The early detection and treatment of juvenile, or early-onset, periodontitis is a significant concern for practicing dentists. Prevalence of periodontitis in children and adolescents is considerably lower than in adult populations but its extent is still under study. Epidemiological studies vary widely, from 1.0/1000 to 8.0/1000, but variations seem to be due to differences in diagnostic methods and criteria (1:57; 4:368). As Neely notes, useful screening methods are still a matter of considerable debate (4:367). Distinctive populations also present the disease at higher rates (e.g., geographically distinct groups or periodontitis associated with systemic disease). There are also considerable differences in the definition of the disease and the term juvenile periodontitis sometimes refers simply to the localized form of the disease (2). Despite differences in estimates of prevalence, however, studies have consistently found the disease in young populations for several decades. Methods of diagnosis and treatment of all forms of the disease have evolved considerably and it is now considered "imperative that children receive a periodontal examination as part of their routine dental visits" (1:59).
Juvenile periodontosis is defined as a disease of the periodontium occurring in otherwise healthy adolescents (onset as low as 11 and as high as 20 years of age) and characterized by rapid alveolar bone loss in one or more permanent teeth (2:73). The disease has been classified into localized and generalized forms. But growing evidence suggests that localized juvenile periodontitis (LJP), generalized juvenile periodontitis (GJP), and chronic adult periodontitis (AP) may be distinct disease entities (3:268). Similarities and differences among the three in terms of the presence of particular microbiological entities, genetic relationships, and the fact that LJP sometimes seems to precede GJP raise many questions that are still ope...