Initial periodontal therapy before referring a patient: an audit

Introduction The extent to which initial therapy has been provided prior to referral for periodontal disease remains unclear despite guidance provided by the British Society of Periodontology.Aim This audit aimed to assess the information given in the referral letter, how this compared to patients' perception of treatment received, the referrers' reports of treatment provided and findings at consultation. The gold standard was taken from the British Society of Periodontology referral criteria which states that all patients should undergo initial periodontal therapy prior to referral.Method Data were collected via questionnaires from 100 randomly selected patients referred for periodontal treatment from patients at consultation and subsequently from the referring practitioners.Results All 100 patients had incomplete referrals with 12 patients having Basic Periodontal Examination (BPE) scores corresponding to those at consultation. Eighty-five patients reported receiving oral hygiene instructions (OHI) and 91 patients root surface debridement (RSD), prior to referral. Twenty-five dentists participated in the survey and reported spending more time providing initial therapy than the patients.Discussion and conclusion Most patients reported having undergone initial periodontal treatment, however, the extent was at variance to the referrers' reports. BPE scores were inaccurate and the majority of referrers failed to provide a diagnosis, with incorrect terminology used. The study highlights the need for improving the management of periodontal disease in primary care.