The Keyes Method

1. Clinical examination and microbiological diagnosis evaluates the tissue damage. They are supplemented with microscopic samplings of white blood cells to assess microorganisms associated with periodontal disease.

2. Patient education. Patients are informed about the nature of periodontal infections, specific bacterial risk factors, and how tissue damage occurs.

3. Professional treatment. Meticulous scraping of root surfaces and irrigations with antiseptic agents.

4. Patient instruction. Patients are instructed in self-care using instruments and agents that combat microorganisms.

5. Monitoring. Every two to four months, the patient's progress is assessed by microscopic sampling of a few problem sites. Patients with more serious infections make more frequent visits.

6. Modulation of therapy. Additional antibacterial agents and syringes or other irrigation devices are considered. Systemic antibiotics or surgery are possible alternatives.

7. Maintenance. Patients practice daily home care. Surgical Treatment

1. Clinical examination. Evaluation of tissue damage.

2. Diagnostic visit. Patient is advised of diagnosis and recommended a sequence of therapy.

3. Reconstruction work (if necessary). Patient may need new bridges, crowns, endodontist evaluation, occlusal adjustment or other work, , depending on the condition of the mouth.

4. Root scaling, soft tissue curettage and instructions in oral physiotherapy.

5. Re-evaluation.

6. Periodontal surgery, if indicated.

7. Re-evaluation and determination if any teeth are to be lost.

8. Bone implantation, if appropriate.