What findings do clinicians use to diagnose chronic periodontitis?

The prevalence of chronic periodontitis is around 40% in the adult population and most patients visiting a dental clinic experience an intervention related to this disease, either as prophylaxis, e.g. disease information, oral hygiene instruction and polishing, or as treatment of the disease, per se. Hence, chronic periodontitis is a diagnosis that initiates time and costs consuming interventions. The findings clinicians use to diagnose chronic periodontitis are probably also the base for their choice of treatment. The aim of this study was to examine: What findings dental students, dental hygienist students, dental teachers, and supervisors in Public Dental Health use to diagnose patients with chronic periodontitis. If different categories of clinicians use different findings to diagnose chronic periodontitis. A questionnaire was distributed. Seventy-six clinicians representing the four categories answered the question: "What findings, or combinations of findings, do you use when you diagnose chronic periodontitis"? Twenty-five different findings were identified as findings the clinicians use when they diagnosed chronic periodontitis. The most frequently reported findings were bleeding, deepened pockets and loss of marginal bone tissue. Variations between different categories of clinicians were identified. For example, dental hygienist students used more findings (P < 0.05), and were also more inclined to use irrelevant findings like calculus, plaque, smoking, compared to the other categories of clinicians (P < 0.05). The majority of clinicians used only one finding at a time to diagnose chronic periodontitis, and more seldom combined findings. Only 12 out of 76 clinicians used a finding that provided soft tissue inflammation, e.g. bleeding, in combination with a finding that provided loss of supporting tissue, e.g. marginal bone loss. Few clinicians commented that there should be a progressive loss of supporting tissue over time. Further research is needed to investigate if these variations in findings used to diagnose chronic periodontitis indicate variations in treatment of these patients.