Bone One Session Treatment (BOST)

What is BOST?

Bone One Session Treatment, or BOST, is a revolutionary treatment in tackling the problems of severe gum disease. The treatment was pioneered by dentists at The Hale Clinic in Central London and already thousands of people around the world have benefited from its excellence in curing what was once thought to be a helpless case in dentistry.

Often gum disease is treated at the early stage where swelling and bleeding of the gums are as bad as the problem gets. Nevertheless, when it develops into periodontis -a much more severe problem where the gums and the underlying ligaments become infected - the treatment becomes a much more complicated procedure. Periodontis is the result of air pockets developing between the teeth and gums where bacteria can thrive, often causing pain, sensitivity, loose teeth and in the worst cases, tooth loss.

With traditional periodontal treatments it is often the case that the worst happens and tooth extraction, sometimes multiple extractions, is necessary to treat the infection; which is often not cured permanently and re-infection is a strong possibility. However, with BOST the worst can be a thing of the past and around 90% of teeth that are deemed irreparable are saved using this new treatment. Furthermore, re-infection is very rare if patients keep up with the custom designed aftercare for BOST.

BOST is a one session treatment that treats periodontis at the source of the infection - under the gums. The treatment takes around four to five hours and requires no invasive surgery. It is fast, comfortable and almost certain to be successful and there is even the added bonus of a custom made treatment bed that is always a hit with those patients who suffer from the dentist chair phobia.

What makes BOST different to traditional periodontal treatment?

The major difference with BOST is its simplicity compared to traditional periodontal treatment. Traditionally this sort of treatment would involve teeth scaling and root planing which most often involves cutting the gums to reach the infection and is extremely painful and unpleasant for the patient. BOST requires no invasive surgery and pain and discomfort is minimal compared to the traditional method.

BOST is also much more successful in curing the problem due to the fact that treatment is carried out in one session; removing all the infecting bacteria at the same time. When patients undergo traditional treatment the procedure is usually carried out in a succession of appointments. It often takes up to a month for the entire treatment to be carried out. A dentist would usually treat a quarter of the mouth at a time because of the severity of the treatment on the gums and the discomfort it can cause to the patient. In between visits, because bacteria still remain in untreated parts of the mouth, there is every chance that bacteria will spread to treated areas and reinfect. This leads to a vicious circle where extraction becomes the only option due to continuous re-infection.

The treatment also helps in forming a strong attachment between the tooth bone and the gums whereas traditional treatment often leaves weak attachments where air pockets remain in which bacteria can thrive once more. The strong attachment means that the pockets are sealed from invading bacteria and healthy tissue is allowed to reform meaning that another flare up is much less likely.

Because BOST is a much kinder treatment for the gums it means that any healthy tissue, free of periodontis, remains undamaged where this may be unavoidable with traditional invasive treatment. With BOST, not only does healthy tissue remain healthy, but the healing time is shortened dramatically as unnecessary trauma is kept to a minimum. This means that the your body can concentrate on repairing the damage left by the infection without having to cope with the added stress of repairing damage caused by the procedure itself.

The treatment process

The technique used in BOST is called the ‘stretch flap’ method. When gum tissue is diseased it becomes spongier. The BOST technique uses this added flexibility to its advantage and stretches the tissue, rather than cutting the gum, allowing access right down to the very root of the problem. With traditional techniques access is limited to around 4 or 5 millimetres into the air pocket; if the infection spreads deeper than this then it will not be effectively eliminated. The BOST method allows access much deeper and this ensures that the problem is treated right to the very core.

The technique ensures that the gums are left in a state that is able to heal effectively. By stretching open the tissue there is no scar tissue left behind; as it is when the gums are cut. Scar tissue is not able to attach itself to the tooth surface. This means that the attachment between the tissue and the bone will remain weak after traditional periodontal treatment and this will allow for bacteria to re-infect the gum. Using the ‘stretch flap’ method, a strong attachment can be formed in which healthy tissue can thrive, leaving the food particles that cause bacteria unable to enter the gum. It is possible using BOST that the attachment between the gum and the tooth after treatment will be as strong as an attachment that was never infected at all.

A standard itinerary for BOST is as follows:

The day after treatment the patient is usually fine to resume day-to-day activities and will restart oral hygiene. By day 3 any bleeding should have stopped. A follow-up check is standard on day 3. By day 4 the pockets will have started to heal and in the first week inflammation continually recedes. By day 14 you should be able to resume normal chewing and day 15 will be your next check-up. On day 30 the pockets should have filled in and by day 45 the bone is beginning to heal. You will then be required to go for a check up after three months to make sure that the healing process has been successful. It will take 9 months however for the bone to heal completely.


The custom designed aftercare treatment is key to the success of BOST. The aftercare is just as important as the treatment itself and if the patient keeps up with the aftercare as advised then there is every chance that the treatment will have been a great success.

The AirPerio kit is given to patients upon completion of the procedure and this should be used twice daily for the first 8 days and then once a day forever. The kit is designed to compliment the healing process and then goes on to preserve the healed result.

Using the AirPerio kit sounds rather scary but it really is simple and pain-free. The idea is to use the pencil-like instrument to clean underneath the gums. The instrument is slim enough to be pushed into the gap between the tooth and the gum without causing damage. Completing this process to a good standard should maintain your newly healthy gums.

Post treatment success

There is absolutely no reason why BOST would be unsuccessful, even in the most severe cases, assuming the patient keeps up with the aftercare instructions. Of the people treated using BOST only 2% have had repeat infections and this has largely been down to their poor efforts in the aftercare process. Not keeping up with the oral hygiene program is a serious factor in failed cases.

However, most of the failed cases have been smokers. Smoking hinders the success of any dental treatment and BOST is no exception. This is not to say that smokers do not have successful results using BOST because smokers’ teeth have been saved by the revolutionary procedure. Nevertheless, it may be the case that where a smoker continues to smoke after treatment, it is essential to repeat the procedure every two to three years to avoid losing teeth.

Cost, eligibility and availability

The cost of the treatment depends solely on the severity of the case. The prices range from £1000 up to £5000 for the most severe cases. A consultation with a BOST specialist will determine the price of your treatment. Alternatively, if you are not in a position to physically attend an appointment, your dentist will be able to send your x-rays for analysis and the severity of your case can usually be determined from these.

It would take a consultation or x-ray analysis to determine whether you are eligible for the treatment but BOST has saved even the most written-off mouths from multiple tooth extractions. In cases where dentists have ordered as many as ten tooth extractions, BOST has been able to save them.

Currently, the treatment is very limited and the procedure is not yet being taught to dental students. However, as the treatment gains popularity there is every chance that it will one day be much more widely available.

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