Which intervention is most appropriate for Stage 4 periodontal disease with tooth mobility?

• A. Plaque control and polishing
• B. Routine dental scaling only
• C. Antibiotics prophylaxis only
• D. Extractions for severely involved teeth

Answer: (D)

Advanced periodontal disease with tooth mobility means there is extensive loss of supporting structures and the teeth are often non-restorable. The priority is to remove the diseased source to stop pain, infection, and further bone loss. Plaque control and polishing help prevent future disease but cannot reverse the damage or stabilize teeth with significant attachment loss. Routine scaling alone won’t address deep pockets or mobility, and antibiotics can help with infection but won’t restore lost support. Extractions of severely involved teeth directly resolves the source of pain and infection and improves overall oral health; after that, focus on maintaining the remaining teeth with ongoing dental care and monitoring.