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SRP on 4-5mm pocket w no BOP

I saw a patient this week that my co-worker had recommended a fine scale on. Pt has vertical bone loss, recession and CL I furcations w 4mm pockets in the posterior and 1- 5mm pocket DB#14 w no BOP. visible calc on x-rays in several areas. Upon exploration w 11/12 I found several areas per quad of sub calc. I would of recommended SRP…I am wrong in my thinking?? Thank you for any advice.



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1 Answer

The presence of calculus alone isn’t an indicator for the need of SRPs. SRPs are warranted when there is active disease with loss of clinical attachment level. So you have to determine if this patient has active disease. If there’s no bleeding, I wonder if this patient has pseudopockets and clinical attachment loss due to bruxism instead of active disease. Or I wonder if this patient is a smoker, so vasoconstriction is occurring keeping the tissue from bleeding. Without seeing the patient its hard to know! I would suggest talking with your co-worker and put your thoughts out there and listen to their’s on why a prophy was treatment planned. It never hurts to get on the same page and collaborate as far as perio protocols!

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