Georgia Periodontics, P.C.

Following therapy, regular Hygiene visits are extremely important in maintaining periodontal health. Maintenance and good oral hygiene, are the keys to good oral health and periodontal success. Studies have shown people who do not maintain their teeth regularly have 20 times the amount of bone loss as those who do.

In situations where there are some residual pockets deeper than 3mm, or where the patient has shown a high susceptibility to breakdown, three month (or more frequent) recalls are critical. In these cases where the patient cannot reach all areas with oral hygiene techniques, bacteria form colonies (plaque) immediately after treatment.

Normally, however, it takes plaque about three months to develop into an aggressive infection. The first three months there is minimal bone loss or inflammation, but after ninety days the breakdown dramatically increases. If the plaque is removed every three months, the tissue will respond in a much more favorable way.

At the periodontal maintenance appointment the following procedures are performed:

• Update of medical and dental history
• Soft tissue cancer exam
• Clinical decay examination
• Clinical periodontal examination
• Review of oral hygiene as needed
• Scaling above the gum level
• Removal of bacteria below the gun line
• Root planing under the gum level as needed
• Recommend fluoride as needed
• Polishing
• Doctor check
• Confirmation of recall frequency and scheduling of next appointment

(Full mouth radiographs, which show the entire root surface, are taken every 3 years to determine if the bone level is stable. Other types of x-rays such as vertical bitewings are taken annually to assess bone halth and check for cavities. See Dental X-Rays)

An important observation at a periodontal maintenance appointment is whether the tissues bleed when probed. In general, as bleeding decreases, the health of the periodontium increases. If there is bleeding, and it is seen on several subsequent recalls, additional treatment in those specific areas may be warranted. A change of the bone level as seen on X-rays may also require attention.The periodontal maintenance appointment should be comfortable and pleasant.

The Patient's Role in Therapy

No matter how successful the periodontal treatment has been, the patient is the most important part in maintaining periodontal health. For maximum results, the patient must accept this role as a "co-therapist" .

The first responsibility of the patient is to eliminate factors that increase susceptibility to periodontal disease. The prime culprit is smoking, which increases the odds of losing teeth 1000%! Diabetic patients are also more susceptible, although this effect is negligible if the blood sugar remains stable. Healthy diets promote healing, but don't be misled by vitamin claims. Periodontal disease is NOT affected by high doses of Vitamin C or calcium supplements, if the patient has a normal diet.

The second responsibility of the patient is to maintain daily plaque control, with brushing and flossing . Brushing is easy for most of us, but flossing is more demanding. Most periodontal disease, however, starts between the teeth, where the brush can not reach. "Floss is the Boss", and the time spent in learning proper technique will pay large dividends. (See Oral Hygiene)

Lastly, the patient is responsible for scheduling regular periodontal maintenance appointments. The frequency is determined by your periodontist and dentist, and is critical! Most patients with moderate and advanced cases should have periodontal maintenance appointments every three months for their lifetime, and staying faithful to this schedule is very important.