TL;DR
- Periodontal maintenance is a deep cleaning for people who’ve had gum disease. It goes deeper than regular cleanings to remove bacteria you can’t reach at home.
- You need it every 3-4 months. Bacteria regrow in about 90 days and can start damaging bone again.
- Persistent bad breath, bleeding or swollen gums, gum recession, tooth sensitivity, loose or shifting teeth, or pus/discharge along the gumline may indicate active periodontal disease or that your maintenance plan is not being followed.
- The procedure includes a thorough gum exam, deep cleaning, root planing if needed, antibacterial treatment, polishing, and personalized home-care guidance.
- Skipping visits causes serious problems like gum disease coming back, bone loss, loose teeth, and links to heart disease and diabetes.
- Gum disease is manageable, not curable. Periodontal maintenance keeps it under control and prevents it from getting worse.
Periodontal Maintenance: An Overview
When one thinks about dental health, often our focus goes to tooth cavities, whitening, and alignment. But the true foundation of a healthy smile is hidden in the gums. Periodontal health is important, and when it is compromised by disease, it requires a special kind of long-term care.
If you’ve been treated for any form of gum disease, from gingivitis to advanced periodontitis, your periodontist probably suggested a new cleaning schedule along with medicines or other adjuncts. This specialized plan is called periodontal maintenance. Let’s take a closer look at what it is.
What is Periodontal Maintenance?
Periodontal maintenance is a professional dental cleaning and monitoring program designed for patients with a history of periodontal disease. Its purpose is to keep the condition in remission and prevent further progression by providing targeted, ongoing care.
Periodontal maintenance is not the same as a regular cleaning. Here’s the key difference:
- A Regular Cleaning (Prophylaxis): This procedure is preventive. It’s intended for patients with normally healthy gums. The focus is on the removal of plaque, calculus (tartar), and stains from above and just slightly below the gumline. This type of cleaning is typically recommended every six months.
- Periodontal Maintenance: This is a therapeutic procedure. It’s for patients who have already been treated for periodontitis, for example, with scaling and root planing (also known as a “deep cleaning”) or gum surgery. Because periodontitis creates deep “pockets” between the teeth and gums, this procedure targets those areas more thoroughly. The aim is to remove bacteria from within these pockets and prevent the disease from becoming active again.
Signs You May Need Periodontal Maintenance
If you’ve already been diagnosed with gum disease, then your periodontists have probably placed you on a periodontal maintenance schedule. It’s vital that you stick to this schedule, even if your gums feel healthy.
As per our experts at Periodontal Specialists, the following symptoms might indicate you either have active gum disease or that your current maintenance plan is not being followed:
- Persistent Bad Breath (Halitosis): This isn’t just “morning breath.” It’s a stubborn, unpleasant odor caused by the particular bacteria that cause gum disease.
- Bleeding or Swollen Gums: Healthy gums should never bleed when brushing or flossing. Bleeding, redness, or puffiness are early signs of inflammation and infection.
- Gum Recession: If your teeth seem longer than they used to, it’s a common indication of gum recession, where the tissue pulls away from a tooth and exposes a sensitive root.
- Tooth Sensitivity: Due to the recession, when the roots are exposed, you may experience a sharp pain while consuming foods and drinks that are hot, cold, or sweet in nature.
- Loose or Shifting Teeth: This is a late-stage, serious sign. It means the bacteria have destroyed enough of the underlying bone that the teeth are no longer firmly supported.
- Pus or Discharge: White or yellow discharge along the gumline clearly signals an active periodontal infection. This symptom demands immediate attention from your periodontist.
If you notice any of these signs, you must consult a dental professional immediately.
What to Expect During a Periodontal Maintenance Appointment?
A periodontal maintenance cleaning is more thorough and detailed than a standard cleaning. While the exact approach varies based on each patient’s needs, the procedure typically includes the following steps:
1. Examination and Pocket Depth Measurement
Your visit always begins with a thorough assessment. Your hygienist or periodontist will:
- Visually inspect your gums for any inflammation, bleeding, or recession.
- Check your medical history for any conditions that may influence gums, such as diabetes.
- Perform periodontal pocket measurements. A small probe will be used to very gently measure the depth of the sulcus, which is the small space between your teeth and gum. Healthy pockets are 1-3mm. Pockets greater than 4 mm in depth indicate active disease, and over time, these measurements will reveal whether your condition has stabilized, improved, or worsened.
2. Plaque and Tartar Removal (Subgingival)
- This is the “cleaning” part. Your periodontal specialists will use special ultrasonic scalers and fine hand instruments to carefully remove plaque and tartar/calculus, both above and below your gum line.
- The primary focus is to clean the bacteria out of those deeper pockets that you cannot reach at home.
3. Root Planing (If Necessary)
- If your dentist finds just a few areas of new tartar buildup on the root surface or evidence of active infection (such as a 5mm pocket which was previously 3mm), they may do “spot treatment.”
- This is selective root planing that smooths the surface of the root to allow the gum tissue to reattach and to prevent bacteria from sticking.
4. Antibacterial Rinsing or Polishing
- Following the scaling, your mouth may be flushed with an antimicrobial rinse, such as chlorhexidine, to kill remaining bacteria. In some cases, a localized antibiotic such as Arestin may be placed directly into a particularly stubborn pocket.
- Finally, your teeth will be polished to remove stains and create a smooth surface that is less likely to trap new plaque.
5. Oral Hygiene Practices Review
Your hygienist reviews your home-care routine and provides tips specifically for you on brushing, flossing, or using other tools such as interdental brushes, a Waterpik, or prescription rinses.
Frequency of Visits
Periodontal maintenance patients require more frequent visits, which usually occur every 3-4 months. This 3-4 month interval is clinically proven. It takes about 90 days for the aggressive bacteria that cause periodontitis to grow back to a level where they can start destroying bone again. Because your dental team is seeing you every 3-4 months, they can disrupt and remove these bacterial colonies before they cause more irreversible damage.
Risks of Skipping Periodontal Maintenance
The risks are severe and often irreversible:
- Recurrence of Gum Infection: Without proper maintenance, gum disease can become active again. Bacteria can recolonize the periodontal pockets, resulting in inflammation, bleeding, and, in more advanced cases, pus formation.
- Irreversible Bone Loss: This is the most considerable consequence. Active periodontitis can destroy the alveolar bone that supports your teeth. Your body cannot replace this bone naturally.
- Tooth Mobility and Loss: As the bone disappears, your teeth lose their support. They can become loose, shift, and eventually, either fall out or need to be extracted.
- Greater Risk of Systemic Health Issues: Gum disease is linked to an increased risk of:
- Heart disease and stroke.
- Impaired blood sugar management among diabetic patients.
- Respiratory infections.
- Adverse pregnancy outcomes include pre-term birth.
- More Complex and Expensive Treatment: Skipping a periodontal maintenance visit may seem minor, but delaying care often allows the disease to advance. When this happens, you may eventually require more extensive treatment, such as full scaling and root planing, which is more time-consuming and significantly more costly than routine maintenance.
Final Thoughts
Periodontal maintenance and timely treatment can halt gum disease, allowing you to maintain a healthy and confident smile for many years. Your journey to healthier gums starts with expert care.
At Periodontal Specialists, we’re dedicated to caring for you at every stage of periodontal disease, using the latest technology and trusted methods to ensure your best health. From non-invasive laser therapy to advanced surgical interventions, our caring team offers personalized treatment just for you.
Feel free to reach out to our friendly periodontists in Rochester, Northfield, Red Wing, Owatonna, or Winona, today and take a positive step towards better oral health!
Frequently Asked Questions (FAQs)
How often should I schedule periodontal maintenance visits?
Patients typically schedule every 3-4 months, depending on gum disease severity, response, and home care.
Is periodontal maintenance painful?
Usually not. It may feel more pressure or scraping, but your hygienist can use numbing gels or an anesthetic for comfort.
Can gum disease recur after treatment?
Yes. It’s a chronic condition that can be managed but not cured. Lifelong maintenance helps prevent relapse.
What if I skip maintenance appointments?
If you skip periodontal maintenance, bacteria can regrow, leading to disease recurrence, bone loss, and even tooth loss.
How much does periodontal maintenance cost?
Periodontal maintenance typically costs more than a regular cleaning but less than active treatment. In the US, the price usually ranges between $150 and $250 per visit, depending on the clinic and the complexity of your care.
