Skill Level of Therapist Influence Outcome of Initial Periodontal Therapy

Objective: The aim of the present study was to verify the influence of the therapist's skill and experience on the outcome of initial therapy of periodontally involved patients. Methods: Initial periodontal treatment was carried out either by second-year periodontal residents (PR) or last year dental student (DS) on two groups of patients (50 in each) with active periodontal disease. Plaque Index (PI), Bleeding Index (BI) and pocket depth (PD) at six locations on each tooth were obtained at the start of treatment and 6-8 weeks after last appointment of initial therapy. Data were separated according to area, type of tooth and pocket depth: 1-3 mm (Group a), 4-5 mm (Group b), and >6 mm (Group c), and analyzed using Student's t-test. Results: At the start of the study measurements were PI=58%, BI=29.5%, and PD=78%, 18%, and 4% in Groups a, b and c, respectively (DS treatment group) compared to PI=72%, BI=79%, and PD=60%, 24.5% and 14.5%, respectively (PR treatment group). In both treatment groups, initial treatment significantly improved (p<0.001) patient compliance (PI=42% in DS and 28% in PR) reduced signs of inflammation (BI=17% in DS, 41% in PR) and pocket depth (DS: 85.5%, 12%, 3%; PR: 74%, 18%, 7% in Groups a, b, and c, respectively). The improvement in PI, BI, and PD of 1-3 mm and >6 was significantly (p<0.001) superior in patients treated by PR compared to the performance of DS. The decrease in percentage of 4-5 mm pockets in the PR group compared to DS group was greater (0<0.01) in the mesial and distal molar surfaces. Conclusion: The findings suggest that the level of the therapist's experience and skill is a significant factor that affects patient compliance and efficacy of mechanical therapy, and in turn, affects the outcome of non-surgical periodontal therapy.