Treating periodontitis: A feasible treatment plan

Successful periodontal therapy stops the inflammation by reducing the numbers of periodontopathogenic bacteria and stabilizing the periodontal state. For this, the individual measures must be coordinated in terms of content, causal aspects and timing – from the thorough examination to lifelong maintenance therapy.

In the case of structured periodontal treatment, the patient goes through the individual phases step by step, with the treatment being tailored to his/her individual situation. As each treatment phase is completed, it is necessary to reassess what further measures are needed for the individual patient.

Diagnostics

Periodontal therapy starts with diagnostics, where the dentist records the patient’s current status on the basis of a thorough examination.

Initial/hygiene phase

In the initial/hygiene phase that follows, the focus is on establishing optimum hygiene conditions. Professional cleaning of the teeth is carried out and the patient is given detailed instructions on the best way to look after their teeth at home.

Reevaluation

Reevaluation takes place approx. 2-4 weeks later. This involves checking whether there has been a significant improvement in the clinical findings and the patient can be transferred to the maintenance phase.

Non-surgical periodontal therapy

If this is not the case, the patient enters the non-surgical phase of periodontal therapy. This phase involves the mechanical removal of plaque and other deposits from the surfaces of the teeth, including subgingivally. Depending on the type and numbers of periodontopathogenic bacteria present, adjunctive antibiotic therapy is useful.

Periodontal follow-up and reevaluation

In periodontal follow-up and reevaluation, the dentist checks the response to treatment after approx. 6-8 weeks. If this is satisfactory, the patient can be discharged into the maintenance phase.

Surgical periodontal therapy

If there is still a need for treatment, surgical periodontal therapy is the next step. This involves removing the pathogenic plaque from relatively inaccessible places such as furcations under magnification.

Maintenance phase

In the maintenance phase, the aim is to prevent the periodontitis from flaring up again. Regular check-ups are therefore needed, tailored to the patient’s individual risk profile.

Ideally, a structured treatment plan should be implemented to achieve an optimum periodontal state. Nevertheless, a periodontitis patient is always considered as having a chronic condition and requires a lifelong regimen of regular, professional care in the dental practice.