BSP UK version of the S3 Treatment Guidelines for Periodontitis

The BSP has rapidly developed a UK version of the European S3 Treatment Guideline document, ensuring compatibility with our UK healthcare system.

Our Wonderful Workshop Participants

The BSP is extremely grateful to all of the dental professionals, medical experts, stakeholders and BSP Patient Forum members, who dedicated a considerable amount of time to this project. Their support in reviewing the guideline document and contributing to the workshop discussions helped to make this project a huge success. 

Together we can we can make a difference and improve gum health in the UK.

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The 2017 Classification scheme was specifically designed to allow for an individualised treatment approach, taking into account the specifics of every case, including severity, extent, progression rates and local and systemic complicating factors. Therefore, the logical next step was to develop clinical guidelines based on the Classification.

The European Federation of Periodontology (EFP) spearheaded this development, choosing the highest quality level for guideline development, the S3 format, that takes into account both a systematic appraisal of the published evidence as well as the clinical experience of a large group of stakeholders.

The development of the guideline was finalised in a workshop in November 2019 and published in May 2020. Many of the BSP were involved in the systematic reviews and participated as Chairs or Working Group members.

The European document entitled, “Treatment of Stage I-III Periodontitis – The EFP S3 Level Clinical Practice Guideline”, on periodontal therapy, takes into account a systematic appraisal of the published evidence, as well as the clinical experience of a large group of stakeholders.

As the guideline document is, by definition, international, to ensure a broad dissemination and general applicability, it was recommended by the EFP that national member societies adopt the document or adapt it to their own healthcare system.

The BSP immediately reviewed the guidelines, by involving Public Health England/NHS England and other important stakeholders, to ensure that the guidance could be used easily and effectively by oral health practitioners in the UK. The Society worked with the moderator of the EFP guidelines, Professor Ina Kopp, to ensure the correct processes were followed. The German and Spanish Periodontal Societies performed the same process ahead of us.

To help the dental community implement the guidelines in UK practice, the BSP has put considerable effort into creating a wide range of educational resources and we suggest dental care professionals in the UK use the “BSP Implementation of Treatment of Stage I-III Periodontitis –The EFP S3 Level Clinical Practice Guideline” in their clinical practice (see Professional Information and Resources).

The BSP rapidly reviewed the European document and developed a UK version of the Guidelines, which were suitable for the UK healthcare system. This was done using the GRADE ADOLOPMENT framework.

“Adolop” simply means that we discussed the guidelines and adopted, modified or developed them as we saw fit, to ensure they were appropriate for us to share with UK dental professionals (dentists, hygienists, therapists), patients and the public.

Led by Prof. Nicola West and Prof. Moritz Kebschull, the BSP held Working Group meetings during lockdown and worked incredibly hard to review the EFP’s Evidenced-based Treatment Guidelines.

We were delighted to engage the services of Professor Ina Kopp, who kindly agreed to moderate the whole of this process for the BSP. Ina has extensive experience in leading, strengthening and supporting international collaborations in guideline development. Her excellent moderation skills and lovely manner ensured that the discussions at every meeting were relevant and useful. The BSP is extremely grateful for her contributions to the discussions, which made our collaboration with dental professionals, medical experts, stakeholders and BSP Patient Forum members run smoothly.

The meetings were held online during June and July and Prof. West remarked on the speed and success of the project,

“We were keen to involve several stakeholders in this project, from a variety of organisations, to gain a broader insight and include different perspectives when reviewing the clinical recommendations. I was delighted to have such fantastic working groups comprised of dental professionals, medical experts, stakeholders and BSP Patient Forum who were all committed to rapidly review the European guidelines.

Together, we achieved an enormous task in a very short time, and I am extremely proud to have led this initiative with Moritz. I greatly appreciate the tremendous support of all participants and would like to thank them for their time, dedication and valuable contributions which helped make this project a huge success.”

Prof. Kebschull echoed the same sentiments and added,

“It was a pleasure to work with the BSP on this important project. The BSP UK version of the guidelines will be an important document, as the recommendations provide evidence-based support for specialists, dentists, dental hygienists and dental therapists.”

The authors and workshop participants of the UK adolopment project are listed below. The list includes dental professionals, medical experts, stakeholders and BSP Patient Forum members,all of whom  dedicated a considerable amount of time to this project. Their support in reviewing the guideline document and contributing to the workshop discussions helped to make this project a huge success. 

Workshop Participants:

Neil Almond, Marie Anderson, Raimondo Ascione, Martin Ashley, Paul Baker, Leon Bassi, Sanjeev Bhanderi, Elena Calciolari, Nigel Carter, Antonio Ceriello, Iain Chapple, Marilou Ciantar, Dominic Clark-Roberton, Nick Claydon, David Cottam, Shauna Culshaw, Andrew Cundy, Francesco D'Aiuto, Thomas Dietrich, Nikos Donos, Ian Dunn, Ken Eaton, Gillian Flett, Chris Fox, Mandeep Ghuman, Jenny Godson, Gareth Griffiths, Stephen Hancocks, Peter Heasman, Debbie Hemington, Penny Hodge, Mark Ide, Matt Jerreat, Roshni Karia, Moritz Kebschull, Gerry Linden, Matt Locke, Isobel Madden, Phil Marsh, Matthew Garrett, Giles McCracken, William McLaughlin, Imogen Midwood, Mike Milward, Aidan Moran, Federico Moreno, Madeleine Murray, Rajan Nansi, Ian Needleman, Luigi Nibali, Sarifa Patel, Divyash Patel, Vipul Patel, Michael Paterson, Alexander Pollard, Philip Preshaw, Devan Raindi, Raj Rattan, Anthony Roberts, Shazad Saleem, Ross Scales (observer), Joon Seong, Praveen Sharma, Andrew Smith, Susan Smith, Jeanie Suvan, Manoj Tank, Richard Tucker, Aru Tugnait, Wendy Turner, Bobby Varghese, Jenny Walker, Nicola West, Paul Weston, Roger Yates.

Methodological Consultant:

Professor Ina Kopp

Workshop Organisation:

British Society of Periodontology and Implant Dentistry –

Professor Nicola West & Professor Moritz Kebschull

Scientific societies involved in the guideline development process:

Association of Clinical Oral Microbiologists

British Association of Dental Therapists

British Endodontic Society

British Society of Dental Hygiene and Therapy

British Society of Periodontology and Implant Dentistry

British Society of Restorative Dentistry

Restorative Dentistry UK

Other organisations involved in the guideline development process:

British Dental Association

BSP Patient Forum

Oral Health Foundation

Dental Protection

Faculty of General Dental Practice (UK)

General Dental Council (Observer)

Office of the Chief Dental Officer (OCDO) England

Public Health England

Royal College of Surgeons of England

Scottish Antimicrobial Prescribing Group

(A list of Clinical Experts/Representatives from each organisation can be viewed HERE.)

The BSP UK version of the S3 Treatment Guidelines for Periodontitis paper is now available online in the Journal of Dentistry, with open access: https://authors.elsevier.com/sd/article/S0300-5712(20)30310-9

The Guidelines communicate in a very transparent way the evidence behind all the treatment interventions that we do in dealing with a case of periodontitis (gum disease).

This is an important document, as the recommendations provide evidence-based support for specialists, dentists, dental hygienists and dental therapists. The BSP has therfore arranged to publish the paper with open access to all.

We believe that this is an incredibly important project. Poor gum health can lead to tooth loss and affect other systemic health issues, so it was wonderful that European experts came together to look at the 4 main phases of periodontal disease management with a view to creating clear guidelines for all.

Within each of the four sections below, the experts looked at specific questions within each category and systematically reviewed the literature in order to provide evidence-based answers:

  • Self-care (oral hygiene) & behaviour modification (risk factor control)
  • Non-surgical treatments
  • Surgical therapy
  • Supportive care/maintenance

As a result, the BSP UK S3 Guideline is the “go-to” document for professionals who need clarification on clinical questions and for patients keen to manage their periodontal disease.

The BSP has created a Glossary of the periodontal terminology used in the BSP Implementation of the S3 Treatment Guidelines for Periodontitis and professional flowchart resource. We hope that you find this document helpful.

We intend to treat the Glossary as a working document, so please contact the Society if there are other terms you feel need explaining.

Click HERE to download resource.

To assist members and the wider dental community in interpreting the guidelines, the BSP has carefully planned and created educational resources to support the profession.

The series of four educational webinars follows the publication of the paper. They can be booked via our Events page or by clicking the links below:

Webinar Series

10 February - Step 1: Prof. Moritz Kebschull, sponsored by GSK

24 February - Step 2: Prof. Iain Chapple, sponsored by Acteon

10 March - Step 3: Prof. Nikos Donos

24 March - Step 4: Prof. Nicola West, sponsored by Oral-B

In addition, the BSP has been kindly supported by GSK on this project. We have worked together to record several educational videos and produce a flowchart resource to help dental care professionals implement the guidelines in clinical practice. The flowchart QR code will link to a short, informative video, guiding you through the four steps, which you can VIEW HERE.

We shall be working with GSK to distribute the flowcharts to UK dental practices, over the coming weeks. The flowchart will be coated in N9 Pure Silver, which is designed to provide anti-microbial performance and is the safe and natural way to protect the printed surface.

By creating a series of short video clips, to be shared via social media and our website, we can help to spread the important educational message to the wider dental profession, patients and the public. (These resources will be added to the website very soon.)

The BSP has also created a lay version of the guidelines for the public and patients, which conveys the importance of gum health in a simplified, informative way. It was extremely important to the BSP to involve patients, who could present their important viewpoints in the Workshops. They have also been involved in the process of creating a lay version of the guidelines.

This lay version will allow patients to empower themselves with evidence-based information to both take responsibility for aspects of their disease management and know that they are being offered appropriate, contemporary, evidence-based treatment.

Our aim in creating resources for patients and the public include:

  • Help the public understand what gum disease is
  • Raise awareness of how you can look after your gums and maintain good oral health
  • Reduce the stigma associated with gum disease (as highlighted in “The Sound of Periodontitis” video) by identifying the many causes including smoking, diabetes etc.
  • Highlight that more can be done to aid gum health in addition to brushing your teeth
  • Encourage the patient to take ownership of their disease and highlight the ways they can do this