An update on the non-surgical treatment of periodontal disease.

For the resolution of gingivitis, the mechanical therapy of scaling and polishing in combination with an efficient plaque control system remains the most efficient therapeutic package. Topical antimicrobial, particularly mouth rinses may aid in plaque control, and irrigation devices enhance their efficacy but are not mandatory to the treatment. In the case of periodontitis, mechanical therapy in addition to the use of antimicrobial agents have proven to be highly efficient, with successful clinical parameters achieved as endpoints. Because of the strong bacterial component of the disease process, its elimination with chemotherapeutic agents becomes a reality. Delivery systems of antimicrobials to the site of action have large potential as adjunct to the existing modalities of treatment. This will especially be applicable in moderate to severe cases where access is difficult. Future directions in research lead us to the potentials of non-steroidal anti-inflammatory agents that interfere with prostaglandin metabolism. Possible alteration of the periodontal disease process at some point in time may be a reality. Inevitably, at some point, especially in severe cases, surgical intervention becomes a necessity as no mechanical therapy is possible because of inaccessibility. In which case, the point of contention is that for periodontal disease, sound principles of anti-infective therapy must be employed constantly.