When is Periodontal Maintenance Not Enough?

Author: Dr. Sarah Mischo, DMD

When you think about dental health, you probably think about teeth. And while it’s true that your dentist and dental hygienist are keeping a close eye to make sure you don’t develop cavities, we are also keeping a close eye on another important part of oral health: your gums. When a patient’s gums (gingiva) begin to develop signs of inflammation (gingivitis) this can lead to resorption of bone and major problems down the road for their teeth. We call this periodontal disease.

Scaling and root planing (SRP), is the initial treatment recommendation for patients with periodontal disease. For many patients, this initial form of treatment is enough to reduce the gingival inflammation. If SRP is effective at reducing gingival inflammation, these patients are then scheduled for periodontal maintenance therapy, where they will come into the office more frequently for cleanings every three or four months.

The Journal of American Dental Association (JADA), had an interesting article back in their May subscription regarding when is “Perio Maintenance not enough?” This article states “the treatment for periodontal disease is straightforward: eliminate inflammation in the periodontal tissue.” That statement makes it seem like that is something that can be achieved within one visit. However, in reality, any one of our hygienists can tell you that end point can be difficult to achieve. Initial steps in treating periodontal disease is to remove the biofilm and calculus, and patient education. Patient education can’t be stressed enough here!! I like to tell my patients that we only get to see them 1% of the time and help them take care of their teeth, the other 99% of the time it’s on the patient to practice what was recommended in order to get their periodontal disease under control.

And while SRP and periodontal maintenance is enough to tackle periodontal disease for many patients, according to Wennstrom and colleagues “slightly more than one-third of the initial deeper pockets (measuring over 5 mm) continued to have clinical signs of inflammation” even after SRP and periodontal maintenance therapy. Advanced therapy from a specialist may be recommended for these patients which may include but is not limited to: SRP with enhanced visualization, surgical access for debridement,or other regenerative procedures.

At Spring Lake Dental Group, we have four wonderful hygienists who are very skilled at what they do and are passionate about teaching their patients proper ways to maintain a healthy, and beautiful, oral environment. Whether it’s been six months or six years, go ahead and give us a call today to schedule an initial assessment!