This commences with the first appointment and involves patient discussion, clinical examination, assessment of any necessary radiographs and scans. Further investigations may be necessary, analysing tooth positions and bite relationships, available bone volume (in the case of implant cases) and aesthetic issues.
The first goal of therapy is to stop active disease. This involves the removal of bacteria and deposits from the tooth and under the gum-line. This is a combination of efforts undertaken at home, with brushing and flossing, and professional procedures to clean beneath the gum-line.
This process is generally undertaken following numbing of the area involved scaling and root planing the teeth, reshaping any rough or sharp restorations, and removing plaque retentive factors.
For many patients undergoing scaling and root planing, there may be no requirement for further active treatment, including surgical therapy. However, it is imperative to continue with maintenance therapy to sustain optimal oral health. Non-surgical therapy does have limitations and when results achieved are inadequate surgery may be indicated to restore periodontal
anatomy damaged by periodontal diseases, or to regenerate lost attachment and bone.