Supportive Periodontal Maintenance Therapy

Following active periodontal therapy, regular maintenance therapy or supportive periodontal cleanings become a vital role to maintaining periodontal health. Professional maintenance care, along with good oral hygiene habits are the keys to good oral health. Studies have shown people who do not maintain regularly have 20 times the amount of bone loss as those who do.

When there are residual pockets deeper than 3mm, or when patients demonstrate a high susceptibility to periodontal breakdown, a three month periodontal cleaning schedule is recommended and followed. This step is critical to the reduction in disease recurrence. The routine removal of plaque/ bacteria build up in deeper hard to reach areas, is the key to maintaining a healthier periodontal status.

If areas of plaque accumulation are not appropriately maintained, a re-initiation of gum infection will develop. Normally, however, it takes plaque about three months to develop into a more aggressive infection. During the first three months there is minimal bone loss, but after ninety days the breakdown dramatically increases. If the plaque is removed every three months, the plaque aggressiveness will stay low.

3 month recalls can reduce bone loss

At the periodontal maintenance appointment the following procedures are performed:

  • Update of medical and dental history
  • Update/ take x-rays and check for radiographic changes to teeth / roots and bone as well as possible new developing decay
  • Oral cancer exam
  • Clinical decay examination
  • Clinical periodontal examination
  • Review of oral hygiene techniques as needed
  • Scaling above the gum level
  • Root planing under the gum level as needed
  • Administration of antibiotics in unstable sites as needed
  • Administration of fluoride as needed
  • Polishing
  • Doctor check and review of current periodontal status (Annual)
  • Confirmation of recall frequency and scheduling of next appointment
  • (Full mouth radiographs, which show the entire tooth and root surfaces are taken every 2 years to determine if the bone level is stable. See Dental X-Rays)

An important observation at a periodontal maintenance appointment is whether the tissues bleed when measured / probed. If there is no bleeding, the mouth is usually healthy. If there is bleeding, and it is seen on several subsequent recalls, additional treatment in that area is warranted. Smoking tends to mask the presence of disease and gives a false sense of health with less bleeding. A change of the bone level as seen on X-rays also requires attention.

The periodontal maintenance appointment should be comfortable and pleasant. Patients who may need a little help with relaxing can easily overcome their anxiety with a prescription medication taken one hour prior to their appointment.

Periodontal maintenance therapy is a critical part of keeping gum disease under control and stable. Failure to remove the build up of bacteria with both good oral hygiene practices at home and with routine professional cleanings will allow the gum disease to re-infect previously treated areas. Periodontitis is not a curable condition; however most periodontal disease cases can be brought to a more stable level along with improved tooth longevity. Once periodontal stability is achieved, periodontal maintenance cleanings are recommended (usually alternating every 3 months between our office and your general dentist).