OBJECTIVES (i) To identify characteristics of currently published patient-based tools used to assess levels of risk for periodontitis progression and (ii) systematically review the evidence documenting the use of patient-based risk assessment tools for predicting periodontitis progression. MATERIAL AND METHODS A systematic review was prepared on the basis of an electronic search of the literature supplemented with manually searching the relevant journals of the latest 5 years. Prospective and retrospective cohort studies were included as no randomized controlled clinical trials were available. RESULTS The search identified 336 titles, and 19 articles were included in this systematic review. The search identified five different risk assessment tools. Results of nine of 10 cohort studies reporting outcomes of 2110 patients indicate that risk assessment tools are able to identify subjects with different probability of periodontitis progression and/or tooth loss. Subjects with higher risk scores showed more progression of periodontitis and tooth loss. CONCLUSIONS In treated populations, results of patient-based risk assessments, for example periodontal risk calculator (PRC) and periodontal risk assessment (PRA), predicted periodontitis progression and tooth loss in various populations. Additional research on the utility of risk assessment and results in improving patient management are needed.