The 3 Pillars Can Save Teeth—But They’re Not the Whole Story

When is a tooth truly periodontally hopeless—and when should we give it a chance to heal? For more than 25 years, our approach to periodontal treatment has been built around what I call The Three Pillars of Periodontal Healing: 1. Root cleanliness 2. Control of active, aggressive infection 3. A biologically neutral bite without damaging forces on the teeth But the Three Pillars aren't the whole story. In this video, I discuss what happens beyond the Three Pillars: the patient's role in plaque control and oral hygiene, nutrition and general health, and something that's difficult to measure in a clinical study—the skill and dedication of the hygienist or clinician actually providing the treatment. I also discuss the term “periodontally hopeless.” Some teeth truly cannot be saved. But I've also seen teeth heal that others might have considered hopeless once we created the conditions that allowed healing to occur. We never know the opportunity for a tooth to heal if we extract it. Give teeth a chance. This channel is for educational purposes and is not a substitute for diagnosis or treatment by your own dentist or periodontist.