Periodontal Maintenance

Periodontal Maintenance (PM) begins after completion of active periodontal therapy and continues at 3-4 month intervals, alternating with your general dentist. PM is an extension of active periodontal therapy. PM procedures are supervised by Dr. Stambaugh and include:

  • Update of medical and dental history
  • Review of patient radiographs
  • Extraoral and intraoral soft tissue examination
  • Dental examination
  • Periodontal examination
  • Review of the patient’s plaque control effectiveness
  • Removal of microbial flora from sulcular or pocket areas
  • Scaling and root planing where indicated
  • Polishing the teeth

These procedures are performed at selected intervals to assist the periodontal patient in maintaining oral health. This is the phase of periodontal therapy during which periodontal diseases and conditions are monitored and etiologic factors are reduced or eliminated. It is distinct from, but integrated with, active therapy. The patient may move from active therapy to periodontal maintenance and back into active care if the disease recurs.

Therapeutic Goals

To minimize the recurrence and progression of periodontal disease in patients who have been previously treated for gingivitis and periodontitis.

To reduce the incidence of tooth loss by monitoring the dentition and any prosthetic replacements of the natural teeth.

To increase the probability of locating and treating, in a timely manner, other diseases or conditions found within the oral cavity.

Treatment Considerations

The following items may be included in a PM visit, subject to previous examination, history, and the judgment of Dr. Stambaugh and her hygienists.

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  • Extraoral examination and recording of results
  • Dental examination and recording of results:
    1. Tooth mobility / fremitus
    2. Caries assessment
    3. Restorative, prosthetic
    4. Other tooth-related problems
  • Periodontal examination and recording of results:
    1. Probing depths
    2. Bleeding on probing
    3. General
    4. Evaluation of furcation invasion
    5. Exudation
    6. Gingival recession
    7. Occlusal examination and tooth mobility
    8. Other signs and symptoms of disease activity
  • Radiographs should be current and based on the diagnostic needs of the patient. The radiographs must permit proper evaluation of the status of the periodontium and dental implants. Radiographs of diagnostic quality are necessary for these purposes.
  • The judgment of the clinician, as well as the degree of disease activity helps determine the need for, the frequency of, and the number of radiographs needed.
  • Assessment of disease status by reviewing the clinical and radiographic examination findings compared with the baseline.
  • Assessment of personal oral hygiene status
  • Removal of sub-gingival and supragingival plaque and calculus
  • Behavior modification:
    1. Oral hygiene re-instruction
    2. Compliance with suggested periodontal maintenance intervals
    3. Counseling on control of risk factors; e.g., cessation of smoking
  • Antimicrobial agents as necessary
  • Surgical treatment of recurrent disease
  • Informing the patient of current status and alterations in treatment if indicated.
  • Consultation with other healthcare practitioners who will be providing additional therapy or participating in the periodontal maintenance program.
  • For most patients with a history of periodontitis, visits at 3-month intervals have been found to be effective in maintaining the established gingival health.
  • Based on evaluation of clinical findings and assessment of disease status, PM frequency may be modified or the patient may be returned to active treatment.
  • The desired outcome for patients on PM should result in maintenance of the periodontal health status attained as a result of active therapy.
  • Inadequate PM or non-compliance may result in recurrence or progression of the disease process.
  • Despite adequate PM and patient compliance, patients may demonstrate recurrence or progression of periodontal disease. In these patients additional therapy may be warranted.