What is the most likely action for a patient with a BPE score of 4 to reduce their score?

The most appropriate action for a patient with a Basic Periodontal Examination (BPE) score of 4 is subgingival debridement. A BPE score of 4 indicates that there are pockets greater than 5mm, which usually signifies the presence of periodontal disease that requires intervention beyond routine oral hygiene measures.

Subgingival debridement is aimed at removing plaque and tartar from below the gumline, which is crucial for reducing the depth of periodontal pockets and improving overall gum health. This thorough cleaning helps to eliminate infection and promotes the healing of the gum tissue. Consequently, addressing the underlying periodontal disease directly is essential in reducing the BPE score and improving the patient's periodontal status.

While dietary advice, fluoride application, and smoking cessation advice are important components of overall oral health and can contribute to the prevention of further periodontal issues, they are not the direct interventions needed to address the existing periodontal condition indicated by a BPE score of 4.