The face of modern day dental practice has changed beyond imagination. Technological advances in the field of dental sciences combined with the economic prosperity have witnessed a dramatic surge in the number of people seeking state-of-the-art dental treatment. Patients have started attaching the greatest importance to the quality of treatment they receive. Thanks to the information explosion, patients are well informed of the various treatment modalities that are possible. With more and more dental institutions coming up every other day, patients now have unlimited options for getting their dental treatment done. It is also quite probable that the treatment rendered by practitioners shall be evaluated frequently. To be successful in such a scenario, a practitioner has no option other than providing quality treatment to their patients. It is true that the ambience and facilities of the clinic and the behavior and approach of the dentist has a major role in determining the patient’s attitude towards the dentist and dental treatment in general and adds to the quality of the practice. However, at the end of the day, the only thing that matters is whether your treatment has contributed to the long-term maintenance of patient’s dentition in function and esthetics. This is possible only through integrating all aspects of dentistry into the day to day clinical practice.

Restorative and prosthetic treatments have conventionally been the major bread winners for a general dental practitioner. Therefore, it is but natural that the practitioner is inclined to looking into these aspects most of the times without paying much attention to the periodontal health of the patient. Without a healthy periodontium, no dental treatment is going to be successful in long-term. In fact, many treatment modalities like fixed partial dentures, orthodontic treatment, and implants can have adverse impact on the patient’s oral health if the periodontal aspect is neglected.

Periodontics has emerged as a major specialty of dentistry worldwide in terms of the magnitude of advancements taking place in both clinical and research aspects. Unfortunately, the extent of periodontal treatment that is being provided in our general dental practice is often confined to scaling and prescription of mouthwashes, gels, and antibiotics. The reasons for this are manifold. First of all, the undergraduate curriculum of Periodontics does not provide a student with much scope for doing any periodontal procedures other than scaling. From a practice point of view, many people find periodontal treatment financially less rewarding considering the time and effort involved. Therefore, little effort is made after graduation to enhance and update one’s knowledge and skills in the subject. Periodontal diseases up to a considerable period of time are rather asymptomatic (other than bleeding gums) and non-disturbing (in terms of pain) for the patient. Therefore, adequate patient motivation and co-operation may be absent or doubtful at the outset. Finally, unlike prosthetic and restorative treatments, the success of any periodontal treatment depends to a major extent on the patient’s oral hygiene maintenance, of which the dentist has no guarantee. Accepting these as relevant factors, they can no longer be used as valid reasons for overlooking the patient’s periodontal health status.

It is true that complex periodontal procedures like flap surgeries and bone grafting requires formal training, however, the number of patients who definitely require these procedures are comparatively less. Majority of the periodontal patients can be treated by the general practitioners themselves. The key to successful periodontal treatment (for that case, any treatment) is the proper diagnosis of the case. Periodontal diagnosis in the current practice set up is largely based on the evaluation of the patient’s oral hygiene status, i.e., the amount of deposits on the teeth. It is generally assumed that patients with more deposits have severe periodontal disease. This is not always true and often leads to the underestimation of the disease, especially in younger patients. Periodontal diagnosis is never accurate without the use of periodontal probes to detect pockets and radiographs to assess the bone levels. X-rays also help to detect conditions like root caries and periapical changes which might be often misdiagnosed as periodontal problems.

Scaling is another aspect that is often taken for granted in clinical practice. It is often taken so casually that some clinicians entrust the procedure to their untrained assistants, which results in incomplete / improper scaling and makes the procedure unimportant in the eyes of the patient. It is high time to change the view regarding scaling as a cosmetic procedure to remove calculus and stains from the visible areas of the teeth. A proper scaling is basic to all periodontal treatment procedures. In fact, astonishing clinical results can be often achieved by a thorough scaling alone. Mouthwashes and antibiotics must be used only as supplements to scaling, not to substitute it.

The value of spending time with the patients to educate and motivate them regarding periodontal treatment is often suspected by practitioners. It is true that initially considerable motivational skills of the doctor might be required to convince the patient regarding the benefits of periodontal treatment and it is quite probable that a significant number of patients might just drop out. But from a positive side, a motivated periodontal patient is an asset for the dentist.

Another important concern in doing periodontal treatment when compared to restorative and prosthetic treatments is “time spent vs. returns gained”. If immediate benefit is the only objective, periodontal treatment is time consuming with lesser returns. But for clinicians with a long-term perspective and vision, addressing the periodontal problem of the patient along with other treatments, shall be truly rewarding in the long run and contribute considerably to the goodwill.

In the recent years, the contributory role of periodontal diseases to major systemic illnesses like diabetes, cardiovascular diseases, respiratory diseases, gastrointestinal problems, and pregnancy related problems have become more evident. As medical practitioners become more aware of this aspect, dentists can expect an increase in the number of patients referred for periodontal treatment in the coming days.

Present day practice requires the integration of all the specialties of dentistry and there is no reason why Periodontics should be an exception. Every practitioner should try to incorporate the practical aspects of periodontal treatment into their day-to-day practice. This can be enhanced by going through journals once in a while, attending CDEs and talks pertaining to periodontal aspects, and interacting with experts in the field. Also, never be reluctant to seek the help of a Periodontist when encountered with complicated cases. Remember, an interdisciplinary approach can work wonders for even the utterly hopeless cases; we only need to widen our approach.