Periodontal maintenance (PM) is a specialized form of professional dental care designed for individuals treated for periodontitis, a serious gum infection. This ongoing care is distinct from a standard cleaning and is recommended once a patient has completed the initial phase of treatment, such as scaling and root planing. The purpose of this routine is to prevent the recurrence or progression of this chronic condition, which damages the soft tissue and bone supporting the teeth. Understanding what PM involves helps patients take a proactive role in preserving their oral health.
Defining Perio Maintenance and Its Purpose
Periodontal maintenance is a therapeutic procedure specifically prescribed for patients who have already undergone treatment for periodontitis, a disease characterized by the loss of the bone that supports the teeth. The procedure is not a preventative measure but a management strategy for a diagnosed chronic condition. It begins immediately following the active phase of periodontal treatment, whether that was non-surgical scaling and root planing or surgical intervention.
The primary goal of maintenance is to monitor and sustain the stability achieved after the initial therapy. This involves disrupting the bacterial biofilm from reforming in the deep pockets around the teeth. By removing plaque and calculus from both above and below the gumline, PM helps control inflammation and prevents further loss of the periodontal attachment and supporting bone. Maintaining this stable state is important because periodontitis is a chronic condition that can exhibit bursts of disease activity if left unmanaged.
How Perio Maintenance Differs from Routine Cleanings
The fundamental difference between periodontal maintenance and a routine adult prophylaxis lies in the patient’s underlying diagnosis. A prophylaxis is intended for patients with healthy gums and no history of bone loss, focusing on removing plaque and calculus primarily from above the gumline. PM, conversely, is reserved for patients who have a documented history of periodontitis and have completed active therapy.
The scope of the cleaning is significantly different, reflecting the disease status. A standard prophylaxis concentrates on cleaning the clinical crown, whereas PM involves cleaning deeper into the gingival sulcus. PM specifically targets the root surfaces below the gumline where disease-causing bacteria reside, requiring specialized techniques and instruments.
Another distinction is the recommended frequency. Routine cleanings are generally recommended twice per year, but PM is advised every three to four months. This more frequent schedule is necessary because the pathogenic bacteria responsible for periodontitis can recolonize the deep periodontal pockets within approximately 90 days.
The Steps of a Perio Maintenance Appointment
A PM appointment begins with a comprehensive assessment to evaluate the current health status of the tissues. The dental professional updates the patient’s medical and dental history and performs a clinical periodontal examination. This examination includes measuring and charting the periodontal pocket depths around each tooth to check for stability or signs of disease recurrence.
Following the assessment, the therapeutic cleaning portion begins. Specialized instruments, including fine hand curettes and ultrasonic devices, are used to carefully remove bacterial plaque and calculus from both the crown and the root surfaces below the gumline. This process is often referred to as site-specific scaling and root planing, focusing on areas where pockets are deep or inflammation is present. The goal is to physically disrupt the subgingival biofilm that drives the inflammatory response.
The appointment concludes with polishing the teeth to remove stains and smooth the surfaces, making it more difficult for plaque to adhere. Fluoride application may also be included to help prevent root surface decay, a common concern in patients with gum recession. The professional also reviews and reinforces the patient’s home oral hygiene techniques, which are necessary for maintaining results between visits.
The Long-Term Role in Managing Periodontal Disease
Periodontitis is a chronic inflammatory disease that can be controlled but not fully cured. Therefore, periodontal maintenance is not a temporary treatment but a necessary, long-term commitment. Consistent compliance with the recommended 3-4 month PM schedule is essential to successfully managing the condition.
The supportive therapy actively works to prevent the disease’s recurrence, which is the primary risk for patients with a history of periodontitis. Stability achieved through initial therapy can be maintained over many years, but disease progression is linked to poor compliance with the supportive care schedule. Discontinuing PM or extending the time between visits allows pathogenic bacteria to flourish, increasing the risk of inflammation, further bone loss, and eventual tooth loss.