Hygienist / Periodontist

Our team of dental hygienists and therapists welcome referrals for periodontal treatment.

They are happy to work under prescription or develop an appropriate periodontal treatment plan under the Direct Access regulations.

They will always follow the latest BSP guidelines to ensure your patients are receiving the latest, evidence-based care.

The referring dentist will be kept fully informed of the treatment plan and the patient's progress.

The main steps undertaken are:

• Explain disease, risk factors & treatment alternatives, risks & benefits (including no treatment)
• Explain the importance of Oral Hygiene (OH), encourage and support behaviour change for OH improvement
• Reduce risk factors including removal of plaque retentive features, smoking cessation and diabetes control interventions
• Provide individually tailored OH advice including interdental cleaning, + / - adjunctive efficacious toothpaste & mouthwash, + /- Professional Mechanical Plaque Removal (PMPR) including supra and subgingival scaling of the clinical crown
• Select recall period following published guidance and considering risk factors such as smoking and diabetes

They will then re-evaluate and if the patient is non-engaging, this will be documented and Step 1 will be repeated.

If the patient is engaging then we move to Step 2.

Where required, undertake subgingival Instrumentation (root surface debridement / PMPR on root) according to the following:

• Reinforce OH, risk factor control, behaviour change
• Subgingival instrumentation, hand or powered (sonic/ultrasonic), either alone or in combination
• Use of adjunctive systemic antimicrobials to be discussed if required

After Step 2, we re-evaluate at 3 months. If unstable sites exist then we proceed to Step 3. If stable, we proceed to Step 4.

• Reinforce OH, risk factor control, behaviour change
• Moderate (4–5mm) residual pockets – re-perform subgingival instrumentation
• Deep residual pocketing (=6mm). Consider alternative causes
• Consider pocket management or regenerative surgery
• If IV. not possible, re-perform subgingival instrumentation

(If all sites are stable after Step 3 proceed to Step 4)

• Supportive periodontal care strongly encouraged
• Reinforce OH, risk factor control, behaviour change
• Regular targeted PMPR as required to limit tooth loss
• Consider evidence-based adjunctive efficacious toothpaste and/or mouthwash to control gingival inflammation

Secure Online Referral Form PDF Referral form Hygienist & Therapist team