Case 1 of 8
Staging and grading a young smoker
The case
A 36-year-old man comes in because his gums bleed and a lower front tooth feels loose. He smokes 15 cigarettes a day and has no other medical history; his HbA1c was 5.4% last month. He has never had periodontal treatment. Full-mouth charting: probing depths up to 7 mm, interdental clinical attachment loss up to 6 mm at the worst sites, bleeding on probing at 60% of sites, and Class II furcation involvement on two lower molars. More than 30% of his teeth are affected. Radiographs: bone loss reaching the middle third of the root at the worst site, about 45% at that site, with a vertical defect of 4 mm on one molar. No teeth have been lost to periodontitis.
Step 1 of 4What is his stage, and why?
Think it through, ideally out loud, before you look.