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Dietrich T, Ower P, Tank M Periodontal diagnosis in the context of the 2017 classification system of periodontal diseases and conditions – implementation in clinical practice. Br Dent J. 2019; 226:16-22
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Step 1 for the treatment of periodontal diseases

From Volume 51, Issue 5, May 2024 | Pages 304-310


Angeline Keh


Periodontology Specialist Trainee, Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London

Articles by Angeline Keh

Email Angeline Keh

Zehra Yonel

BDS, MFDS RCS(Ed), FHEA, BDS, MFDS (RCS Edin) (RCS Eng), PGCert, MPH (Hons), PhD

Department of Periodontology, Birmingham Dental Hospital, St Chad's Queensway, Birmingham B4 6NN, UK

Articles by Zehra Yonel


The association between periodontitis and the dysbiotic biofilm necessitates that patients maintain excellent oral hygiene. Therefore, step 1 of the UK clinical practice guidelines for the treatment of periodontal diseases is aimed at behaviour change and motivation in successful removal of the supragingival dental biofilm and risk-factor control, which involves all the health behavioural change interventions that mitigate recognized risk factors for periodontitis onset and progression (smoking cessation, diabetes management). Step 1 should be tailored for the patient throughout the treatment journey and jointly with clinical findings and medical history.

CPD/Clinical Relevance: Step 1 lays the groundwork when progressing through ensuing steps of treatment and can affect response to any periodontal therapy.


A key finding from the 2009 Adult Dental Health Survey was that only 17% of dentate adults in England, Wales and Northern Ireland had very healthy periodontal tissues and no periodontal disease (no bleeding on probing (BOP), no calculus and no periodontal pockets of >4 mm).1 Marcenes et al highlighted that severe periodontitis is the sixth most prevalent condition, affecting 11.2% globally.2 This broadly aligns with the World Health Organization (WHO), which suggested a global prevalence of periodontitis of 19%.3

Periodontitis is a chronic, multifactorial non-communicable disease characterized by inflammation of the oral tissues, and associated with dysbiotic dental plaque biofilms. According to the classification of periodontal and peri-implant diseases and conditions defined in the 2017 World Workshop,4 there are broadly three categories of plaque-related periodontal conditions:

Following the world workshop, the European Federation of Periodontology (EFP) guidelines were produced, and shortly thereafter the UK implementation of the EFP guidelines was published, in which management of periodontal diseases within the UK healthcare context was outlined.

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