Various periodontal classification systems have been used over the years and have been modified to reflect advances in knowledge and research. • Extraction of hopeless teeth and provisional replacement if needed (may be postponed to a more convenient time), • Diet control (for patients at high caries risk), • Scaling and root planing to remove bacterial plaque biofilm and calculus, • Correction of contributing restorative and prosthetic factors, • Removal of caries and restoration of teeth (temporary or final, depending on whether a definitive prognosis for the tooth has been arrived at and on the location of the caries), • Antimicrobial therapy (local or systemic), • Evaluation of response to Phase I (occurs 1 month or longer after completion), • Reassess gingival condition and pocket depth, • Rechecking for plaque, calculus, and caries, • Periodontal surgery, including placement of implants, • Evaluation of response to restorative phase, • Periodontal condition (pockets, inflammation), (Reprinted and adapted by permission from Newman MG, Takei HH, Klokkevold PR, et al, eds. Phases of treatment plan. Periodontal maintenance occurs while the other phases of treatment are ongoing because the completion of the entire treatment plan can take months or years, and decline in the status of periodontal patients has been observed much earlier, after as little as 90 days. 5. Other risk factors for periodontal disease also should be identified and modified where possible. • Discuss informed consent and its importance to the process of patient care. 2. Scaling, root debridement and planing are performed. Periodontal therapy is diagnosis-driven and, to the extent possible, should address all modifying factors and risk factors that impact development and progression of plaque-induced periodontal disease. 1. For coordination of the total treatment of the patient, the treatment plan can be divided into various segments or phases. Identify the patient factors to be considered when establishing the treatment plan sequence. All treatment plans must be understood by the patient and reflect the patient’s wishes and preferences. 6. Most patients who have been treated for moderate to advanced periodontal disease require maintenance visits every 3 months. Scaling and Root Planning In the first phase of your treatment, special instruments will be used to carefully and thoroughly clean (debride) and polish each tooth and its root surfaces. 2. The significance of reassessment after Phase I therapy. Because of the complexity of the periodontal treatment required to meet planned goals, a series of appointments is often required. The dental hygiene treatment plan consists of services that are performed by the dental hygienist within the total treatment plan.2 Treatment planning occurs after the assessment of all clinical data and reflects the diagnosis and prognosis of the patient. Principally, the comprehensive periodontal therapy can be divided into four main phases followed by any dental emergency 7. • Teeth that will require removal. Patient education and plaque control instruction occur at the beginning of this phase. The goals of the treatment plan are to eliminate and control etiologic and predisposing factors of disease, maintain health, and prevent recurrence of disease.1,4 These goals are the same, regardless of the sequence of treatment or the individual who is delivering the dental care. established before the beginning of treatment, and it must be carefully monitored. This system was adopted by the American Academy of Periodontology (AAP) and is widely accepted by the dental community as the preferred classification system.13 The classifications are outlined in Box 10-2. Initial Periodontal Treatment A. Figures 10-1 to 10-4 are examples of successful therapeutic results achieved by a dental hygienist providing Phase I therapy. 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