Periodontitis is characterized by inflammation of the marginal gingiva and progressive loss of supporting bone. Patients’ awareness is often limited to the acute manifestations. In its advanced stages, periodontitis compromises prosthetic and occlusal functions, leading to tooth hypermobility, drifting, and tooth loss.

The first line of therapy involves the non-surgical removal of the primary etiologic factors for periodontitis, such as subgingival bacteria, biofilm, and calcified deposits. This is also referred to as etiologic therapy or hygienic therapy. Advances in technology, combined with an improved understanding of periodontal tissues, have made non-surgical therapy extremely effective.

Non-surgical therapy, aka scaling and root planing, is minimally invasive, well accepted by patients, and cost-effective, which allows for wide access to treatment across society.

The case I present today involves Ms. M., who presented with generalized Stage 3 Grade C periodontitis, featuring 8–12 mm pocket depths, gingival inflammation, gingival overgrowth, horizontal and vertical bone loss approaching 50% of root length, and absence of lamina dura. Scaling and root planing was performed by our exceptional hygienists, Reese and Clare, resulting in reduced inflammation, probing depths reduced to physiological values of 3 mm, spontaneous bone fill in vertical infrabony defects, and corticalization of the bone crest.

High-quality scaling and root planing successfully treated periodontitis, restoring health in a reduced periodontium and improving the prognosis from unfavorable to favorable. More than five years after therapy, Ms. M. has not required surgical intervention for pocket depth reduction after scaling and root planing. Her periodontal condition has remained stable since the first therapy.