Interventions for Periodontal disease

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Age Cohort: Pregnancy and newborn

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Create awareness on oral health including periodontal disease to the communities Increase knowledge and practices among the public through community programmes Fully integrating oral health into community health programmes. Community Health workers training on periodontal disease including prevention measures	Daily oral hygiene measures to prevent periodontal disease including brushing properly on a regular basis (at least twice daily), Flossing daily Using an antiseptic mouthwash: Chlorhexidine gluconate-based mouthwash Adoption of healthy lifestyles such as no smoking or cessation of smoking, use of healthy balanced diets Regular dental check-ups Community level screening for periodontal disease		Recognition of symptoms indicative of periodontal disease such as bleeding gums, drifted or loose teeth or a complaint of bad breath, Good oral hygiene/oral hygiene instructions including brushing and flossing Guidance on healthy diet/good nutrition Use of antiseptic mouth washes as a temporary primary oral hygiene measure Relieve of symptoms such as pain with pan killers such as paracetamol Referral to a health facility for management of pregnant women with periodontal disease
Primary Care
Education to pregnant women on periodontal disease including prevention measures Information to pregnant women on the increased risk of developing pregnancy gingivitis and its prevention measures Health workers training on periodontal disease, prevention and management	Guidance on good oral hygiene practices including brushing; flossing Guidance on avoidance of factors that predispose to periodontal disease including on the effect of smoking on their oral health and general health and assist them on smoking cessation. Advice/guidance on control of diabetes as Poorly controlled diabetes enhances the signs and symptoms of gingivitis and periodontitis Information and guidance to patient on the benefits of a healthy, balanced diet to their oral health including prevention of periodontal disease Encourage patients to modify other lifestyle factors that may impact on their oral health. Dental prophylaxis during pregnancy Screening pregnant women for periodontal disease at every routine examination.		History and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth Treatment planning and Patient education on the treatment choice Guidance to patient on their role in improving periodontal health. Oral Hygiene instructions modelled on patient behavior change strategies (TIPPS-talk, instruct, practice, plan, support) Use of mouth washes as a temporary primary oral hygiene measure Ensure that the patient is motivated to achieve and maintain effective plaque removal. Antimicrobial Medication, Local antimicrobials, including disinfectants such as chlorhexidine and systemic antimicrobials Use of analgesics where there is pain Referral of pregnant women with periodontal disease to a hospital for further management including management of any underlying conditions such as diabetes /cardiovascular disease that predisposes to periodontal disease
Referral Facility: General
Education to pregnant women on periodontal disease including prevention measures Information to pregnant women on the increased risk of developing pregnancy gingivitis and its prevention measures Health workers training on periodontal disease; prevention and management	Guidance on good oral hygiene practices including brushing, flossing Guidance on avoidance of factors that predispose to periodontal disease including on the effect of smoking on their oral health and general health and assist them on smoking cessation Early treatment/management of predisposing conditions such as diabetes, cardiovascular disease as a preventive measure Advice/guidance on control of diabetes as Poorly controlled diabetes enhances the signs and symptoms of gingivitis and periodontitis Information and guidance to patient on the benefits of a healthy, balanced diet to their oral health including prevention of periodontal disease Encourage patients to modify other lifestyle factors that may impact on their oral health. Dental prophylaxis during pregnancy Screening pregnant women for periodontal disease at every routine examination.		Physical, clinical and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth Diagnostics including; * Study models for diagnostics especially of gingival recession * Use of clinical photographs calibrated by inclusion of a probe to monitor gingival recession * Use of Radiographs (x-rays) to determine the extent of periodontal disease and for treatment planning. These include periapical radiographs & or panoramic radiographs Treatment planning and Patient education on the treatment choice Oral Hygiene instructions modelled on patient behaviour change strategies (TIPPS-talk, instruct, practice, plan, support) Use of mouth washes as a temporary primary oral hygiene measure Removal of plaque and calculus including supragingival debridement and root surface instrumentation Ensure that the patient is motivated to achieve and maintain effective plaque removal. Management of Local Plaque-retentive Factors e.g. crowded teeth, partial dentures, bridgework, orthodontic appliances Antimicrobial Medication; Local antimicrobials, including disinfectants such as chlorhexidine and systemic antimicrobials Use of analgesics where there is pain Advanced treatment through periodontal surgery to prevent more bone loss Management of any underlying conditions such as diabetes/cardiovascular disease that predisposes to periodontal disease Supportive periodontal therapy-long term program of Follow up and check ups after successful periodontal treatment
Referral Facility: Specialist
Education to pregnant women on periodontal disease including prevention measures Information to pregnant women on the increased risk of developing pregnancy gingivitis and its prevention measures Health workers training on periodontal disease; prevention and management	Guidance on good oral hygiene practices including brushing, flossing Guidance on avoidance of factors that predispose to periodontal disease including on the effect of smoking on their oral health and general health and assist them on smoking cessation Early treatment/management of predisposing conditions such as diabetes, cardiovascular disease as a preventive measure Advice/guidance on control of diabetes as Poorly controlled diabetes enhances the signs and symptoms of gingivitis and periodontitis Information and guidance to patient on the benefits of a healthy, balanced diet to their oral health including prevention of periodontal disease Encourage patients to modify other lifestyle factors that may impact on their oral health. Dental prophylaxis during pregnancy Screening pregnant women for periodontal disease at every routine examination.		Physical, clinical and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth Diagnostics including; Study models for diagnostics especially of gingival recession Use of clinical photographs calibrated by inclusion of a probe to monitor gingival recession Use of Radiographs (x-rays) to determine the extent of periodontal disease and for treatment planning. These include periapical radiographs & or panoramic radiographs Treatment planning and Patient education on the treatment choice Oral Hygiene instructions modelled on patient behaviour change strategies (TIPPS-talk, instruct, practice, plan, support) Use of mouth washes as a temporary primary oral hygiene measure Removal of plaque and calculus including supragingival debridement and root surface instrumentation Ensure that the patient is motivated to achieve and maintain effective plaque removal. Management of Local Plaque-retentive Factors e.g. crowded teeth, partial dentures, bridgework, orthodontic appliances Antimicrobial Medication; Local antimicrobials, including disinfectants such as chlorhexidine and systemic antimicrobials Use of analgesics where there is pain Advanced treatment through periodontal surgery to prevent more bone loss Management of any underlying conditions such as diabetes/cardiovascular disease that predisposes to periodontal disease Supportive periodontal therapy-long term program of Follow up and check ups after successful periodontal treatment

Age Cohort: < 5 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Create awareness on oral health including periodontal disease to the communities Increase knowledge and practices among the public through community programmes Fully integrating oral health into community health programmes. Community Health workers training on periodontal disease including prevention measures	Daily oral hygiene measures to prevent periodontal disease including brushing properly on a regular basis (at least twice daily) Flossing daily Using an antiseptic mouthwash Chlorhexidine gluconate-based mouthwash Ensuring the child eats healthy balanced diets Regular dental check-ups		Recognition of symptoms indicative of periodontal disease such as bleeding gums, drifted or loose teeth or a complaint of bad breath, Good oral hygiene/ oral hygiene instructions including brushing and flossing. Guidance on healthy diet/good nutrition Use of antiseptic mouth washes as a temporary primary oral hygiene measure Relieve of symptoms such as pain with analgesics Referral to a health facility for management of under 5s with periodontal disease
Primary Care
Education to the under 5s and their families on periodontal disease and prevention measures Health workers training on periodontal disease including prevention and management in children	Guidance to under 5s and their parents/families on good oral hygiene practices including brushing, flossing for the child Guidance to parents on their role in improving periodontal health of the under 5s Information and guidance to parents/families on the benefits of a healthy, balanced diet to the child’s oral health including prevention of periodontal disease Advice on frequent dental visits for dental prophylaxis and or supportive periodontal therapy for the under 5s Screen under 5s for periodontal diseases at every routine examination.		Physical, clinical and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth Treatment planning and Patient/parent education on the treatment choice Guidance to patient/parents on their role in improving periodontal health. Oral Hygiene instructions modelled on patient behaviour change strategies (TIPPS-talk, instruct, practice, plan, support) Use of mouth washes as a temporary primary oral hygiene measure Ensure that the patient or parents is/are motivated to achieve and maintain effective plaque removal for the child Antimicrobial Medication, Local antimicrobials, including disinfectants such as chlorhexidine and systemic antimicrobials Use of analgesics where there is pain Referral to a hospital for further management including management of any underlying conditions such as cardiovascular diseases that predisposes to periodontal disease
Referral Facility: General
Education to the under 5s and their families on periodontal disease and prevention measures Health workers training on periodontal disease including prevention and management in children	Guidance to under 5s and their parents/families on good oral hygiene practices including brushing; flossing for the child Guidance to parents on their role in improving periodontal health of the under 5s Information and guidance to parents/families on the benefits of a healthy, balanced diet to the childs oral health including prevention of periodontal disease Advice on frequent dental visits for dental prophylaxis or supportive periodontal therapy for the under 5s Screen under 5s for periodontal diseases at every routine examination.		Physical, clinical and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth Diagnostics including; * Study models for diagnostics especially of gingival recession * Use of clinical photographs calibrated by inclusion of a probe to monitor gingival recession * Use of Radiographs (x-rays) to determine the extent of periodontal disease and for treatment planning. These include periapical radiographs & or panoramic radiographs Oral Hygiene instructions modelled on patient behaviour change strategies (TIPPS-talk, instruct, practice, plan, support) Use of mouth washes as a temporary primary oral hygiene measure Removal of plaque and calculus including supragingival debridement and root surface instrumentation Ensure that the patient is motivated to achieve and maintain effective plaque removal. Management of Local Plaque-retentive Factors e.g. crowded teeth, partial dentures, bridgework, orthodontic appliances Antimicrobial Medication; Local antimicrobials, including disinfectants such as chlorhexidine and systemic antimicrobials Use of analgesics where there is pain Supportive periodontal therapy-long term program of Follow up and check ups after successful periodontal treatment
Referral Facility: Specialist
Education to the under 5s and their families on periodontal disease and prevention measures Health workers training on periodontal disease including prevention and management in children	Guidance to under 5s and their parents/families on good oral hygiene practices including brushing; flossing for the child Guidance to parents on their role in improving periodontal health of the under 5s Information and guidance to parents/families on the benefits of a healthy, balanced diet to the childs oral health including prevention of periodontal disease Advice on frequent dental visits for dental prophylaxis or supportive periodontal therapy for the under 5s Screen under 5s for periodontal diseases at every routine examination.		Physical, clinical and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth Diagnostics including Study models for diagnostics especially of gingival recession Use of clinical photographs calibrated by inclusion of a probe to monitor gingival recession Use of Radiographs (x-rays) to determine the extent of periodontal disease and for treatment planning. These include periapical radiographs & or panoramic radiographs Oral Hygiene instructions modelled on patient behaviour change strategies (TIPPS-talk, instruct, practice, plan, support) Use of mouth washes as a temporary primary oral hygiene measure Removal of plaque and calculus including supragingival debridement and root surface instrumentation Ensure that the patient is motivated to achieve and maintain effective plaque removal. Management of Local Plaque-retentive Factors e.g. crowded teeth, partial dentures, bridgework, orthodontic appliances Antimicrobial Medication; Local antimicrobials, including disinfectants such as chlorhexidine and systemic antimicrobials Use of analgesics where there is pain Supportive periodontal therapy-long term program of Follow up and check ups after successful periodontal treatment

Age Cohort: 5 - 11 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Create awareness on oral health including periodontal disease to the communities Increase knowledge and practices among the public through community programmes Fully integrating oral health into community health programmes. Community Health workers training on periodontal disease including prevention measures	Daily oral hygiene measures to prevent periodontal disease including brushing properly on a regular basis (at least twice daily), Flossing daily Using an antiseptic mouthwash: Chlorhexidine gluconate-based mouthwash Adoption of healthy lifestyles such as use of healthy balanced diets Regular dental check-ups Community level screening for periodontal disease		Recognition of symptoms indicative of periodontal disease such as bleeding gums, drifted or loose teeth or a complaint of bad breath, Good oral hygiene /oral hygiene instructions including brushing and flossing Guidance on healthy diet/good nutrition Use of antiseptic mouth washes as a temporary primary oral hygiene measure Relieve of symptoms such as pain with analgesics Referral to a health facility for management of school age children with periodontal disease
Primary Care
Education to the school age children and their families on periodontal disease and prevention measures Health workers training on periodontal disease including prevention and management in children	Guidance to school age child on good oral hygiene practices including brushing, flossing Guidance to the school age child on their role in improving periodontal health. Information and guidance to the school age child /to their parents/families on the benefits of a healthy, balanced diet to the child’s oral health including prevention of periodontal disease Advice on frequent visits for dental prophylaxis and or supportive periodontal therapy Screen school children for periodontal diseases at every routine examination.		Physical, clinical and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth Treatment planning and Patient/parent education on the treatment choice Guidance to patient/parents /school age child on their role in improving periodontal health. Oral Hygiene instructions modelled on patient behaviour change strategies (TIPPS-talk, instruct, practice, plan, support) Use of mouth washes as a temporary primary oral hygiene measure Ensure that the patient or parents is/are motivated to achieve and maintain effective plaque removal for the child Antimicrobial Medication, Local antimicrobials, including disinfectants such as chlorhexidine and systemic antimicrobials Use of analgesics where there is pain Referal for school age child with periodontal disease to a hospital for further management and Management of any underlying conditions such as diabetes /cardiovascular disease that predisposes to periodontal disease
Referral Facility: General
Education to the school age children and their families on periodontal disease and prevention measures Health workers training on periodontal disease including prevention and management in children	Guidance to school age child on good oral hygiene practices including brushing; flossing Guidance to the school age child on their role in improving periodontal health. Information and guidance to the school age child/to their parents/families on the benefits of a healthy, balanced diet to the child’s oral health including prevention of periodontal disease Advice on frequent visits for dental prophylaxis or supportive periodontal therapy Screen school age children for periodontal diseases at every routine examination.		Physical, clinical and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth Diagnostics including; * Study models for diagnostics especially of gingival recession * Use of clinical photographs calibrated by inclusion of a probe to monitor gingival recession * Use of Radiographs (x-rays) to determine the extent of periodontal disease and for treatment planning. These include periapical radiographs or panoramic radiographs Treatment planning and school age child education on the treatment choice Oral Hygiene instructions modelled on patient behaviour change strategies (TIPPS-talk, instruct, practice, plan, support) Use of mouth washes as a temporary primary oral hygiene measure Removal of plaque and calculus including supragingival debridement and root surface instrumentation Ensure that the patient is motivated to achieve and maintain effective plaque removal. Management of Local Plaque-retentive Factors e.g. crowded teeth, partial dentures, bridgework, orthodontic appliances Antimicrobial Medication; Local antimicrobials, including disinfectants such as chlorhexidine and systemic antimicrobials Use of analgesics where there is pain Advanced treatment through periodontal surgery to prevent more bone loss Management of any underlying conditions in school age child such as diabetes /cardiovascular disease that predisposes to periodontal disease Supportive periodontal therapy-long term program of Follow up and check ups after successful periodontal treatment
Referral Facility: Specialist
Education to the school age children and their families on periodontal disease and prevention measures Health workers training on periodontal disease including prevention and management in children	Guidance to school age child on good oral hygiene practices including brushing; flossing Guidance to the school age child on their role in improving periodontal health. Information and guidance to the school age child/to their parents/families on the benefits of a healthy, balanced diet to the child’s oral health including prevention of periodontal disease Advice on frequent visits for dental prophylaxis or supportive periodontal therapy Screen school age children for periodontal diseases at every routine examination.		Physical, clinical and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth Diagnostics including; Study models for diagnostics especially of gingival recession Use of clinical photographs calibrated by inclusion of a probe to monitor gingival recession Use of Radiographs (x-rays) to determine the extent of periodontal disease and for treatment planning. These include periapical radiographs or panoramic radiographs Treatment planning and Patient education on the treatment choice Oral Hygiene instructions modelled on patient behaviour change strategies (TIPPS-talk, instruct, practice, plan, support) Use of mouth washes as a temporary primary oral hygiene measure Removal of plaque and calculus including supragingival debridement and root surface instrumentation Ensure that the patient is motivated to achieve and maintain effective plaque removal. Management of Local Plaque-retentive Factors e.g. crowded teeth, partial dentures, bridgework, orthodontic appliances Antimicrobial Medication; Local antimicrobials, including disinfectants such as chlorhexidine and systemic antimicrobials Use of analgesics where there is pain Advanced treatment through periodontal surgery to prevent more bone loss Management of any underlying conditions in school age child such as diabetes /cardiovascular disease that predisposes to periodontal disease Supportive periodontal therapy-long term program of Follow up and check ups after successful periodontal treatment

Age Cohort: 12 - 24 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Create awareness on oral health including periodontal disease to the communities Increase knowledge and practices among the public through community programmes Fully integrating oral health into community health programmes. Community Health workers training on periodontal disease including prevention measures	Daily oral hygiene measures to prevent periodontal disease including brushing properly on a regular basis (at least twice daily), Flossing daily Using an antiseptic mouthwash Chlorhexidine gluconate-based mouthwash Adoption of healthy lifestyles such as no smoking or cessation of smoking, use of healthy balanced diets Regular dental check-ups Community level screening for periodontal disease		Recognition of symptoms indicative, of periodontal disease such as bleeding gums, drifted or loose teeth or a complaint of bad breath Good oral hygiene/oral hygiene instructions including brushing and flossing Guidance on healthy diet/good nutrition Use of antiseptic mouth washes as a temporary primary oral hygiene measure Relieve of symptoms such as pain with analgesics Referral to a health facility for management of adolescent with periodontal disease
Primary Care
Education to the adolescents and their families on periodontal disease and prevention measures Health workers training on periodontal disease including prevention and management in adolescents	Guidance to adolescents on good oral hygiene practices including brushing, flossing Guidance to the adolescents on their role in improving periodontal health. Guidance on avoidance of factors that predispose to periodontal disease including the effect of smoking on their oral health and general health and assist them on smoking cessation. Advice/guidance on control of diabetes as Poorly controlled diabetes enhances the signs and symptoms of gingivitis and periodontitis Information and guidance to the adolescents on the benefits of a healthy, balanced diet to their oral health including prevention of periodontal disease Advice on frequent visits for dental prophylaxis and or supportive periodontal therapy Screen adolescents for periodontal diseases at every routine examination.		Physcal, clinical and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth Treatment planning and Patient education on the treatment choice Guidance to patient on their role in improving periodontal health. Oral Hygiene instructions modelled on patient behaviour change strategies (TIPPS-talk, instruct, practice, plan, support) Use of mouth washes as a temporary primary orla hygiene measure Ensure that the patient is motivated to achieve and maintain effective plaque removal. Antimicrobial Medication, Local antimicrobials, including disinfectants such as chlorhexidine and systemic antimicrobials Use of analgesics where there is pain management Referral for an adolescent with periodontal disease to a hospital for further management including management of any underlying conditions such as diabetes /cardiovascular disease that predisposes to periodontal disease
Referral Facility: General
Education to the adolescents and their families on periodontal disease and prevention measures Health workers training on periodontal disease including prevention and management in adolescents	Guidance to adolescents on good oral hygiene practices including brushing, flossing Guidance to the adolescents on their role in improving periodontal health. Guidance on avoidance of factors that predispose to periodontal disease including the effect of smoking on their oral health and general health and assist them on smoking cessation. Early treatment/management of predisposing conditions such as diabetes; cardiovascular disease as a preventive measure Advice/guidance on control of diabetes as Poorly controlled diabetes enhances the signs and symptoms of gingivitis and periodontitis Information and guidance to the adolescents on the benefits of a healthy, balanced diet to their oral health including prevention of periodontal disease Advice on frequent visits for dental prophylaxis and or supportive periodontal therapy Screen adolesents for periodontal diseases at every routine examination.		Physical, clinical and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth Diagnostics including; * Study models for diagnostics especially of gingival recession * Use of clinical photographs calibrated by inclusion of a probe to monitor gingival recession * Use of Radiographs (x-rays) to determine the extent of periodontal disease and for treatment planning. These include periapical radiographs & or panoramic radiographs Treatment planning and Patient education on the treatment choice Oral Hygiene instructions modelled on patient behaviour change strategies (TIPPS-talk, instruct, practice, plan, support) Use of mouth washes as a temporary primary oral hygiene measure Removal of plaque and calculus including supragingival debridement and root surface instrumentation Ensure that the patient is motivated to achieve and maintain effective plaque removal. Management of Local Plaque-retentive Factors e.g. crowded teeth, partial dentures, bridgework, orthodontic appliances Antimicrobial Medication, Local antimicrobials, including disinfectants such as chlorhexidine and systemic antimicrobials Use of analgesics where there is pain Advanced treatment through periodontal surgery to prevent more bone loss Management of any underlying conditions such as diabetes /cardiovascular disease that predisposes to periodontal disease Supportive periodontal therapy-long term program of Follow up and check-ups after successful periodontal treatment
Referral Facility: Specialist
Education to the adolescents and their families on periodontal disease and prevention measures Health workers training on periodontal disease including prevention and management in adolescents	Guidance to adolescents on good oral hygiene practices including brushing, flossing Guidance to the adolescents on their role in improving periodontal health. Guidance on avoidance of factors that predispose to periodontal disease including the effect of smoking on their oral health and general health and assist them on smoking cessation. Early treatment/management of predisposing conditions such as diabetes; cardiovascular disease as a preventive measure Advice/guidance on control of diabetes as Poorly controlled diabetes enhances the signs and symptoms of gingivitis and periodontitis Information and guidance to the adolescents on the benefits of a healthy, balanced diet to their oral health including prevention of periodontal disease Advice on frequent visits for dental prophylaxis and or supportive periodontal therapy Screen adolesents for periodontal diseases at every routine examination.		Physical, clinical and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth Diagnostics including; Study models for diagnostics especially of gingival recession Use of clinical photographs calibrated by inclusion of a probe to monitor gingival recession Use of Radiographs (x-rays) to determine the extent of periodontal disease and for treatment planning. These include periapical radiographs & or panoramic radiographs Treatment planning and Patient education on the treatment choice Oral Hygiene instructions modelled on patient behaviour change strategies (TIPPS-talk, instruct, practice, plan, support) Use of mouth washes as a temporary primary oral hygiene measure Removal of plaque and calculus including supragingival debridement and root surface instrumentation Ensure that the patient is motivated to achieve and maintain effective plaque removal. Management of Local Plaque-retentive Factors e.g. crowded teeth, partial dentures, bridgework, orthodontic appliances Antimicrobial Medication; Local antimicrobials, including disinfectants such as chlorhexidine and systemic antimicrobials Use of analgesics where there is pain Advanced treatment through periodontal surgery to prevent more bone loss Management of any underlying conditions such as diabetes /cardiovascular disease that predisposes to periodontal disease Supportive periodontal therapy-long term program of Follow up and check-ups after successful periodontal treatment

Age Cohort: 25 - 59 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Create awareness on oral health including periodontal disease to the communities Increase knowledge and practices among the public through community programmes Fully integrating oral health into community health programmes. Community Health workers training on periodontal disease including prevention measures	Daily oral hygiene measures to prevent periodontal disease including brushing properly on a regular basis (at least twice daily), Flossing daily Using an antiseptic mouthwash, Chlorhexidine gluconate-based mouthwash Adoption of healthy lifestyles such as no smoking or cessation of smoking, use of healthy balanced diets Regular dental check-ups Community level screening for periodontal disease		Recognition of symptoms indicative of periodontal disease such as bleeding gums, drifted or loose teeth or a complaint of bad breath Good oral hygiene/oral hygiene instructions including brushing and flossing Guidance on healthy diet/good nutrition Use of antiseptic mouth washes as a temporary primary oral hygiene measure Relieve of symptoms such as pain with analgesics Referral to a health facility for management of adult with periodontal disease
Primary Care
Education to the adults on periodontal disease and prevention measures Health workers training on periodontal disease including prevention and management in adults	Guidance on good oral hygiene practices including brushing Guidance to patient on their role in improving periodontal health. Guidance on avoidance of factors that predispose to periodontal disease including the effect of smoking on their oral health and general health and assist them on smoking cessation . Advice/guidance on control of diabetes as Poorly controlled diabetes enhances the signs and symptoms of gingivitis and periodontitis Information and guidance to patient on the benefits of a healthy, balanced diet to their oral health including prevention of periodontal disease Advice on frequent visits for dental prophylaxis and or supportive periodontal therapy Screen adults for periodontal diseases at every routine examination		Physical, clinical and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth Treatment planning and Patient education on the treatment Guidance to patient on their role in improving periodontal health. Oral Hygiene instructions modelled on patient behaviour change strategies (TIPPS-talk, instruct, practice, plan, support) Use of mouth washes as a temporary primary orla hygiene measure Ensure that the patient is motivated to achieve and maintain effective plaque removal. Management of Local Plaque-retentive Factors e.g. crowded teeth, partial dentures, bridgework, orthodontic appliances Antimicrobial Medication, Local antimicrobials, including disinfectants such as chlorhexidine and systemiicrobials Use of analgesics where there is pain Referral for the adult patient with periodontal disease to a hospital for further management including managemnet of any underlyng conditions
Referral Facility: General
Early treatment/management of predisposing conditions such as diabetes cardiovascular disease as a preventive measure Advice/guidance on control of diabetes as Poorly controlled diabetes enhances the signs and symptoms of gingivitis and periodontitis Guidance on good oral hygiene practices including brushing Guidance to patient on their role in improving periodontal health. Guidance on avoidance of factors that predispose to periodontal disease including the effect of smoking on their oral health and general health and assist them on smoking cessation Information and guidance to patient on the benefits of a healthy, balanced diet to their oral health including prevention of periodontal disease Advice on frequent visits for dental prophylaxis and or supportive periodontal therapy Screen adults for periodontal diseases at every routine examination.	Education to the adults on periodontal disease and prevention measures Health workers education on periodontal disease including prevention and management in adults		Physical, clinical and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth Diagnostics including; Study models for diagnostics especially of gingival recession Use of clinical photographs calibrated by inclusion of a probe to monitor gingival recession Use of Radiographs (x-rays) to determine the extent of periodontal disease and for treatment planning. These include periapical radiographs & or panoramic radiographs Treatment planning and Patient education on the treatment choice Oral Hygiene instructions modelled on patient behaviour change strategies (TIPPS-talk, instruct, practice, plan, support) Use of mouth washes as a temporary primary oral hygiene measure Removal of plaque and calculus including supragingival debridement and root surface instrumentation Ensure that the patient is motivated to achieve and maintain effective plaque removal. Management of Local Plaque-retentive Factors e.g. crowded teeth, partial dentures, bridgework, orthodontic appliances Antimicrobial Medication; Local antimicrobials, including disinfectants such as chlorhexidine and systemic antimicrobials Use of analgesics where History and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every there is pain Advanced treatment through periodontal surgery to prevent more bone loss Management of any underlying conditions such as diabetes /cardiovascular disease that predisposes to periodontal disease Supportive periodontal therapy-long term program of Follow up and check ups after successful periodontal treatment
Referral Facility: Specialist
Early treatment/management of predisposing conditions such as diabetes cardiovascular disease as a preventive measure Advice/guidance on control of diabetes as Poorly controlled diabetes enhances the signs and symptoms of gingivitis and periodontitis Guidance on good oral hygiene practices including brushing Guidance to patient on their role in improving periodontal health. Guidance on avoidance of factors that predispose to periodontal disease including the effect of smoking on their oral health and general health and assist them on smoking cessation Information and guidance to patient on the benefits of a healthy, balanced diet to their oral health including prevention of periodontal disease Advice on frequent visits for dental prophylaxis and or supportive periodontal therapy Screen adults for periodontal diseases at every routine examination.	Education to the adults on periodontal disease and prevention measures Health workers education on periodontal disease including prevention and management in adults		Physical, clinical and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth Diagnostics including; Study models for diagnostics especially of gingival recession Use of clinical photographs calibrated by inclusion of a probe to monitor gingival recession Use of Radiographs (x-rays) to determine the extent of periodontal disease and for treatment planning. These include periapical radiographs & or panoramic radiographs Treatment planning and Patient education on the treatment choice Oral Hygiene instructions modelled on patient behaviour change strategies (TIPPS-talk, instruct, practice, plan, support) Use of mouth washes as a temporary primary oral hygiene measure Removal of plaque and calculus including supragingival debridement and root surface instrumentation Ensure that the patient is motivated to achieve and maintain effective plaque removal. Management of Local Plaque-retentive Factors e.g. crowded teeth, partial dentures, bridgework, orthodontic appliances Antimicrobial Medication; Local antimicrobials, including disinfectants such as chlorhexidine and systemic antimicrobials Use of analgesics where there is pain Advanced treatment through periodontal surgery to prevent more bone loss Management of any underlying conditions such as diabetes /cardiovascular disease that predisposes to periodontal disease Supportive periodontal therapy-long term program of Follow up and check ups after successful periodontal treatment

Age Cohort: 60+ years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Create awareness on oral health including periodontal disease to the communities Increase knowledge and practices among the public through community programmes Fully integrating oral health into community health programmes. Community Health workers training on periodontal disease including prevention measures	Daily oral hygiene measures to prevent periodontal disease including brushing properly on a regular basis (at least twice daily), Flossing daily Using an antiseptic mouthwash: Chlorhexidine gluconate-based mouthwash Adoption of healthy lifestyles such as no smoking or cessation of smoking, use of healthy balanced diets Regular dental check-ups Community level screening for periodontal disease		Recognition of symptoms indicative of periodontal disease such as bleeding gums, drifted or loose teeth or a complaint of bad breath Good oral hygiene/oral hygiene instructions including brushing and flossing Guidance on healthy diet/good nutrition Use of antiseptic mouth washes as a temporary primary oral hygiene measure Relieve of symptoms such as pain with analgesics Referral to a health facility for management of elderly person with periodontal disease
Primary Care
Education to the elderly and their families on periodontal disease and prevention measures Health workers training on periodontal disease including prevention and management in elderly patients	Guidance on good oral hygiene practices including brushing Guidance to patient on their role in improving periodontal health. Guidance on avoidance of factors that predispose to periodontal disease including the effect of smoking on their oral health and general health and assist them on smoking cessation. Advice/guidance on control of diabetes as Poorly controlled diabetes enhances the signs and symptoms of gingivitis and periodontitis Information and guidance to patient on the benefits of a healthy, balanced diet to their oral health including prevention of periodontal disease Advice on frequent visits for dental prophylaxis and or supportive periodontal therapy Screen elderly persons for periodontal diseases at every routine examination.		Physcal, clinical and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth Treatment planning and Patient education on the treatment choice Guidance to patient on their role in improving periodontal health. Oral Hygiene instructions modelled on patient behaviour change strategies (TIPPS-talk, instruct, practice,plan, support)* * Use of mouth washes as a temporary primary oral hygiene measure Use of mouth washes as a temporary primary oral hygiene measure Ensure that the patient is motivated to achieve and maintain effective plaque removal. Antimicrobial Medication, Local antimicrobials, including disinfectants such as chlorhexidine and systemic antimicrobials Use of analgesics where there is pain Referral to a hospital for further management of an elderly person with periodontal disease
Referral Facility: General
Education to the elderly and their families on periodontal disease and prevention measures Health workers training on periodontal disease including prevention and management in elderly patients	Guidance on good oral hygiene practices including brushing Guidance to patient on their role in improving periodontal health. Guidance on avoidance of factors that predispose to periodontal disease including the effect of smoking on their oral health and general health and assist them on smoking cessation Early treatment/management of predisposing conditions such as diabetes cardiovascular disease as a preventive measure Advice/guidance on control of diabetes as Poorly controlled diabetes enhances the signs and symptoms of gingivitis and periodontitis Information and guidance to patient on the benefits of a healthy, balanced diet to their oral health including prevention of periodontal disease Advice on frequent visits for dental prophylaxis and or supportive periodontal therapy Screen elderly persons for periodontal diseases at every routine examination.		Physical, clinical and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth Diagnostics including: Study models for diagnostics especially of gingival recession Use of clinical photographs calibrated by inclusion of a probe to monitor gingival recession Use of Radiographs (x-rays) to determine the extent of periodontal disease and for treatment planning. These include periapical radiographs & or panoramic radiographs Treatment planning and Patient education on the treatment choice Oral Hygiene instructions modelled on patient behaviour change strategies (TIPPS-talk, instruct, practice, plan, support) Use of mouth washes as a temporary primary oral hygiene measure Removal of plaque and calculus including supragingival debridement and root surface instrumentation Ensure that the patient is motivated to achieve and maintain effective plaque removal. Management of Local Plaque-retentive Factors e.g.crowded teeth, partial dentures, bridgework, orthodontic appliances Antimicrobial Medication, Local antimicrobials, including disinfectants such as chlorhexidine and systemic antimicrobials Use of analgesics where there is pain Advanced treatment through periodontal surgery to prevent more bone loss Management of any underlying conditions such as diabetes /cardiovascular disease that predisposes to periodontal disease Supportive periodontal therapy-long term program of Follow up and check ups after successful periodontal treatment
Referral Facility: Specialist
Education to the elderly and their families on periodontal disease and prevention measures Health workers training on periodontal disease including prevention and management in elderly patients	Guidance on good oral hygiene practices including brushing Guidance to patient on their role in improving periodontal health. Guidance on avoidance of factors that predispose to periodontal disease including the effect of smoking on their oral health and general health and assist them on smoking cessation Early treatment/management of predisposing conditions such as diabetes cardiovascular disease as a preventive measure Advice/guidance on control of diabetes as Poorly controlled diabetes enhances the signs and symptoms of gingivitis and periodontitis Information and guidance to patient on the benefits of a healthy, balanced diet to their oral health including prevention of periodontal disease Advice on frequent visits for dental prophylaxis and or supportive periodontal therapy Screen elderly persons for periodontal diseases at every routine examination.		Physical, clinical and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth Diagnostics including; Study models for diagnostics especially of gingival recession Use of clinical photographs calibrated by inclusion of a probe to monitor gingival recession Use of Radiographs (x-rays) to determine the extent of periodontal disease and for treatment planning. These include periapical radiographs & or panoramic radiographs Treatment planning and Patient education on the treatment choice Oral Hygiene instructions modelled on patient behaviour change strategies (TIPPS-talk, instruct, practice, plan, support) Use of mouth washes as a temporary primary oral hygiene measure Removal of plaque and calculus including supragingival debridement and root surface instrumentation Ensure that the patient is motivated to achieve and maintain effective plaque removal. Management of Local Plaque-retentive Factors e.g.crowded teeth, partial dentures, bridgework, orthodontic appliances Antimicrobial Medication, Local antimicrobials, including disinfectants such as chlorhexidine and systemic antimicrobials Use of analgesics where there is pain Advanced treatment through periodontal surgery to prevent more bone Management of any underlying conditions such as diabetes /cardiovascular disease that predisposes to periodontal disease Supportive periodontal therapy-long term program of Follow up and check ups after successful periodontal treatment