Which non-surgical treatment should be prioritized for patients with severe deep pockets?

For patients with severe deep pockets, scaling and root planing is the non-surgical treatment that should be prioritized. This procedure involves the thorough cleaning of the tooth surfaces both above and below the gum line, which is essential for removing plaque, calculus, and bacterial toxins that contribute to periodontal disease.

By effectively debriding the root surfaces, scaling and root planing helps to reduce inflammation and promotes healing of the periodontal tissues. This can lead to pocket depth reduction and improved periodontal health. It is a crucial first step in managing periodontal disease, particularly for patients with deep pockets, as it can paves the way for potentially restoring periodontal attachment.

Other treatments, such as antibiotic therapy, can be used as adjunctive therapy in certain cases, but they do not replace the need for mechanical debridement that is provided through scaling and root planing. Surgical intervention is a more invasive approach and is typically considered when non-surgical methods are not effective, while regular brushing and flossing are important for maintenance but do not address existing severe periodontal conditions on their own. Therefore, scaling and root planing is essential for the initial management and treatment of periodontal disease in these patients.