How many times I have struggled to find one or other official guidelines on periodontitis management in the UK. In this post I’ve wanted to collect in one place all of the latest periodontitis management guidelines for UK based clinicians. This information is extremely useful for dental care professionals, like general dentists, hygienists and dental therapists. Most of the links will lead to the resources on the British Society of Periodontology and Implant Dentistry website.
BPE – Basic Periodontal Examination for Adults
In 2019 British Society of Periodontology and Implant Dentistry has published updated guidelines on how to perform Basic Periodontal Examination for adults and how to interpret the findings.
It is expected that dental care professionals would perform it at every new patient assessment and at every routine examination. I believe it should be done at least once a year, or more often if the patient is high risk for developing periodontitis.
sBPE – simplified BPE for assessing Under 18s
In September 2021 Guidelines for periodontal screening and management of children and adolescents under 18 years of age have been updated. This was a joint project by the British Society of Periodontology and Implant Dentistry and British Society of Paediatric Dentistry. You can find the full version or just check out the executive summary.
Children should be screened from the age of 7, assessing their first molars and central incisors. I believe it is very important to screen even the youngest patients for periodontal disease. It is rare to find periodontitis in such age groups, but it’s definitely not something you would want to miss in such young and vulnerable people.
2017 Classification of Periodontal Diseases
You can access original papers of the 2017 World Workshop that were published in both Journal of Clinical Periodontology (European Federation of Periodontology) and Journal of Periodontology (American Association of Periodontology) here. And this is the main paper outlining the classification.
- If you practice in the UK, you should be using the BSP implementation of the 2017 Classification.
- There are also free webinars, on different aspects of the new classification.
- I would advise to watch the first webinar from the series, which covers the history of our knowledge and classification of periodontal diseases.
- And I strongly suggest the second webinar, which explains the newest classification.
It’s been a while since the most recent 2017 Classification of Periodontal Diseases, yet many dental care professionals struggle with it. The trick is – ideally you need full mouth periapicals to be able to identify tooth with most extensive bone loss, and then reach a diagnosis using additional information, like age, HbA1C, smoking status, number of teeth lost due to the gum disease… Or just refer to me:
2019 Treatment Guidelines for Periodontitis Stages I-III
By far, the most important of periodontitis management guidelines for UK based clinicians.
In 2019 top periodontists of the world got together with orthodontists, endodontists, prosthodontists, medical companies and other stakeholders. Through careful analysis of the scientific evidence and joint discussions, they came up with the Treatment Guidelines for Periodontitis Stages I-III. You can access for free all related original articles here as well as the main document outlining the guidelines here.
Once again, BSP decided to review the guidelines and present to the UK dental care professionals an adapted version. There is a whole BSP page with a lot of useful resources on the treatment guidelines. For dental care professionals, who are not periodontists, I suggest checking out these main ones:
- Full BSP paper outlining all the guidelines with supporting evidence.
- A very straightforward flowchart detailing the 4 steps of periodontitis treatment.
- Webinar on Step 1: Patient Motivation and Risk Factor Management.
- Webinar on Step 2: Non-Surgical Treatment of Periodontitis.
How to treat Periodontitis Stage IV, then? Well, initial management is the same. We are awaiting for guidelines that should be published late this year. Those guidelines will be concentrating mostly on ortho-perio and resto-perio interface.
Updated UK Glossary AKA no more Scale and Polish
Throughout the years, different techniques of non-surgical periodontal treatment have been practiced, like curettage, root planing, root surface debridement, that are not performed nowadays. It has also been decided that it is about time to get rid of derogatory “scale and polish”, which does not sound medical enough. The new glossary can be found here. Introducing PMPR – professional mechanical plaque removal.
Post last time updated 2nd February 2022