If you are treating periodontitis as an infectious disease only (SRP, antimicrobial, ultrasonic, home-care, etc.), this is probably why your treatment plan does not provide your patient positive predictable outcomes!
Definition of an infectious disease
Caused by pathogenic microorganisms, such as bacteria, viruses, parasites or fungi; the diseases can be spread, directly or indirectly, from one person to another. http://www.who.int/topics/infectious_diseases/en/
Definition of an inflammatory disease
Long-term inflammatory processes directed at a particular endogenous or exogenous antigen.
http://hmg.oxfordjournals.org/content/18/R1/R101.full
The liver produces C-reactive protein (CRP) when it detects signs of inflammation, such as the presence of cytokine molecules like interleukins. CRP is not present in large amounts in the blood of healthy people.
Insult
The most common cause that initiates a destructive inflammatory response is bacterial plaque in the form of a biofilm and calculus. Trauma may also initiate an inflammatory response (i.e. a recently placed crown or a restoration with a sub-gingival margin).
While complete removal of periodontal bacterial burden is not possible (and the threat of reinfection is constant), we must have in place the most effective treatments and adjuncts for in-office and home care. This becomes even more important for patients with risk factors for periodontal disease.
Host/Immune System
This is the body’s own inflammatory response to the insult. When this inflammation is prolonged (chronic) or excessive then periodontal tissue destruction occurs rather than tissue repair.
• Periodontal disease
• Asthma
• Atherosclerosis
• Autoimmune Diseases
• Crohn's disease
• Heart Attack & Stroke
• Infectious Diseases
• Lupus
• Many forms of Cancer
• Multiple sclerosis
• Nerve Disorders
• Rheumatoid arthritis
• Type 1 diabetes
All chronic diseases have dysregulated and excessive inflammatory responses.
" Research has shown that periodontal disease is associated with several other diseases. For a long time it was thought that bacteria was the factor that linked periodontal disease to other disease in the body; however, more recent research demonstrates that inflammation may be responsible for the association. Therefore, treating inflammation may not only help manage periodontal diseases but may also help with the management of other chronic inflammatory conditions. "
Source: www.perio.org/consumer/other-diseases