Treatment of periodontal conditions

Refer to Section 5 of the full guidance.

Non-surgical periodontal therapy begins by motivating and instructing the patient in adequate self care, followed by re-evaluation of their level of oral hygiene.

Non-surgical instrumentation to disrupt the plaque biofilm and remove calculus to give a clean, smooth tooth/root surface can then be completed both supra- and sub-gingivally.

If the patient can achieve good personal oral hygiene, then non-surgical therapy can be highly effective in stabilising periodontal health.

  • Explain to the patient the potential benefits of successful treatment and their role in improving their periodontal health.
  • Use Oral Hygiene TIPPS to address inadequate plaque removal. Where applicable, give smoking cessation advice.
  • Explain to patients with crowded teeth, partial dentures, bridgework and orthodontic appliances the importance of adequate plaque removal around these local risk factors. If possible, correct local plaque retentive factors.
  • Remove supra-gingival plaque, calculus and stain. Highlight to the patient areas where supra-gingival deposits are detected. Carry out root surface instrumentation (RSI) at sites of ≥4 mm probing depth where sub-gingival deposits are present or which bleed on probing. Local anaesthesia may be required.
  • Advise the patient that they may experience some discomfort and sensitivity following treatment and to expect some gingival recession as a result of healing.
    • Proprietary desensitising toothpastes or mouthwashes can be used to treat particular areas of dentine sensitivity following RSI
  • Carry out a full periodontal examination a minimum of 8 weeks post treatment.