Prepare for battle – periodontal treatment from a different perspective

We can learn a lot from military history if you consider dentistry as the battlefield and we, as dental professionals, the commanders drawing up the battle plans. The tactics used in guerrilla warfare in particular apply to our approach to dental care such as the careful exploitation of weak points, but only after taking into consideration such factors as the enemy, the terrain, logistics and the available resources.

As dentists, our traditional training can be somewhat focused and, dare I say it, blinkered – but I am pleased to say that this is dramatically changing for the better and there are some great training courses now available. However, we all learn in different ways and so, when teaching, I like to approach the same subject from different


So, looking at the tactics of guerrilla warfare, there are certain steps taken in devising, implementing and maintaining a battle plan and there is much we, as dentists, can learn from these from both a clinical and business perspective. To begin with, this process involves six fundamental considerations:

• Objective

• Civil support

• Build up

• Attrition

• Transition

• Takeover


To help patients keep their teeth for life with minimal discomfort and to match their aesthetic demands (within reason).

Civil support

From a military perspective, this involves the hearts and minds of the local population. Periodontally, it involves getting the patient to emotionally buy into the need for periodontal care. Behavioural change management and ethical sales techniques are paramount. Failure at this stage both periodontally and militarily will result in ultimate failure. Think of Vietnam!


Militarily, it is necessary to build up the troops in sufficient numbers with necessary supply chains in place. In periodontics, we have to work with the patient to enable their oral hygiene techniques and provide them with the appropriate tools to do it with. It is the precursor. It builds up to the next stage…


Wear down the opposition. We need to eliminate the bugs and allow the body to overcome the microbial challenge. Following initial non-surgical therapy – where we are operating in difficult-to-access areas – patients then need to maintain their oral hygiene procedures over the next three months until the recall visit. It really is a war of attrition and that is why civil support and build-up are so crucial.


Militarily speaking, guerrilla warfare can progress to a more conventional form of warfare dependent upon a number of factors. The timing and implementation is crucial to the ultimate success or failure to achieve the objectives. Periodontally this can be considered as the maintenance phase when hopefully treatment becomes simpler, and patients can maintain themselves to a greater or lesser degree. Failure to progress to this stage can result in more adjunctive treatment to maintain the status quo or, in some cases, failure to achieve the objectives.


Guerrilla warfare that progresses to conventional warfare can then progress to takeover of the arena. What we want with periodontal care is for us to have controlled the periodontal disease so that we can take over the mouth and progress onto more advanced procedures to meet the patient’s need and desires. Upselling.

Failure to progress through the above stages will result in us failing to achieve the best for out patients. Patients will miss out and so will our practices.

Become a Dentistry Online member

Become a member
Add to calendar