Periodontal maintenance

Maintenance corresponds to the phase following the initial treatment of your periodontal disease. It is as important as the initial treatment. If it is not done correctly, the bone tissues and the alveolo-dental ligament will continue to deteriorate, as the different sites will become reinfected.

It must be carried out by a specialist: Axelsson and Lindhe demonstrated in 1981 that when maintenance procedures were carried out by dentists whose specialty it is not, periodontitis recurred. They also demonstrated in 2004 that if performed correctly, it minimized the risk of cavities and loss of dental attachment.

It is carried out in the practice using an innovative protocol called G.B.T (Guided Biofilm Therapy), using the latest generation devices, allowing perfect elimination of dental plaque.

Each periodontal maintenance session should include a reassessment of the state of health, a clinical examination, an analysis of individual plaque control and a deep removal of plaque and tartaric spicules.

A patient treated without follow-up is a patient at high risk of recurrence.

Long-term success can only be achieved with regular follow-up.

Follow-up is adapted to each patient, depending on their periodontal risk and their ability to maintain effective and lasting plaque control.

The objectives of periodontal maintenance

• Help the patient to control the bacterial load by personalized advice on his plaque control. Control risk factors: dental hygiene, tobacco, occlusion, stress, immunity, etc.
• Detect any pathology having an effect on the oral cavity.
• Adapt or re-adapt the pace and content of follow-up in relation to changes in risk factors (prognosis indicator).
• Monitor the dentition (caries, occlusion, prosthesis embrasures, overhang, etc.).
• Perform scaling/surfacing/polishing/irrigation.
• Decide on the need for retreatment in case of recurrence based on bleeding on probing, deepening of pockets or presence of suppuration.

This retreatment may be a root surface under anesthesia or periodontal surgery.

The stages of a periodontal maintenance appointment

• At the beginning of the session: consultation of x-rays (panoramic and retro-aleolar assessment),
• updating of the patient’s medical questionnaire, new pathologies (eg diabetes), or new habits (stress, tobacco, alcohol, etc.), questioning of the patient on his condition (pain, bleeding, mobility, discomfort, etc.)
• Clinical examination with evaluation of periodontal health criteria
• Personalized information on plaque control techniques

Professional plate control mechanical phase

• It consists of scaling, root planing, polishing and subgingival irrigation using antiseptics.
• Ultrasonic scalers then surfacing with very fine curettes, residual pockets must be debrided, use of air polishers with different powders.

Conclusion

Each periodontal follow-up session should include a reassessment of the state of health, a clinical examination, an analysis of individual plaque control and a deep removal of plaque and deposits.

Reinforcement of plaque control by the patient is a key element of follow-up, random compliance or drop-out from follow-up by the patient affects treatment success.

Any recurrence detected during follow-up must be taken care of immediately. Many scientific studies show the relationship between periodontal health and general health.

Indeed, periodontitis acts as a risk factor for myocardial infarction and cardiovascular diseases, for type 2 diabetes, for the birth of premature children and for rheumatoid arthritis.