The role of supragingival plaque in the control of progressive periodontal disease

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Abstract
Levels of supragingival plaque and calculus have been related to progressive periodontal disease, and control of supragingival plaque in conjunction with professional tooth cleaning subgingivally forms the basis for the management of progressive periodontal disease. However, the contribution towards the management of progressive periodontal disease brought about by supragingival plaque control alone is not clear. There are studies which address, directly or indirectly, the contribution of supragingival plaque control alone towards the management of progressive periodontal disease. The effects of supragingival plaque control alone have been evaluated clinically, histologically and microbiologically, and taken together, the evaluations suggest that these effects may not be as marked as when professional subgingival tooth cleaning is also performed. These studies, however, given the patterns of periodontal disease found in adults in many communities, can form the basis for advocating high individual levels of supragingival plaque control as a community measure in the management of periodontal disease. Further long-term investigations into this approach may be warranted.