Four steps: how the guideline orders the treatment

Dentistry – and the field of periodontology in particular – is advancing quickly. Our editorial team sifts through the wealth of information and gathers here what is new and worth knowing on the subject:

10.02.2026

Four steps: how the guideline orders the treatment

The German-language S3 guideline on the treatment of periodontitis in stages I to III follows the European model and arranges the therapy in four steps.

Step 1 addresses the causes the patient can influence: information, oral hygiene, risk factors such as smoking, together with the cleaning of the visible tooth surfaces. Step 2 is the anti-infective treatment proper, below the gum margin. The findings are then recorded anew.

Step 3 follows only where pockets remain; surgical procedures come into consideration here, and regenerative ones depending on the defect. Step 4 is the lifelong aftercare at individually determined intervals.

The ordering principle is notable: only when one step has reached its aim does the next follow. An operation without preceding oral hygiene and cleaning is not foreseen in this system.

Source: S3 guideline on the treatment of periodontitis stages I to III, Deutsche Gesellschaft für Parodontologie and Deutsche Gesellschaft für Zahn-, Mund- und Kieferheilkunde.

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