Periodontal Maintenance

What is Periodontal Maintenance?

A periodontal maintenance procedure (PMP) is defined as a procedure that is recommended following periodontal treatment (such as scaling and root planing) and continues at varying intervals, determined by the clinical evaluation of the dentist. These intervals can be as frequent as every two months and they can be extended as long as six months, depending on the patient. Keeping up your PMP interval is important because periodontal disease can recur without adequate follow-up.

Do I Need Periodontal Maintenance?

If you have periodontal (gum disease), contact us to find out if you need periodontal maintenance. The main cause of gum disease is bacterial plaque which constantly forms over your teeth and gums. Daily brushing and flossing will minimize the formation of hardened plaque but won’t prevent it completely, which is why regular trips to the dentists are important in gum disease prevention. If you have gum disease, you will need to see us to determine the proper treatment plan. A gingivectomy is necessary when the gums have pulled away from the teeth creating deep pockets. The pockets make it hard to clean away plaque and calculus. Gingivectomy is usually done before gum disease has damaged the bone supporting the teeth.

What Does Periodontal Maintenance Involve?

PMP includes removal of plaque and tartar above and below the gums, scaling and root planing of specific areas, and polishing. PMP is always completed following active periodontal treatment, such as scaling and root planing or more extensive gum surgery, and it involves:

• Thorough Cleaning: Periodontal maintenance includes a thorough cleaning both above and below the gum line to remove plaque, hardened tartar, and bacteria.
• Regular Appointments: We recommend recurring periodontal maintenance appointments roughly every three months because periodontal bacteria can flourish within three to twelve weeks.
• Risk Prevention: If we can ensure a professional cleaning every three months, we can prevent the bacteria from spreading, check for hidden problems, and remove hardened plaque at intervals that best suit your oral care needs.

Periodontal maintenance is an essential part of your oral healthcare following gum disease treatment because it prevents the resurgence and spread of gum disease.

What Happens at the Periodontal Maintenance Appointment?

• Health History: During your periodontal maintenance appointment, you can expect a to speak with Dr. Lee or one of our other qualified dental professionals regarding any health history changes and an assessment of oral hygiene habits.
• Thorough Examination: We’ll conduct a thorough examination of your teeth for decay and any other mouth issues, measure the pocket depths around your teeth, and remove any bacterial plaque or tartar.
• Dental X-Rays: X-rays will be taken to evaluate the health of your teeth and jawbones. If a medication is prescribed, we will also apply this during your periodontal maintenance appointment.

How Frequently do I Need Periodontal Maintenance?

While periodontal maintenance should occur more often than a general professional cleaning, the amount of time between your periodontal maintenance appointments is determined on a case by case basis. Your periodontal condition and the overall health of your teeth and gums are the major deciding factors.

Ultimately, Dr. Lee will determine how often you should come in for periodontal maintenance based on these considerations:

• The type of periodontal disease you have
• The type of periodontal treatments you have undergone
• Your current response to the treatment
• The rate of your plaque growth
• Your commitment to a good at-home oral care routine

Scaling and Root Planing

Scaling and root planing is a special type of treatment that goes deeper BELOW the gum line to remove contaminated debris and bacteria, most often performed on patients with active periodontitis.

What is the Difference Between Scaling, Root Planing, and a Cleaning?

This seems to be a procedure that causes much confusion for patients trying to understand the difference between “just a cleaning” and scaling and root planing, and the need/reason for this procedure.

• Professional Cleaning: A professional polishing or prophy removes only the soft sticky plaque and hard crusty calculus that is ABOVE the gum line on the crown of the tooth. Scaling and root planing is done to remove soft sticky plaque and hard crusty calculus that is loaded with bacteria, around and BELOW the gum line on root surfaces. It is a method of treating gum disease when pockets formed around the teeth have a measurement of greater than 3mm and there is evidence of bleeding and tissue attachment loss.
• Scaling: Scaling is a procedure that meticulously removes contaminated biofilm, plaque, calculus, microorganisms and toxins from around the gum line down to the bottom of each periodontal pocket, in order to obtain a healing response.
• Root Planing: Root planing involves smoothing the root surfaces of your teeth with thin instruments so gum tissue can more firmly reattach to roots that are clean and smooth, to prevent tooth loss and sensitivity problems. This procedure makes it more difficult for plaque, calculus, and bacteria to accumulate along these root surfaces. Because this procedure goes deeper than a regular cleaning, your mouth may be numbed. The cleaning may take one to six visits to complete. Depending on the extent of the disease, you may need one or more quadrants of the mouth to be treated with scaling and root planing.

When is Scaling and Root Planing Necessary?

• To control the growth of harmful bacteria
• Help the pocket wall reattach firmly to the clean root surface
• Prevent further bleeding of the gums from disease
• Reduce inflammation
• Reduce discomfort
• Prevent bone loss
• Prevent gum disease related tooth loss
• Reduce systemic disease

Home Care After Root Planing & Scaling

• Rinse with warm salt water every few hours (1/2 tsp. salt in 8 oz. water) for the remainder of the day to encourage healing and soothe discomfort.
• Be careful not to bite or chew your lip, cheek or tongue while they are numb.
• Avoid chewing for 2 hours after this procedure or until the numbness has worn off.
• Keep your fingers and tongue away from the areas that have been treated.
• Take Tylenol or ibuprofen according to directions on the manufacturer’s label for a couple of days to help with the discomfort; do NOT take aspirin because it may prolong bleeding.
• Rinse your mouth with Closys or Chlorohexidine, if prescribed by your dentist, to reduce oral bacteria.
• Do not smoke or chew tobacco for 72 hours after the procedure to allow for healing.
• Gently brush and floss your teeth after each meal. How you care for your teeth and gums at home after treatment is critical to reducing the risk of recurring periodontal disease.

Schedule Your Periodontal Maintenance Appointment

Periodontal disease is a major cause of tooth loss in adults, and we at Edelweiss Dental Implant Center are committed to keeping our patients smiling beautifully. Periodontal maintenance helps to prevent future problems and keep your gums and underlying bone healthy. With regular periodontal maintenance and the assurance that your oral health is being actively cared for, you will be able to eat, speak, and smile more confidently.