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Chapter 22: Periodontal Maintenance Therapy (Components of Periodontal…
Chapter 22: Periodontal Maintenance Therapy
Refractory periodontal disease
Occurs when a patient who has been treated for periodontal disease fails to remain in a healthy perio state. Patients may experience refractory due to inadequate home care or treatment. Presence of systemic implications may also influence this.
Reflection: Friends of mine have been able to quit smoking cigarettes but not permanently and that is due to refraction.
Objective of Periodontal Maintenance
Prevent or minimize recurrence of periodontal disease
Prevent or reduce incidence of tooth or implant loss
increase the probability of locating and treating other conditions found in the mouth
Preserve the health, comfort, and function of the teeth.
Reflection: Objectives allow us to define our role in each task that we set out to accomplish. Objectives for perio maintenance allow us to design and reach goals for patients
Components of Periodontal Maintenance Vist
Dental examination and periodontal assessments
Radiographic review
EOIO exam
Oral hygiene evaluation and education
Update medical and dental history
Review of the patients biofilm control efficacy
Removal of dental bio film, both supra and subgingival. Root debridement where needed and adjunctive therapy if needed.
Reflection: At our clinic, we follow these same steps for each patient whether patient is in periodontal maintenance or receiving oral prophylaxis treatment.
Treatment: Recurrent Periodontal Disease vs Well Maintained Periodontium
In recurrent periodontal disease the following symptoms are shown are likely seen
Bleeding on probe
Increase tooth mobility
continued soft tissue attachment loss
Suppuration is also noticeable
Reflection: It is important to tell if a patient has recurrent periodontal disease as there may be an underlying cause. Referral may be necessary if nonsurgical treatment alone does not reduce periodontal disease.
Frequency of Care
Determined on an individual bases
Severity of treatment, patient compliance, home care and systemic health play a major role
Reflection: My recare interval is 6 months because I am at low risk for periodontal disease with low severity treatment
General Dentist and Periodontist Relationship
Patients can be monitored by both their general dentist and periodontist but must visit their periodontist once a year for perio maintenance appointments
Reflection: Seeing a dermatologist as well as a primary care provider can be similar to visiting general dentist and periodontist for oral health.