The Root Surface Debridement (Step 2) Notes Template
A root surface debridement (Step 2 non-surgical periodontal therapy) notes template captures the subgingival PMPR visit — pre-treatment OH and engagement re-assessment, anaesthesia, quadrant/sextant treated, instruments used (ultrasonic + hand), pocket depths and BoP completion check, adjuncts (local antimicrobial / PDT if used), OH reinforcement, and 8-12 week re-evaluation interval — meeting BSP UK Clinical Practice Guidelines (EFP S3 implementation, 2021).
BSP UK CPG (2021) now uses the term "subgingival PMPR" instead of "root planing" — and requires documentation of patient engagement before Step 2 starts. Below is the template UK clinicians paste into their PMS for each Step 2 visit.
Download the free Root Surface Debridement (Step 2 NSPT) template — plain text, GDC/FGDP(UK)-aligned.
Why this root surface debridement (step 2 nspt) template wins
- BSP-aligned terminology: "subgingival PMPR" not "root planing" — current UK standard.
- Patient engagement re-assessment BEFORE Step 2 — BSP CPG requires evidence of OH compliance before progressing.
- Specific instruments documented (ultrasonic + Gracey) — defends against "you didn't treat properly" if pockets fail to resolve.
- Adjunct decision rationale — local antimicrobials and PDT are evidence-based for specific scenarios; document the indication.
- Furcation-specific access noted — Grade 2 furcations are the hardest to manage; specific technique documented.
Compliance: the medico-legal angle
- BSP UK Clinical Practice Guidelines (EFP S3, 2021) — Step 2 NSPT framework including patient engagement requirement.
- Terminology change — "subgingival PMPR" replaces "root planing" per BSP 2021.
- GDC Principle 4 — operative records sufficient for continuation by another clinician.
- BSP guidance on antimicrobial stewardship — systemic antibiotics only for aggressive (now Grade C / Stage III/IV with rapid progression) forms.
Common mistakes UK dentists make
- Starting Step 2 without patient engagement evidence (improved OH score) — BSP requires Step 1 success first.
- Routine systemic antibiotic prescription for Step 2 — antimicrobial stewardship issue, NOT BSP first-line.
- No 8-12 week re-evaluation booked — without this, Step 3 decision (surgery or refer) can't be made.
- Using "root planing" terminology — outdated; BSP has moved to PMPR.
- No furcation-specific access documented for grade 2/3 furcation sites — leaves the area undertreatment.
Frequently asked questions
What's the difference between Step 1 and Step 2?
Step 1: supragingival PMPR + OHI + risk factor modification + initial motivation. Step 2: subgingival PMPR for pockets ≥4mm with BoP, after Step 1 has demonstrated patient engagement. Step 2 is what was historically called "root planing" or "deep cleaning" — now formally PMPR.
Why do I need to confirm patient engagement before Step 2?
BSP CPG requires it because Step 2 outcomes depend on home OH. Without compliance, pockets re-colonise within weeks. BSP: confirm plaque score reduction and behaviour change before progressing. Document the assessment.
Should I do quadrant-by-quadrant or full-mouth scaling?
BSP CPG: no significant outcome difference between quadrant-by-quadrant (over 4-6 weeks) and full-mouth disinfection (within 24 hours). Choose based on patient tolerance, anaesthetic load, scheduling. Document the approach.
Are local antimicrobials worth it?
Evidence supports use at specific isolated deep pockets non-responsive to mechanical therapy alone — particularly Grade 2+ furcations and persistent ≥5mm pockets after Step 2. PerioChip, Arestin are evidence-based. Not first-line for general use. Document the clinical justification.
When do systemic antibiotics fit in?
BSP: NOT first-line for chronic periodontitis (Stage I-III Grade B). Reserved for Grade C rapid progression / aggressive forms — typically amoxicillin 500mg TDS + metronidazole 400mg TDS for 7 days, alongside mechanical therapy. Document the indication.
When do I move from Step 2 to Step 3 (surgery / referral)?
At 8-12 week reassessment: persistent pockets ≥6mm with BoP, persistent furcation 2/3, ongoing bone loss. Refer to periodontist or perform surgical access (if within your competence). Document the decision and rationale.