Non-surgical therapy
Combine personalised biofilm control, risk-factor support and subgingival instrumentation where indicated. Re-evaluate response before escalation.
Understand
Non-surgical care combines behaviour change, risk-factor management and effective supra- and subgingival instrumentation. Tissue response is assessed after healing.
Assess
Set a baseline chart and evaluate patient-performed plaque control. Identify access difficulties, furcations and sites that may require additional approaches.
Apply
Treat in a phased, comfortable manner and re-evaluate bleeding, pocketing and plaque. Residual disease triggers diagnosis and shared decisions, not automatic repetition of the same treatment indefinitely.
Key distinctions
The first phase should create a mouth the patient can clean. Subgingival instrumentation is more effective when plaque control and local restorative factors are addressed. Reassessment after healing is the decision point: residual deep sites, bleeding and patient goals guide maintenance, further non-surgical work, surgery or referral. Record response rather than only the number of appointments completed.
Think through a case
At re-evaluation, most sites have resolved but one deep molar furcation still bleeds. A site-specific plan is more useful than repeating whole-mouth treatment indiscriminately.
The distinction to remember
Do not escalate to surgery before allowing healing and checking whether the patient can maintain adequate plaque control.
Test your recall
When should residual pockets be judged for further care?
Show answer
After healing and a documented periodontal re-assessment.