Nonsurgical Treatment of Chronic Periodontitis

Publication Date: June 26, 2015
Last Updated: March 14, 2022

Recommendations

SRP* (No Adjuncts) 

For patients with chronic periodontitis, clinicians should consider SRP as the initial treatment. (In Favor)
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SRP With Systemic Subantimicrobial-dose

Doxycycline For patients with moderate to severe chronic periodontitis, clinicians may consider systemic subantimicrobial-dose doxycycline {20 milligrams twice a day) for 3 to 9 months as an adjund to SRP, with a small net benefit expected. (In Favor)
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SRP With Systemic Antimicrobials

For patients with moderate to severe chronic periodontitis, clinicians may consider systemic antimicrobials as an adjunct to SRP, with a small net benefit expected. (Weak)
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SRP With Locally Delivered Antimicrobials

For patients with moderate to severe chronic periodontitis, clinicians may consider locally delivered chlorhexidine chips as an adjund to SRP, with a moderate net benefit expected. (Weak)
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For patients with moderate to severe chronic periodontitis, clinicians may consider locally delivered doxycycline hyclate gel as an adjunct to SRP, but the net benefit is uncertain. (Expert Opinion For)
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For patients with moderate to severe chronic periodontitis, clinicians may consider locally delivered minocycline microspheres as an adjunct to SRP, but the net benefit is uncertain. (Expert Opinion For)
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SRP With Nonsurgical Use of Lasers

For patients with moderate to severe chronic periodontitis, clinicians may consider PDT† using diode lasers as an adjunct to SRP, with a moderate net benefit expected. (Weak)
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For patients with moderate to severe chronic periodontitis, clinicians should be aware that the current evidence shows no net benefit from diode lasers (non-PDT) when used as an adjunct to SRP. (Expert Opinion Against)
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For patients with moderate to severe chronic periodontitis, clinicians should be aware that the current evidence shows no net benefit from neodymium:yttrium-aluminum-garnet lasers when used as an adjunct to SRP. (Expert Opinion Against)
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For patients with moderate to severe chronic periodontitis, clinicians should be aware that the current evidence shows no net benefit from erbium lasers when used as an adjunct to SRP. (Expert Opinion Against)
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* SRP: Scaling and root planing.
† PDT: Photodynamic therapy.

Recommendation Grading

Overview

Title

Nonsurgical Treatment of Chronic Periodontitis

Authoring Organizations

Publication Month/Year

June 26, 2015

Last Updated Month/Year

July 31, 2023

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

A panel of experts convened by the American Dental Association Council on Scientific Affairs presents an evidence-based clinical practice guideline on nonsurgical treatment of patients with chronic periodontitis by means of scaling and root planing (SRP) with or without adjuncts.

Target Patient Population

Patients with chronic periodontitis

Inclusion Criteria

Female, Male, Adolescent, Adult, Older adult

Health Care Settings

Ambulatory, Outpatient

Intended Users

Dentist, nurse, nurse practitioner, physician, physician assistant

Scope

Assessment and screening, Management, Treatment

Diseases/Conditions (MeSH)

D010518 - Periodontitis, D002710 - Chlorhexidine, D055113 - Chronic Periodontitis, D016745 - Root Planing

Keywords

periodontitis, antibiotics, root planing, chronic periodonitis, chlorhexidine