Reflections on Aggressive Periodontitis as a Disease Entity

The current periodontitis paradigm embraces the idea of the existence of several particular disease entities. Among them, aggressive periodontitis has been defined as a particular form of periodontitis characterized by severe periodontal destruction usually affecting persons under 30 years of age and presenting with clearly identifiable clinical and laboratory features. Nonetheless, considerable heterogeneity exists in the criteria used to identify the disease; only scant evidence exists substantiating the suggested distinct features; and several voices have expressed concerns on the suggested advantages of considering aggressive periodontitis as a particular disease entity. The main explanation for this impasse can be found in the deep rooted belief that periodontitis is a group of particular clinical entities. This approach to periodontal disease is based on an essentialistic understanding of illness that obstructs advance in periodontal research. The use of a pragmatic nominalistic approach to periodontal diseases would provide a more rational framework for understanding periodontal health and disease and would easy the conduct of periodontal research. The implications of using a pragmatic definition of periodontitis are discussed.