Guidelines for Periodontal Treatment 2018-08-16T06:28:24+00:00

Suggested Guidelines for Periodontal Treatment

In order to promote a high standard of care, these guidelines were created with the approval of members of the Dental Advisory Board and in association with a number of periodontists. Please keep in mind that the Owner/Dr has the clinical authority to oversee all aspects of dental treatment in the office, thus individual office guidelines may vary slightly.

*Initial Periodontal Maintenance (IPE) 45 min, 12 mouth SRP 45 min and Periodontal Maintenance 45 min.

Case Type Description Step 1 Treatment Step 2 Perio Ref? Step 3 Continuing Care
Healthy
  • Treatment 1-3 mm pockets
  • Pink
  • Stippled
  • No attachment loss
  • No bleeding
  • Light plaque/supragingival calculus
  • No inflammation
  • No bone loss
  • Preventative Treatment
  • Prophylaxis ADA 1110
No
  • Preventative Treatment
  • Prophylaxis ADA 1110 every 6 months
Type I Gingivitis
  • No pockets over 4 mm
  • No bone loss
  • Inflammation of gingival
  • Possible exudate
  • Bleeding on probing
  • Light deposits of calculus
  • Debridement-Gross Scale
  • Prophylaxis ADA 1110
No
  • Preventative Treatment
  • Prophylaxis ADA 1110 every 6 months
Type II Early Periodontitis No Risk Factors*
  • Generalized 3 – 4 mm pockets
  • 1-2 localized 5mm pockets
  • Slight alveolar bone loss possible
  • Slight attachment loss
  • No mobility
  • No furcation
  • Initial Perio Eval (IPE) including gross scale w/ irrigation
  • Quadrant scale D4341 w/irrig. + Arestin per protocol
  • Polish at last SRP appt.
Possible
  • 3 month perio maintenance
  • D4910 w/irrigation and site specific Arestin
  • 3-6 month D4910 based on needs
Type II Early Periodontitis Some Risk Factors*
  • Generalized 3 – 4 mm pockets
  • 1-2 localized 5mm pockets
  • Slight alveolar bone loss possible
  • Slight attachment loss
  • No mobility
  • No furcation
  • Initial Perio Eval (IPE) including gross scale w/ irrigation
  • Quadrant scale D4341 w/irrig. + Arestin per protocol
  • Polish at last SRP appt.
Possible
  • 3 month perio maintenance
  • D4910 w/irrigation and site specific Arestin
  • 3-6 month D4910 based on needs
  • Alternate w/ specialist
Type III Moderate Periodontitis
  • 4 or more teeth with 4-6+ mm pockets especially in posterior
  • Noticeable attachment loss
  • Noticeable loss of bone support
  • Increased mobility
  • Possible furcation involvement
  • Moderate to severe subgingival calculus
  • Initial Perio Eval (IPE) including gross scale w/ irrigation
  • Quadrant scale D4341 w/irrig. + Arestin per protocol
  • Polish at last SRP appt.
Yes
  • 3-6 mo. perio maintenance D4910 w/irrigation and site specific Arestin
  • Alternate w/ specialist
Type IV Advanced Periodontitis
  • Pocket depths present greater than 7 mm
  • Significant attachment loss
  • Major loss of alveolar bone
  • Increased mobility
  • Furcation involvement
  • Tenacious calculus
  • Initial Perio Eval (IPE) including gross scale w/ irrigation
  • Quadrant scale D4341 w/irrig. + Arestin per protocol
  • Polish at last SRP appt.
Yes
  • 3-6 mo. perio maintenance D4910 w/irrigation and site specific Arestin
  • Alternate w/ specialist

* Risk factors include, but are not limited to: Tobacco use, diabetes, heart disease, some medications and previous periodontal therapy