Step 4 / Supportive Periodontal Therapy (SPT)
Lifelong maintenance — risk-adapted recall (3–12 months), full-mouth probing, individualised reinforcement of OH and PMPR (R7.x). 'A perio patient never ceases to be a perio patient.'
SPT is lifelong. The reduced periodontium remains a chronic-disease state — recurrence is the main risk to manage.
Evidence Guidelines & evidence
- EFP S3 R7 — SPC frequency
Supportive periodontal care visits should be tailored to the patient's risk profile, typically every 3 to 6 months for treated periodontitis patients.
- 2018 World Workshop — Reduced healthy periodontium
After successful treatment, patients have a reduced but stable periodontium and require lifelong supportive care to prevent disease recurrence.
1 Risk-based recall scheduling
Recall frequency tailored to grade (A/B/C) and individual risk profile — typically 3–6 months for treated periodontitis patients (R7.x). Document risk factors at every visit. A perio patient never ceases to be a perio patient — SPT is lifelong.
2 Full-mouth assessment at every recall
Probing depths at six sites per tooth, BOP, plaque index, mobility check, screening for caries and prosthetic factors. Compare to prior visits.
3 Reinforcement of self-performed plaque control
Re-instruct OH including interdental brushes, electric brushes, antiseptic mouth rinses where indicated. Smoking cessation and glycaemic control reinforcement at every visit.
4 Professional mechanical plaque removal
Supragingival + targeted subgingival PMPR. Re-instrumentation of residual pockets. Aim: maintain PD ≤ 4 mm with no BOP at every site. Sterify Gel may be considered as a non-antibiotic adjunct at sites with localised inflammation during recall visits.
