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Demystifying the S3 guidelines: what do they actually mean?

From Volume 51, Issue 5, May 2024 | Pages 300-302


Devan S Raindi

BDS Hons (Birm) MJDF RCS (Eng) MClinDent Hons (KCL) MPerio RCS (Edin) AFHEA, BDS Hons (Birm), MJDF RCS (Eng), MClinDent Hons (KCL), MPerio RCS (Edin), AFHEA

Specialist in Periodontics, Guy‘s Hospital, London

Articles by Devan S Raindi

Email Devan S Raindi

Iain Chapple


Professor and Honorary Consultant in Restorative Dentistry, Birmingham Dental Hospital and School

Articles by Iain Chapple

Moritz Kebschull

Dr med dent, Dr med dent habil, MBA

Periodontal Research Group, Institute of Clinical Sciences, University of Birmingham

Articles by Moritz Kebschull


Recent guidelines have been developed by the European Federation of Periodontology (EFP) and adoloped by the British Society of Periodontology to provide evidence-based guidance for clinicians in the UK to deliver periodontal therapy. To ensure the guidelines are as robust as possible the process of development is carefully structured. This article explores the background behind S3-level guidance for the treatment of periodontitis.

CPD/Clinical Relevance: Understanding the process behind guideline formulation allows clinicians to apply them appropriately and confidently within their clinical practice.


The treatment of periodontitis encompasses management of the disease itself as well as appropriate management of the consequences of the disease, for example mobility, recession and tooth loss. Periodontology is fortunate in its abundance of robust evidence, which continues to expand. However, as research increases at a rapid rate, this provides a challenge for clinicians delivering evidence-based dentistry to their patients. Clinical guidelines can therefore help consolidate complex research into statements supporting clinical decision making. The European Federation of Periodontology (EFP) Workshop Committee have therefore developed comprehensive evidence-based S3-level treatment guidelines for both the treatment of periodontitis and the rehabilitation/maintenance of treated periodontitis patients. This brief article explores what S3 guidance is, and how guidelines are structured, while the subsequent articles in this issue of Dental Update explore the content of these guidelines across a range of periodontally relevant topics for clinicians in general practice.

When guidelines are proposed for clinical care, there are various ways in which they can be developed, namely, an informal recommendation by a group of experts, a structured consensus, systematic evaluation of the evidence or, ideally, a combination of both these, that is, a synthesis of available evidence and structured consensus by a representative committee. Table 1 summarizes the different levels of guideline development and as can clearly be seen, S3 guideline development represents the highest level.

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