Individual susceptibility to periodontal breakdown involves an interplay of genes, periodontal pathogens and other modulating factors. Anti-infective treatment, which includes
oral hygiene measures, mechanical
debridement, pharmacologic intervention and surgery, has been shown to be effective in arresting the progression of
periodontal disease. Nevertheless, due to the chronic nature of the disease, susceptible individuals who are not maintained in a supervised recall program subsequent to the active treatment phase, show signs of recurrent destruction. Supportive periodontal
therapy (SPT) is an integral part of periodontal treatment for patients with history of
periodontitis, and is needed to prevent recurrence of disease in susceptible individuals. To prevent
re-infection with periodontal pathogens, SPT includes elimination of
dental plaque and bacteria from the oral cavity, thereby preventing the recurrence of pathogens into the gingival area. For individuals at risk of developing
periodontitis, SPT should combine self-performed and professional anti-infective
therapy, using mechanical and pharmacological means. The existing evidence suggests that the adjunctive use of antimicrobial pharmacologic
therapy during SPT may enhance the results of mechanical
debridement. The use of antimicrobials varies between patients, and is dependent on risk assessment and longitudinal monitoring of the clinical status of the periodontium.