Penam Periodontics - Evidence based Personalized Periodontics

Periodontal Maintenance

After the Periodontist has completed the active phase of periodontal treatment, your periodontal disease will be under control. We will provide you with a personalized maintenance program of care to keep your gums healthy.

Maintenance therapy is very important as it provides a method of control of the bacteria which cause periodontitis. The bacteria which cause the disease are part of the normal bacterial flora of your mouth. If the correct environment to facilitate the bacterial growth occurs they will grow within the dental plaque and may reinitiate the disease. These bacteria require blood products for their growth so the maintenance program should be based around prevention of the reestablishment of the bacterial growth such as by reducing bleeding of the gums. We will recommend a time period for visits based upon our assessment of the factors involved in potential disease reactivation or progression in any case. These include the ability to perform good daily oral hygiene, the status of the disease, the genetic susceptibility, the associated systemic disease and whether the patient smokes.   

Adherence to a program of conscientious home oral care and regularly scheduled maintenance therapy visits with the dentist and periodontist will give an excellent chance of keeping the patients teeth for their lifetime. However no matter how careful you are following this, a percentage of patients will experience a recurrence of their gum disease. The shortest period required to demonstrate recurrence is approximately three months in those with very poor oral hygiene. It can take up to 18-24 months to see recurrence even in the best maintained mouths.

Whilst these maintenance programs are very effective in stopping disease recurrence we still see ~12-15% of people may get recurrence or progression of their disease even with good maintenance. These patients are usually heavy smokers or may have other disease susceptibility issues. We do are developing gene tests to determine the potential likelihood of recurrence in this treatment group. However once we can identify you as being within this group we will take action to modify your standard treatment based upon the factors that may be involved in the development of progression. The changes in your therapy may involve the use of antibiotics, QUIT smoking programs or other patient/condition dependent treatments.

Who should perform supportive periodontal therapy?

The answer depends on the patient, the severity of their gum disease before treatment and whether they show evidence of progression or lack of disease stability. Generally, the more severe the periodontal disease is, the more often the periodontist will want to see you. For the very stable patients we will frequently start an alternating program of maintenance with the general dentist. Together, we will work out the most effective schedule for your supportive periodontal care.

What happens at your maintenance visit?

We will discuss any changes in the patients medical health, examine of their mouth tissues for any changes since the last visit and we may measure the attachment loss and inflammation around your teeth. We will assess the oral hygiene status, give out a score card showing the areas where there are problems and give instruction as to how to correct these. We may take an x-ray of any area that is a problem and we will check the teeth for decay and other dental problems. We will remove the bacterial plaque and calculus and if necessary apply medications to reduce tooth sensitivity or other problems you may have.

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