Nonsurgical Periodontal Therapy: a Review of Current Standards of Care and Innovations to Improve Gingival and Periodontal Health

  • Maria L. GeisingerEmail author
  • Maninder Kaur
  • Hussein Basma
Clinical Periodontics (Y Stathopoulou, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Clinical Periodontics


Purpose of Review

Regular home care delivered by patients as well as professional mechanical debridement is a cornerstone of periodontal and peri-implant health. This report will examine current therapies for nonsurgical periodontal and peri-implant diseases, including oral hygiene measures and behavioral modification, scaling and root planing, adjunctive systemic and local antibiotic therapy, and novel pharmacologic and physical adjunctive treatments.

Recent Findings

Periodontitis is a highly prevalent, destructive disease and has been estimated to result in $54 billion of lost productivity yearly worldwide. Additionally, it is estimated that up to 5 million dental implants are placed each year and, with the increasing number of implants comes increasing numbers of cases of peri-implant mucositis and peri-implantitis. Nonsurgical therapy is the first line of treatment and long-term prevention for both of these conditions. Mechanical therapy requires a high level of operator skill and an understanding of expected results and the modifiers which may affect treatment outcomes. Proper patient selection, patient compliance, and assessment of optimal treatment options are required for successful results of therapy. Adjunctive therapy in high-risk patients, for example, smokers, may improve treatment outcomes, and care should be taken to select adjunctive therapies based upon their mechanisms of action and the deficits in host defense noted in patients with additional risk factors. Furthermore, long-term maintenance and surveillance of disease recurrence are necessary in the management of these chronic diseases.


Nonsurgical therapy is a cost-effective intervention to address periodontal diseases, and patients with select risk factors may receive additional benefit when adjunctive therapies are employed during this phase of treatment.


Periodontal diseases Periodontitis Oral health Oral hygiene Gingivitis Nonsurgical therapy 



The authors would like to thank Ms. Elizabeth Bolton for her assistance with this manuscript.

Compliance with Ethical Standards

Conflict of Interest

Dr. Geisinger reports her role as Vice Chair of the American Dental Association’s Council on Scientific Affairs and Chair of the ADA Seal Subcommittee, reviewing the safety and efficacy of over-the-counter patient-delivered products for dental health and oral hygiene.

Maninder Kaur and Hussein Basma each declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Maria L. Geisinger
    • 1
    Email author
  • Maninder Kaur
    • 1
  • Hussein Basma
    • 1
  1. 1.Department of PeriodontologyUniversity of Alabama at BirminghamBirminghamUSA

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