Periodontal Maintenance

Periodontal maintenance (PM) is most commonly utilized for patients who have had active period treatment. It is ongoing treatment for patients with Periodontitis, which is a chronic and non-curable bacterial infection. The objective of PM is to keep the disease under control. Any type of periodontal treatment is ineffective in the long term without an effective PM regimen.*

Is a Prophy the same as a Perio Maintenance?

No, a prophy is a non-therapeutic procedure for the maintenance of a healthy mouth. Prophy is only provided for patients without Periodontitis. It ‘s a procedure to clean above the gum line and is provided at six-month intervals.

Periodontal maintenance is provided every three months. The rationale for three-month maintenance intervals is not arbitrary; it is based on a sound bacterial rationale. When plaque is not removed adequately from the surfaces of the teeth, bacteria invades the plaque  and multiply within three to 12 weeks. This means that by the end of 12 weeks/three months, the perio bugs are flourishing. That’s when we want to reduce their numbers, not one month later or three months later.

Research has shown that patients who undergo active perio treatment of any kind, surgical or non-surgical, and do not have periodontal maintenance at the appropriate interval lose two to three times more teeth and have active perio therapy twice as often as those having maintenance.* Shumaker ND, et al. Periodontal and peri-implant maintenance: a critical factor in long-term treatment success. Compendium Sept. 2009; 30(7):388-406.

Alternating periodontal maintenance and prophys at three-month intervals is inappropriate because the prophys are non-therapeutic and supragingival. This regimen has the same net clinical effect as the perio patient who presents for maintenance every six months. The longevity of favorable perio treatment outcomes is dependent on two factors: the effectiveness of daily biofilm control through home care and patients presenting for maintenance every three months.

Patients treated with alternating PM and prophys will not have the same longevity of favorable therapeutic results compared to perio patients having PM every three months. Understanding the difference between these two procedures and applying them properly will enhance the care we provide for our patients, and that is what it is always about.