Perio Maintenance Vs Scaling and Root Planing (Deep Cleaning) Vs Prophy

Perio Maintenance Vs Scaling and Root Planing (SRP/Deep Cleaning) Vs ProphyYour oral health has implications for your overall well-being. Not only does advanced gum disease lead to tooth loss, but research has also linked gum disease to other health conditions, such as diabetes and heart disease.

Professional dental cleanings are an essential component of preventing gum disease, but there’s no one-size-fits-all treatment for maintaining healthy teeth and gums. Different patients may require different cleaning procedures, depending on the state of their oral health.

For Patients with Good Oral Health: Regular Cleaning

Brushing and flossing twice a day is crucial, but even if you practice excellent oral hygiene, plaque buildup is still inevitable. If it’s not removed regularly, it can eventually harden into unsightly tartar, or cause gum infections. For patients with healthy teeth and gums, regular teeth cleanings – or prophylaxis – is sufficient to remove plaque and prevent inflammation.

During regular cleanings, a dental hygienist will use a small handheld instrument called a scaler to scrape tartar from your teeth, or an ultrasonic device to shake plaque loose. Prophylaxis takes place on the crowns of your teeth, above the gumline, and most people with good oral health can maintain their smile with twice-yearly prophylactic cleanings.

For Patients with Periodontal Disease: Deep Cleaning

For almost half of the dental patients in the United States, regular prophylaxis isn’t enough to maintain optimal oral health. According to the Centers for Disease Control and Prevention, 47% of American adults aged 30 and over have some form of periodontal disease, a gum infection that can damage the tissue and bone that supports your teeth. The mildest form of gum disease is gingivitis, which causes red, swollen gums that bleed easily. Left untreated, gingivitis can progress to periodontitis, resulting in severe deterioration of the gums and bone, and with time, tooth loss.

Fortunately, there is a proven way to help reverse the effects of mild to moderate gum disease. A 1981 study conducted at the University of Michigan found that scaling and root planing, also known as a deep cleaning, was effective in treating patients with mild to moderate gum disease.

During scaling, your dentist or dental hygienist will remove the plaque and tartar from your teeth, both above and below your gumline, using handheld instruments, ultrasonic instruments, or a combination of both. Once your teeth are cleaned via scaling, the dental practitioner will then perform root planing to smooth out the roots of your teeth. This two-step process creates a better environment for your gums to reattach back to your teeth, effectively closing any loose pockets.

Periodontal Maintenance After a Deep Cleaning

After you’ve undergone a deep cleaning or periodontal surgery you’ll need to keep regular periodontal maintenance visits to maintain your gums and prevent the recurrence of gum disease. A 1984 study in the Journal of Clinical Periodontology showed that harmful, disease-causing bacteria recolonizes underneath the gums as early as one to two months after a deep cleaning. This is why those with a past history of gum disease should return for periodontal maintenance approximately every three months.

During a periodontal maintenance visit, your pocket depths are measured and your periodontal status is reassessed. While standard prophylaxis cleans the crowns of your teeth above your gumline, periodontal maintenance goes a little deeper, slightly below the gumline, since you are more susceptible to plaque and tartar buildup based on your past history of gum disease.

To ensure optimal oral health, and preserve the integrity of your teeth and gums, patients should visit the dentist every three months for periodontal maintenance. However, the exact intervals may vary depending on the precise condition of your gums.

Maintain your Oral Health with help from San Diego Periodontics & Implant Dentistry

At San Diego Periodontics & Implant Dentistry, we offer a periodontal maintenance program that is customized to fit the needs of each individual patient. Dr. Kwok will evaluate your dental history and the overall state of your teeth and gums, and prepare a treatment plan to optimize your oral health. For questions on our periodontal maintenance program, or your dental health in general, please call our office at (619) 543-0905.

3 Responses

  1. Hello,

    I was diagnosed with periodontitis. Three years ago (2021) there was a root planing/scaling completed at a periodontist’s office. Thereafter, a return to my general dentist involved an examination and a cleaning. Although I asked for a “perio-maintenance” cleaning, the hygienist said she could not go below the gum line, even though I had asked for a perio-maintenance cleaning. So, does a perio-maintenance cleaning involve work BELOW the gum line AND includes work (general cleaning) of the teeth ABOVE the gum line, or are they two completely different procedures? Should I toggle between a periodontist’s office and my primary dentist’s office for these cleanings, if the perio-cleaning does not include the prophy? Very confusing…

    Dennis K.

    1. Hi Dennis,
      Yes you are correct in that a periodontal maintenance cleaning involves cleaning above and below the gum line. The intention of a prophylaxis is to only clean above the gum line. For most patients with a history of periodontitis, they alternate between the periodontal office and their general dentist. Hope that helps!

    2. If an examination was performed, the dentist and hygienist should have ascertained that you had a history of periodontal disease with prior deep cleanings. At that point if no active infection was present, a periodontal maintenance is the ONLY treatment that should have been recommended for you. Just so you know, no hygienist should be doing a prophy because it is done to prevent disease and you already have periodontal disease. So, perio maintenance is indicated for you to keep under control and maintain your condition. Furthermore, a hygienist, even in a general practice, is qualified to do perio maintenance so I don’t understand why she could not go below your gum line. Finally, you should never have to “ask” for perio maintenance. A perio evaluation by the dentist/hygienist will reveal your history of perio disease and at that time, “THEY’ should be telling you you need perio maintenance, if know active infection is present. If that isn’t what’s happening, don’t continue your care there.

      A Concerned Hygienist

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