Page 17 - IDX-DecisionTree-Booklet-Digital

Step 5

Adjunctive Supportive Measures Advanced/Surgical
(When indicated) or Intensified Therapy

Candida albicans:
Repeat antifungal therapy or alternate agent;
assess for systemic predisposition (e.g., diabetes,
immunodeficiency).

Pseudomonas aeruginosa:
Repeat full-mouth irrigation and debridement;
coordinate with physician if systemic involvement
suspected.

S. mutans:
Address active caries lesions with restorative
treatment; reinforce fluoride and sealant protection.

Step 6

Maintenance Phase

• Recall every 3–6 months for patients with prior
medium/high-level detection.
• Provide professional cleaning, antiseptic irrigation,
and fluoride or remineralizing treatments.
• Re-test annually or if symptoms reappear to
monitor recolonization trends.
• Reinforce home care, salivary support, and dietary
management.

• If recolonization or flare occurs → return to Step 2b
for targeted retreatment.