Purpose: The aim of the study was to explore and gain an understanding of patients' views on their periodontal conditions, their perceived impact of periodontitis on daily life, as well as their attitudes to oral health and expectations of treatment.

Materials And Methods: The study subjects were patients with chronic periodontitis, who had been referred to a specialist clinic. The constant comparative method for grounded theory was used to collect and analyse the data. Audiotaped, open-ended interviews were conducted after periodontal examination, but before treatment. The interviews were transcribed verbatim and consecutively analysed in hierarchical coding processes and continued until saturation was reached (n = 17). In the analysis, a conceptual model that outlined the steps involved in the diagnosis of periodontitis was generated. The core concept of the model, keeping up appearance and self-esteem, was related to the following four additional categories and their dimensions; doing what you have to do--trying to live up to the norm, suddenly having a shameful and disabling disease, feeling deserted and in the hands of an authority, and investing all in a treatment with an unpredictable outcome.

Results: The results illustrated that subjects diagnosed with chronic periodontitis felt ashamed and were willing to invest all they had in terms of time, effort and financial resources to become healthy and to maintain their self-esteem. However, they perceived a low degree of control over treatment decisions and treatment outcome.

Conclusions: The results demonstrate the vulnerability of patients diagnosed with chronic periodontitis and emphasise the importance of communication in dentistry.

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