Periodontal Maintenance

A regular cleaning, a root planing procedure and periodontal maintenance are not the same. So what are the differences?

What is periodontal maintenance?

Periodontal disease is very common, but does not always have distinct symptoms. It is an inflammation and infection of the supporting structures of the teeth (gums, bone, ligaments, root surfaces) that eventually results in the loss of teeth. You may notice that your gums bleed easily, that you have a bad taste in your mouth, that your gums appear red or swollen, that your teeth appear longer or have shifted. Or you may not notice anything at all.

If you have periodontal disease, you may require root planing to remove diseased deposits from the roots of your teeth. Other treatment, including surgery, may be required. After the disease process is under control, a regular cleaning is not appropriate anymore. Instead, you will require special on-going gum and bone care procedures, also known as periodontal maintenance to keep your mouth healthy.

What is a periodontal maintenance procedure?

The American Dental Association describes periodontal maintenance as a procedure for patients who have previously been treated for periodontal disease.. . (which) continues at varying intervals, determined by the clinical diagnosis of the dentist, for the life of the dentition (or the life of the teeth)... (and) includes the removal of the supra and subgingival microbial flora and calculus, site specific scaling and root planing.

The removal of the supra and subgingival microbial flora and calculus means that any deposits and/or bacteria (microbial flora) that are in place either above or below the gum-line are scaled away.

Root planing means that root surfaces, both above and below the gum line are scaled and smoothened to remove calculus, and diseased cementum and/or dentin.

A periodontal maintenance procedure is not the same treatment as a regular cleaning even though a hygienist may perform both services. A periodontal maintenance procedure, also known as supportive periodontal treatment (SPT), includes, but may not be limited to:

• An update of your medical and dental history
• X-ray review
• Mouth/face exam-inside and outside including cheeks,lips, tongue, gums, throat
• Tooth examination (by the dentist)
• Gum and bone examination (periodontal probing around each tooth to check for bone loss)
• Review of home care
• Scaling and root planing, as needed
• Polishing of teeth as needed
• Gums and pocket irrigation with medicine, as needed

(The dentist's exam is usually separate from the periodontal maintenance and billed separately, as well).

Typically, an interval of three months between appointments is effective, but more frequent appointments may be needed.

As in many other chronic conditions, successful long-term control of the disease and prevention of tooth loss depends on continual, and possibly life-time maintenance.

I understand that I need to come frequently for periodontal maintenance. How often will my insurance pay?

Many insurance plans pay for periodontal maintenance twice a year, even though most patients require appointments four times a year.

Remember that insurance plans limit the number of exams, cleanings, and periodontal maintenance appointments that they will cover because these are the types of treatments that many people need to have frequently. The good news is that any amount paid reduces what you have to payout of your own pocket. It helps!

If my insurance plan will only pay for periodontal maintenance twice a year, why should I have it done more often?

Your insurance plan can help you pay for the treatment that you need, however it was never designed to pay for everything. Most plans typically pay a minimum regardless of what you might need as an individual. It is a mistake to let benefits be your sole consideration when you make decisions about your dental condition. People who have lost their teeth often say that they would pay any amount of money to get them back. Your teeth, smile, attractiveness, ability to chew and enjoy food, and general sense of well being are dependent on your dental health. It is worth the extra time and expense to keep your teeth for a lifetime.

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