Understanding the Importance of Maintenance Therapy

Our gum maintenance therapy program consists of four main stages:

  • Re-assessment: This involves assessments of the periodontal status, including repeat measurements of pockets, bleeding, recession, mobility and oral hygiene levels.
  • Diagnosis: Based on the measurements taken, we can diagnose the disease that may have relapsed, or detect a new disease. By complying with recommended maintenance intervals, this can be found early, thereby avoiding the need for extensive repeat treatment.
  • Treatment: Any remaining pockets (either existing or relapsed) are re-scaled, sometimes with the use of local anaesthetic. Occasionally, medicaments are placed in the pockets to help them heal. General scaling of the whole mouth is also carried out. Oral hygiene is re-instructed and re-inforced to help keep you motivated. Occasionally, a site still gets worse and just scaling and maintenance are not enough to control it – so alternative treatments may be suggested.
  • Risk Evaluation: Based on the measurements taken and assessments carried out, risk evaluation is performed to provide you with a recommendation of how long a gap should be left before the next maintenance visit.

Why Is It Needed?

Imagine your tooth support (gum, bone and ligament) are like a car or a house – they need constant servicing and looking after to run smoothly and prevent breakdown. All research shows that without maintenance, also known as supportive periodontal therapy (SPT), you have a much higher chance of relapse. This would, therefore, lead to the need for repeat intensive treatment and the risk of further tooth loss.

Despite your best efforts with oral hygiene, there is always a risk of relapse of the condition. Remember, gum disease is not usually painful, so you are unlikely to notice this yourself. SPT allows for early detection and treatment, thereby helping maintain teeth for as long as possible and avoid the need for repeat treatments.

If you have pockets remaining after treatment, no matter how well you clean, there would still be some areas that accumulate plaque (you can only clean up to 3mm below the gum line). Therefore, these pockets need to be scaled regularly to prevent them from deteriorating. If they do get worse, you run the risk of further bone and tooth loss, the decay of the root surfaces and loss of tooth vitality (the tooth may die).

Who Does It?

In most cases, evidence shows that SPT carried out, or at least led, by a periodontist is the most effective. Frequently, we advise the dentist or their hygienist to carry out some maintenance at intervals with the need for a further assessment with the periodontist in between (so that we can make appropriate diagnoses and risk assessments).

How Often Is It Needed?

This is very prescriptive to individual cases. Typically, it starts at three months and gradually extends to every four, then six, then 12 months depending on how stable the condition remains between these visits. Likewise, if the condition deteriorates again, maintenance visits can be brought closer together to achieve and maintain periodontal stability.

What Happens If I Don’t Comply?

You stand a very high chance of needing to have extensive treatment carried out again, and you may not always respond as well as the first time. This is because each time you restart a program of periodontal therapy, you lose bone around the teeth. Each time you don’t see a periodontist, the chances are the disease is worse than the first time and therefore, the overall prognosis is poorer because the disease is more advanced to start with.

What Can I Do If I Have Already Lapsed?

Just contact the periodontist and start again – it may not be too late! If you are concerned about periodontal disease, give us a call on 020 8506 0701, and we will be able to pass on more information to you. You can also contact us to arrange a visit to our Essex clinic.

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