Arianna Ritchey RDH
What is a Periodontal Maintenance?
One of the terms that is commonly used by dental professionals, and also commonly misunderstood by patients, is ‘Periodontal Maintenance.’ A periodontal maintenance procedure is similar to a prophy, or general adult cleaning, but is a more involved procedure meant for patients who have periodontal disease.
Periodontal disease, or gum disease, is characterized by deep periodontal pockets, inflammation, and bone loss. Periodontal disease is an irreversible condition which, if left untreated, may lead to further bone loss and eventually tooth loss. In order to treat periodontal disease, a dental hygienist or dentist will likely recommend a procedure called a “deep cleaning,” also known as SRP, or scaling and root planing. Once a deep cleaning is completed, inflammation will reduce and periodontal pockets may decrease in depth. When the patient’s periodontal status has stabilized, the next step in the care of the teeth and gums is periodontal maintenance, or more colloquially, “perio maintenance.”
Periodontal maintenance is a teeth cleaning procedure which is done at either 3, 4, or 6 month intervals, depending on the patient’s needs. The purpose of the periodontal maintenance procedure is to maintain the level of the periodontal disease present, and to prevent it from getting any worse. Unfortunately, bone that has been lost as a result of periodontal disease does not grow back, and as such, periodontal pockets may remain at a deeper-than-optimal level despite the initial deep cleaning therapy. These deep periodontal pockets collect plaque and tartar, and are impossible to clean properly with a toothbrush, floss, and other dental hygiene aids. In order to keep these periodontal pockets clean and prevent further bone loss, it is necessary to have a dental hygienist regularly perform professional cleanings.
Periodontal maintenance involves a dental hygienist scaling and root planing some areas in order to remove irritating tartar buildup. When a dental hygienist performs root planing, instrumentation is completed below the gumline all the way to the bottom of the periodontal pocket. This cleaning of the root surface below the gumline is what makes a periodontal maintenance different, more involved, and potentially more costly than a prophy, or regular cleaning.
In patients who have deep periodontal pockets, a prophy, or general cleaning, is not beneficial, because the irritating plaque and tartar below the gumline that is causing the most irritation and loss of bone is not removed during a prophy or general cleaning. Performing a general cleaning on a patient with periodontal disease would be similar to sweeping dirt under the rug instead of properly cleaning a floor. The offending dirt in the case of the floor, or the bacteria-infused-tartar in the case of the mouth, is still present and causing harm.
As dental hygienists, our primary goal and concern is to assist patients in maintaining the healthiest oral cavity possible. Providing periodontal maintenance treatments for our patients who have periodontal disease at 3, 4, or 6 month intervals, along with the patient’s good oral hygiene care at home, is the best way to work towards a stable periodontal health status and to help our patients from experiencing bone and tooth loss.
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