When dental biofilm irritates the gingiva, it breaks down the tissue and bone supporting the dentition. Left untreated, periodontitis can increase periodontal pocket depth (PD) and bleeding on probing (BOP), and may lead to the spread of active infection to healthy sites.

This epithelial cell-associated biofilm lining the epithelial surface of the pocket contains primarily spirochetes and gram-negative bacterial species. Three of the most prominent species are P. gingivalis, T. denticola, and T. forsythia, comprising the class known as red complex bacteria (RCB).

RCB multiply rapidly, and re-colonization is a persistent threat. Scaling and root planing (SRP) alone may not be enough to achieve and sustain a healthier balance of bacteria.

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