What is Periodontal Maintenance Therapy?
Periodontal Maintenance Therapy consists of four main stages:
1. Reassessment – This involves assessment of the periodontal status, including repeat measurements of pockets, bleeding, gum recession, mobility and oral hygiene levels.
2. Diagnosis – We can diagnose disease that may have relapsed or detect new disease based on the measurements taken. By complying with the recommended maintenance intervals this can be detected early, thereby helps to avoid the need for extensive repeat treatment.
3. Treatment – Any remaining pockets (either existing or relapse) are rescaled, sometimes with the use of local anaesthetic. Occasionally, medicaments are placed in the pockets to help them heal. General scaling of the whole mouth is also carried out. Oral hygiene is re-instructed to reinforce the key points you should remember. Occasionally it can be found that a site is worsening and that scaling and maintenance alone are not sufficient to control it. Therefore alternative treatments may be advised.
4. Risk Evaluation – Based on the measurements taken and assessments carried out, a risk evaluation is performed in order to provide you with a recommendation of how long a gap should be left before the next maintenance visit.
Why is Periodontal Maintenance Therapy Necessary?
Imagine your tooth support (gum, bone and periodontal ligament) are like a car or a house – they need constant servicing and looking after in order to operate smoothly and prevent breakdown. Research strongly indicates that without periodontal maintenance, also known as Supportive Periodontal Therapy (SPT), you have a much greater chance of periodontal and/or gingival disease relapse. Consequently, periodontal structures may become increasingly compromised and the risk of tooth loss may increase. A relapse in periodontal destruction would therefore indicate the need for repeat intensive treatment.
Despite your best efforts with oral hygiene, there is always a risk of relapse of the condition. Remember, gum and periodontal disease is not typically painful, so you are unlikely to notice this yourself. Maintenance therapy allows for early detection and treatment, thereby helping to maintain your teeth for as long as possible and to avoid the need for repeat treatments. If you had pockets remaining after treatment was completed, no matter how well you clean, there will still be some areas that will accumulate plaque (you can only effectively clean up to 3 mm below the gum line with typical brushing and interdental cleaning). Therefore, these pockets need to be professionally cleaned and scaled regularly in order to prevent them from deteriorating. If they do get worse, you run the risk of further bone and tooth loss, decay of the root surfaces and loss of tooth vitality (the tooth may die).
Who will Carry Out the Periodontal Maintenance Therapy Appointment?
In most cases, evidence shows that maintenance therapy carried out by a periodontist is the most effective in being successful. Frequently we will advise the dentist or dental hygienist to carry out maintenance therapy at individually tailored time intervals. In addition to these appointments at a general dental practice, it is important to continue to attend appointments with the periodontist as outlined in the periodontal treatment plan. These maintenance appointments will be designated depending on individual need and will allow for close monitoring of the periodontal condition, risk assessments and appropriate follow-up diagnosis.
How often is Periodontal Maintenance Therapy Required?
This is very prescriptive to individual cases. Typically, maintenance therapy starts at an interval of 3 months. This interval may gradually be extended depending on how stable the periodontal condition remains between visits. Commonly, individuals may be advised to attend the periodontist on a 4 month, 6 month or 12 month frequency. Continual reassessment of the periodontal condition allows for recommendations to be tailored to the individual case of the patient.
What happens if I don’t comply?
Non-compliance stands a very high chance of needing to have extensive treatment carried out again and the second attempt at treatment may not always show as positive a response as the initial therapy. The amount of supporting bone around the teeth will likely undergo further destruction, which is a progression of periodontal disease that is more complex for the periodontist to treat. In this instance, the periodontal condition is likely to be more advanced, thus, increasingly difficult to treat versus during your initial treatment, resulting in a poorer prognosis to treatment.
What Can I Do If I have missed a Periodontal Maintenance Therapy Appointment?
Better later than never! Just call the Pure Periodontics team on 020 7253 3157 to arrange a maintenance appointment.
Thank you for consulting Pure Periodontics for your gum and periodontal health. We look forward to the opportunity to provide the highest level of periodontal care that enables our patients to achieve optimal oral health improvement outcomes.