# From primary to secondary care level: Assessing patient retention of periodontal staging and grading information

## TL;DR

Few patients referred for gum disease knew the severity or progression of their condition, but a simple questionnaire can help dentists identify these knowledge gaps and improve patient understanding.

## Contribution

A PSG questionnaire is introduced as a practical tool to assess patient understanding of periodontal staging and guide clinical communication.

## Key findings

- Only 19.3% of patients knew their specific periodontitis stage and grade.
- Patients with advanced periodontitis had better alignment between self-reported and clinical severity.
- Symptoms like tooth loss and mobility correlated strongly with clinical staging.

## Abstract

Accurate communication of periodontal stage and grade by general dentists in primary care is critical for patient understanding and engagement, yet patient retention and self‐reporting of this information upon referral to secondary care remains unclear.

A total of 372 periodontal patients referred were informed about their diagnosis by their general dentists and then referred to secondary care level. Data were collected through an eight‐item periodontal staging and grading (PSG) questionnaire, along with demographic, medical, and dental records. Periodontal diagnoses were classified by a specialist using the 2018 classification system. Associations between clinical diagnosis and patient perception were analyzed using Chi‐square tests and Spearman's rank correlation.

While 46.9% of patients diagnosed with periodontitis reported to be informed of their condition, only 19.3% reported knowing their specific stage and grade. Among patients with advanced periodontitis (stage III/IV), self‐reported severity often aligned with clinical staging. However, for early‐stage disease (stage I/II), perceptions were less accurate, and only 30.2% of grade C patients recognized rapid progression. Significant correlations were found between patient‐reported symptoms and clinician‐assigned staging: tooth loss (ρ = 0.69, p < 0.0001), root exposure (ρ = 0.638, p < 0.0001), and tooth mobility (ρ = 0.55, p < 0.0001).

Most patients referred to secondary care lacked information on their disease stage and grade. Severe stages and grades were better perceived by patients compared with mild forms of periodontitis. The PSG questionnaire offers a valuable tool for identifying knowledge gaps and guiding tailored discussions in clinical practice.

Our study asked 372 people referred for gum disease to fill out a simple eight‐question survey about how they see their own gum health and compared their answers to the detailed diagnosis made by periodontists. We found that fewer than one in five patients knew exactly how severe their disease was or how fast it was progressing. People with more advanced gum damage generally understood their condition, but those with mild disease often thought they were healthier than they really were. When patients reported losing teeth, seeing root surfaces, or noticing loose teeth, these experiences matched closely with the clinical measures of disease severity. These results show that many patients lack clear information about their gum health and that a brief questionnaire can help dentists pinpoint misunderstandings, improve patient education, and support better treatment decisions.