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 your visits based upon our assessment of the factors involved in potential disease reactivation or progression in your case. These include your ability to perform good daily oral hygiene, the status of your disease (aggressive/ advanced/ moderate/ mild) and whether you smoke or have some other susceptibility issues such as diabetes.
Adherence to a program of conscientious home oral care and regularly scheduled maintenance therapy visits with your dentist and periodontist will give you an excellent chance of keeping your teeth for your 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 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 patient are usually heavy smokers or may have other disease susceptibility issues. We do not currently have a good test to determine the likelihood of you falling into this difficult to treat 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 you and the severity of your gum disease before treatment and whether you start to show progression or lack of disease stability. Generally, the more severe your 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 your general dentist. Together, you, your general dentist and our periodontists will work out the most effective schedule for your supportive periodontal care.
What happens at your maintenance visit?
We will discuss any changes in your medical health, examine of your mouth tissues for any changes since the last visit and we may measure the attachment loss and inflammation around your teeth. We will assess your oral hygiene status, give you 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 your 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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