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Non-surgical periodontal therapy (NSPT) underpins all other restorative treatment which takes place in the mouth. Therefore a thorough understanding of the process of delivery of effective NSPT and long-term maintenance of periodontal health is essential for every dental practitioner. This article covers the steps involved and discusses the benefits and challenges which may be encountered. CPD/Clinical Relevance: This article highlights the benefits and challenges of non-surgical management of periodontal disease and the key role that the patient plays in achieving and maintaining periodontal health.

The objective of this case report is to illustrate the diagnosis and classification of periodontitis according to the 2017 Classification system as recommended in the British Society of Periodontology (BSP) implementation plan.A 37-year-old female was diagnosed with periodontitis (Molar-Incisor-Pattern), stage III grade C - currently unstable. Several issues pertinent to the diagnosis of localised forms of periodontitis in young patients are discussed in relation to the current and previous classification systems.Periodontitis can be limited to a few sites and this case highlights the importance of a careful application of the Basic Periodontal Examination (BPE).

Case report A case of a 59-year-old female patient who attended with a history of periodontitis, who had been successfully treated and maintained for several years, is described. Following a full periodontal assessment, the patient was diagnosed with 'generalised periodontitis; stage IV; grade C; currently stable'.Conclusion The present case report exemplifies the use of the 2017 classification system in a successfully treated and well-maintained patient whose treatment need is supportive periodontal treatment. It recognises the fact that, by staging and grading, the patient is a high-risk periodontitis patient due to historical disease experience, but also that following successful therapy and maintenance she is currently 'stable' with no need for active periodontal therapy.

This case report is the fourth in a series that illustrates the application of the BSP implementation plan for diagnosing periodontitis patients according to the 2017 classification. It demonstrates the diagnostic approach and disease classification for a previously treated patient who presented with a diagnosis of unstable generalised periodontitis; stage IV, grade C. We describe a case of a 49-year-old patient who attended with a history of periodontal treatment over several years. Following a full periodontal assessment, the patient was diagnosed with 'generalised periodontitis; stage IV, grade C; currently unstable'. This case report presents an example of how to classify and diagnose a patient using the 2017 classification system and highlights challenges with the application of the new classification in patients with a previous history of periodontal therapy.

There have been numerous reports in the scientific literature investigating the possible association between alcohol-containing mouthwashes and oral cancer but relatively few epidemiological surveys have taken place and the findings have been equivocal. This article will address the controversial issue of the safety of mouthwashes and provide an objective assessment of the latest scientific evidence. CPD/Clinical Relevance: The evidence surrounding the safety of ‘over the counter’ alcohol-containing mouthwashes is evaluated. This provides guidance for dentists and dental care professionals of when it is appropriate to recommend mouthwash use to their patients.

Introduction: The objective of this case report is to illustrate the diagnosis and classification of periodontitis according to the 2017 Classification system as recommended in the British Society of Periodontology (BSP) implementation plan.Case report: We describe two cases in the form of a pair of siblings, who developed periodontitis very early in life. A 19-year-old female was diagnosed with “Generalised periodontitis; Stage III/Grade C; currently unstable”. Her 14year-old sister was diagnosed with “Localised periodontitis; Stage II, Grade C; currently unstable”.Conclusion: The present case report presents an example for the application of the new classification system and illustrates the importance of a periodontal check for children and adolescents and/or their relatives

Introduction: The objective of this case report is to illustrate the diagnosis and classification of periodontitis according to the 2017 Classification system as recommended in the British Society of Periodontology (BSP) implementation plan.Case report: We describe a case of a patient who was diagnosed with “Localised periodontitis; Stage II, Grade B; currently unstable”.Conclusion: The present case report presents an example for the application of the new classification system and illustrates how the new classification system captures disease severity, extent and disease susceptibility by staging and grading periodontitis

Since 1949 the British Society of Periodontology (BSP) has been working hard to research, debate and involve themselves in all issues that affect its members. The aim of the BSP is to raise public, patient, dental and medical professionals' awareness of periodontology. Last year's president of the BSP, Dr Penny Hodge, here explains the structure, role and activities of the society.

This article will focus on the antiplaque efficacy of mouthwashes. An antiplaque agent inhibits the formation of plaque and also reduces gingivitis. There is good evidence that chlorhexidine digluconate, used in the correct concentrations, is the gold standard agent against which all others should be measured. It does, however, have some unwanted side-effects. One of the major problems for antiplaque mouthwashes is that they have a much reduced effect on established plaque within the oral environment. Although they can flow into the biofilm channels and kill bacteria in the superficial layers of dental plaque, they cannot penetrate the biomass and inhibit the pathogenic bacteria adjacent to the tooth surface and gingival margin. There is no evidence that they prevent the progression of periodontitis. Clinical relevance: The evidence supporting the use of ‘over the counter’ antiplaque mouthwashes is evaluated. This provides guidance for dentists and dental care professionals of when it is appropriate to recommend mouthwash use to their patients.

Background Periodontal disease is the most common oral disease affecting adults, and although it is largely preventable it remains the major cause of poor oral health worldwide. Accumulation of microbial dental plaque is the primary aetiological factor for both periodontal disease and caries. Effective self-care (tooth brushing and interdental aids) for plaque control and removal of risk factors such as calculus, which can only be removed by periodontal instrumentation (PI), are considered necessary to prevent and treat periodontal disease thereby maintaining periodontal health. Despite evidence of an association between sustained, good oral hygiene and a low incidence of periodontal disease and caries in adults there is a lack of strong and reliable evidence to inform clinicians of the relative effectiveness (if any) of different types of Oral Hygiene Advice (OHA). The evidence to inform clinicians of the effectiveness and optimal frequency of PI is also mixed. There is therefore an urgent need to assess the relative effectiveness of OHA and PI in a robust, sufficiently powered randomised controlled trial (RCT) in primary dental care. Methods/Design This is a 5 year multi-centre, randomised, open trial with blinded outcome evaluation based in dental primary care in Scotland and the North East of England. Practitioners will recruit 1860 adult patients, with periodontal health, gingivitis or moderate periodontitis (Basic Periodontal Examination Score 0–3). Dental practices will be cluster randomised to provide routine OHA or Personalised OHA. To test the effects of PI each individual patient participant will be randomised to one of three groups: no PI, 6 monthly PI (current practice), or 12 monthly PI. Baseline measures and outcome data (during a three year follow-up) will be assessed through clinical examination, patient questionnaires and NHS databases. The primary outcome measures at 3 year follow up are gingival inflammation/bleeding on probing at the gingival margin; oral hygiene self-efficacy and net benefits. Discussion IQuaD will provide evidence for the most clinically-effective and cost-effective approach to managing periodontal disease in dentate adults in Primary Care. This will support general dental practitioners and patients in treatment decision making. Trial registration Protocol ID: ISRCTN56465715

Objective: To develop and apply a detailed clinical protocol for screening and assessing subjects with a complaint of halitosis. Design: Cross-sectional. Subjects and methods: Several methods were used to recruit subjects with a complaint of halitosis, including a newspaper advertisement. A definition of halitosis arising from within the oral cavity, which is not related to generalized chronic gingivitis, chronic periodontitis or pathology of the oral mucosa was used. An extensive list of exclusion criteria was applied at the initial visit. Eligible subjects were asked to follow strict instructions and complete a questionnaire prior to their second visit for data collection. The clinical examination consisted of an organoleptic assessment, Halimeter® reading and periodontal examination. Results: The best method of recruiting subjects was advertising. Of 66 individuals recruited, four failed to attend the screening visit and 25 were excluded. The main reasons for exclusion were poor oral hygiene and existing periodontal disease. Thirty-seven completed the full protocol, resulting in identification of 18 with halitosis and 19 controls. Conclusions: Application of the exclusion criteria resulted in significant attrition of eligible participants. Our results suggest that organoleptic assessment should be regarded as a useful standard for defining subjects with halitosis.

This was a cohort study. A longstanding prospective study was carried out of a birth cohort born in Dunedin (New Zealand) in 1972–1973. Periodontal examinations of the study participants were carried out when they reached the age of 26 and 32 years by calibrated examiners; smoking exposure was measured by questioning at ages 15, 18, 21, 26 and 32 years. Socioeconomic status (SES) was measured at the age of 26 years by categorising adult occupation using standard New Zealand occupation indices. Dental visiting behaviour was assessed by questioning at age 25 and 32 years. Chi-square tests were used to examine the statistical significance of differences observed with categorical dependent variables. Analysis of variance was used for continuous variables. Logistic regression modelling was used to examine smoking exposure and periodontitis prevalence and incidence while controlling for sex, SES, dental plaque accumulation and the use of dental services. Complete data were available for 810 individuals of whom 48.9% had smoked at some point (31.5% were current smokers). Table 1 shows the prevalence, for a selection of smoking exposure groups of attachment loss at age 32 and the odds ratio compared with never-smokers and Table 2 the incidence of 3+ mm attachment loss. Sites with >5 mm attachment loss and were more likely to be incident cases after age 26 (OR, 5.2 and 3.2, respectively). Two thirds of new cases in individuals older than 26 years were attributable to smoking. There were no significant differences in periodontal health between never-smokers and those who had quit smoking after age 26. Current and long-term smoking in young adults is detrimental to periodontal health, but smoking cessation may be associated with a relatively rapid improvement in the periodontium.