This is the mainstay of initial periodontal therapy and will form the basis for treatment wherever appropriate. The soft tissue response will be monitored some months after the initial therapy and, if necessary, further treatment planned and discussed. Even in severe cases, non-surgical periodontal therapy often precedes surgical therapy and is done to improve the overall tissue quality prior to surgery.

I try to involve the referring practice in the treatment of their own patients as much as possible and often request that they provide additional therapy between the initial debridement and reassessment.