Periodontal Maintenance After a Deep Cleaning

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Periodontal disease is actually a group of diseases, all of which lead to the same result — loss of the bone that supports the teeth and, ultimately, the teeth themselves. It starts as gingivitis, inflammation of the gum tissues. Unless this is treated, most adults will develop a more serious form of periodontal disease called periodontitis. This is characterized by loss of bone, gum tissues, and the ligament that connects them to the teeth.

The US Centers for Disease Control and Prevention (CDC) cites the following recent data for the prevalence of periodontitis in the US:

• 47.2% of adults aged 30 years and older have some form of periodontal disease.
• Periodontal disease increases with age: 70.1% of adults 65 years and older have periodontal disease.

Periodontal treatment is aimed at removing the cause of the disease — biofilm and calculus or tartar — from the teeth and root surfaces, and eliminating contributing factors that lead to their retention, like root surface irregularities and roughness. Your periodontist (a specialist in the diagnosis and treatment of diseases of the supporting structures of the teeth) or his or her hygienist will teach you how to effectively remove dental plaque (biofilm) at home through daily brushing and flossing, and will give you a meticulous, professional cleaning of the crowns and root surfaces of the teeth. Periodontal treatment is also aimed at controlling risk factors like smoking, keeping you healthy and minimizing stress. Any inflammatory condition that affects your health — diabetes, cardiovascular disease, and rheumatoid arthritis for example — can also make periodontal disease worse, and vice versa.

Although you’ve completed periodontal treatment, which included surgery, and you may now be disease-free, this doesn’t guarantee a cure. Periodontal treatment corrects the effects of the disease — gum detachment and bone deformities — to restore your periodontal health, but it doesn’t change your susceptibility. Without continuing maintenance care, periodontal disease can recur.

For individuals with gingivitis, periodontal maintenance may be adequate at six-month intervals to begin with. For individuals with a history of periodontal disease, the data from the majority of the scientific studies suggest that a three-month periodontal maintenance interval will result in decreased likelihood of progressive disease compared to individuals receiving maintenance on a less frequent basis.

However, a three-month interval is not set in stone. For those with more aggressive variants of periodontal disease, it may be necessary to have periodontal maintenance every two months. Additionally, systemic medication, topical antibiotics or other anti-bacterials, for example, may be needed to support maintenance.

Especially in the immediate post-surgical period, periodontal maintenance beginning at three-month intervals allows your periodontist the time to individualize and personalize follow-up care to ensure your dental health is stable. Depending upon a variety of factors, including your own ability to maintain optimal daily hygiene (biofilm or plaque control), the interval may be reduced to four or even six months depending upon progress and experience over time.

Periodontal maintenance at three-month intervals, given all we know, is a good “one size fits all” place to start at your stage of treatment for prevention of recurrence.