Refer to Section 8 of the full guidance

In some cases it may be appropriate to refer the patient to a specialist practitioner or to secondary care for further periodontal care. These cases include patients with severe disease or where the treatment required is complex or complicated by other factors.

In general, patients with a BPE score of 1-3 in any sextant should be treated in general dental practice.

Patients with a BPE score of 4 in any sextant may receive initial non-surgical treatment in general dental practice. Those unresponsive to inital treatment, or those patients requiring surgery involving the periodontal tissues, may be accepted for referral.

Patients with a BPE score of 4 in any sextant plus a modifying factor, such as a medical condition which affects the periodontal tissues or a diagnosis of aggressive periodontitis, should be referred.

  • Consult any local guidelines and the BSP to determine if the patient is a suitable candidate for referral.
  • Where referral is considered, use Oral Hygiene TIPPS to address inadequate plaque removal and carry out initial therapy to remove supra- and sub-gingival deposits. Where applicable, give smoking cessation advice.
  • Make referrals formally in writing and keep a copy of the referral letter with the patient’s clinical notes.
  • Provide supportive periodontal therapy for patients who have been discharged from secondary care.