The course of periodontal disease is marked by a discontinuous pattern of disease activity and inactivity showing exacerbation and remission of tissue destruction.1-3 As such, a critical challenge for clinicians is not the detection of periodontal disease but rather the identification of patients with an elevated risk of experiencing active and progressing disease. In 2017, the American Academy of Periodontology revised the 1999 periodontal classification system to serve as a framework for measuring disease progression using 2 clinical parameters: (1) staging, which captures the severity and the extent and distribution of the pathologic damage, and (2) grading, which relates to the rate of disease progression and risk factors that facilitate it.