Periodontitis: Initial Therapy

The first step in dental treatment is initial therapy, which includes intensifying oral hygiene and tartar and plaque removal. In addition, the affected person is encouraged to stop smoking.

Initial therapy consists of:

• Oral hygiene education including training.
  • Mechanical plaque control – this includes toothpaste and its components.
  • Toothbrushing technique
  • Interdental space hygiene (interdental hygiene)
• Professional dental cleaning (PZR), ie professional mechanical plaque removal.
• Attachment status recording, i.e. determination of:
  • Probing depths as the distance between the marginal gingiva (gums) and the bottom of the pocket.
  • Recessions (visible recession of the gums around a tooth) as the distance between the enamel-cement interface or, in the case of crowned teeth, the restoration margin and the marginal gingiva
• Subgingival debridement (removal of all attachments to the tooth structure).
  • Subgingival curettage – to remove plaque or calculus from under the gumline.
  • Supra- and subgingival scaling – for the removal of plaque above and also below the gingival margin.

After three months, a re-evaluation (re-evaluation of the findings or the situation in the course of the disease). Then, if necessary, subgingival reinstrumentation (see above) or periodontal surgical therapy (see below “Surgical Therapy”). Irrespective of the further procedure, the patient must be encouraged to eliminate all individual risk factors (see below “Prevention”).

Note: The result of a complex periodontal therapy can only be stabilized in the long term if the patient subsequently adheres to the program of supportive periodontal therapy (UPT; synonyms: Supportive Periodontal Therapy; Periodontal Maintenance Therapy; PET).

Aim of periodontal therapy, category “A”.