Longterm clinical studies showed that patients who received regular supportive periodontal therapy are more likely to retain their teeth than patients who received sporadic care or who dropped out of care completely.
Supportive care comprises the following:
- Risk Assessment
- Maintenance debridement / maintenance clean
- Localised re-treatment as required under local anaesthesia
- Home care and lifestyle advice
- Revision of toothbrushing techniques
- Setting the recall cycle using the risk assessment profile as reference
- Decide if referral to the periodontist is warranted
How often should I attend?
It depends. If you are at high risk of deterioration then you may see your hygienist once very 8 weeks whereas low risk patients may only see their hygienist on an annual basis. Regular maintenance visits also serve as a screening visit where potential problems are noted and managed before they develop into acute problems. Re-infection of the gums is detected at an early stage so that any necessary treatment can be arranged promptly. If there are any changes in your lifestyle or other risk factors for disease you may be advised to reduce or increase the number of visits per year.
Can I see my family dentist or his/her hygienist for supportive periodontal therapy?
The short answer is yes you can but here at PerioCARE we see severe disease on a daily basis and our systems are designed to meet your clinical needs. All hygienists and dentists are trained in the management of periodontal diseases but there are other considerations in the delivery of optimum supportive care. Whom you should see for maintenance is determined on a patient by patient basis. The ideal scenario is that you are sufficiently stable periodontally that it really doesn't matter whom or where you receive your maintenance care so long as you attend these visits on schedule. Nowadays it is quite common for many patients to be in a shared care or co-management program. The periodontist would provide a prescription for supportive periodontal care. It is not unusual for someone who normally attends 4 times a year or once every 3 months to require one slightly longer appointment once a year with us with the remainder appointments with their dentist, much like a "mini-spring clean"
In cases of re-infection or deterioration your hygienist or dentist will most probably refer you back to a periodontist for assessment and further treatment. A structured maintenance program will greatly reduce the need for re-treatment and if re-treatment is indicated any treatment is usually confined to one or two sites.
Our patients have a full mouth re-evaluation with Dr. Soo at least once every 24 months to update their periodontal treatment plan.
Broadly there are three types of periodontal patients based on clinical needs.
- Those who have straightforward problems and have a great response to periodontal therapy. These patients are highly committed to their daily toothbrushing routines. These patients are often very well managed with their dentist (or the dentist's hygienist) after completing a course of care with us.
- Patients with medical issues, complex prosthetic plans, difficult anatomy, highly susceptible to periodontal infections and who may have inconsistent homecare are best managed at a specialist periodontal practice. Any deviations from a very structured and prescriptive supportive care will result in deterioration of the gums and bone and possibly loss of the tooth or the dental implant. Any prosthetic work on top of the natural teeth or implants will thus be affected.
- Patients who are somewhere in between the first two groups. They are a mixed bag and at different time points they may have very different clinical needs. So that for a period of time they may find themselves well looked after at the dentist's and at other times they require specialist care.
Similarly there are three types of dental practices based on their in-house systems for hygienist care.
- There are some great practices who have integrated hygiene systems and equipment. These practices are well placed to provide supportive care for Patients Type I and III above.
- Other practices prefers philosophically to out-source periodontal maintenance for moderate to high risk cases entirely so that they can focus on other parts of the patient's treatment plan.
- Practices who choose to provide supportive care on a case by case basis.
Individual patient preference
Many of our patients request to see us for supportive periodontal care even though their clinical needs may be relatively straightforward as they would like peace of mind and an assurance that their dental prostheses attached to the teeth and implants will be retained for as long as possible. It is important to us that your family dentist and specialist prosthodontist are involved in your care so if you are seeing us for all of your maintenance we will provide a copy of your clinical notes to your dentist/prosthodontist.
The ideal scenario is that you are sufficiently stable periodontally that it really doesn't matter whom or where you receive your maintenance care so long as you attend these visits on schedule.