Periodontitis: Therapy

General measures

  • Pay attention to oral hygiene!
  • Nicotine restriction (refrain from tobacco use).
  • Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day).
  • Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition using electrical impedance analysis.
    • BMI ≥ 25 → participation in a medically supervised weight loss program.
    • Falling below the BMI lower limit (from the age of 45: 22; from the age of 55: 23; from the age of 65: 24) → Participation in a medically supervised program for the underweight.
  • Review of permanent medication due topossible effect on the existing disease.
  • Avoidance of psychosocial stress:
    • Stress
  • Avoidance of environmental stress:
    • Heavy metal poisoning such as with lead.

Note: The result of a costly periodontal therapy can be permanently stabilized only if the patient is subsequently committed to the program of supportive periodontal therapy (UPT; synonyms: Supportive Periodontal Therapy; Periodontal Maintenance Therapy; PET).

Conventional nonsurgical therapy methods

Mechanical plaque control

  • Toothbrushing techniques: Modified Bass technique, Charters technique, Modified Stillman technique.
  • Interdental space hygiene – dental floss, interdental space brush (interdental space brush).
  • Professional dental cleaning (PZR)

Chemical plaque control

Other measures

  • Supra- and subgingival scaling (scaling below the gumline).
  • Root scaling – The removal of biofilm and supra- and subgingival calculus is called scaling. After that, remaining tartar particles and roughness are leveled during the so-called root planing (root smoothing).
  • Subgingival curettage – inflammatory altered soft tissue is carefully curetted (scraped out with so-called sharp spoons).
  • Photo-activated chemotherapy (PACT; synonym: antimicrobial photodynamic therapy) – The principle of photo-activated chemotherapy (PACT) is based on killing bacteria of the oral cavity by means of a photosensitizer (tolonium chloride), which forms active oxygen when irradiated (60-120s, depending on the area of application) with light of a wavelength of 635 nm with a power of up to 100 mW. This oxygen destroys the cell walls of the bacteria and leads to the death of the germs. The efficiency is 99.9%.
  • Powder jet technology – a method of professional dental cleaning (PZR), with which a powder–water-air mixture the tooth deposited hard discoloration and microbial soft plaque (biofilm) can be removed gently and in places inaccessible for domestic dental care.

Regular check-ups

  • There should always be a comprehensive follow-up in the form of regular control appointments to ensure the lasting success of the therapy.
  • Regular dental checkups.

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
    • A total of 5 servings of fresh vegetables and fruit daily (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
    • Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
    • High-fiber diet (whole grain products).
  • Observance of the following special dietary recommendations:
  • Selection of appropriate food based on the nutritional analysis
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement (eg with coenzyme Q 10 and probiotics).
  • Detailed information on nutritional medicine you will receive from us.

Sports Medicine

Psychotherapy