if required on the basis of research but why change names of disease so frequently? Whether it is plaque induced or non-plaque induced gingivitis, it is ultimately “gingivitis.” Whether it is chronic periodontitis or aggressive periodontitis or periodontitis as a manifestation of systemic disease, it is “Periodontitis.” at the end of the day.
Another question, which comes to my mind frequently, is why can't we have a classification system proposed by Indian Society that can be followed by us and world over…
