Non-surgical periodontal therapy remains the gold standard for resolution of dental plaque biofilm induced oral disease. This therapy involves patient oral home care on a daily basis for success. In incidents of NSPT failure, more than just patient compliance should be considered. Periodontal disease is a multi-factorial disease and needs to be considered in multi-modal therapeutic regimens. Practitioner's deliberations around failures after NSPT ought to evaluate the very nature of disease, the biology inherent in tooth to gum interactions, and the rather limited means of addressing such factors.

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