Maintenance is the corner stone of every dental treatment plan particularly a periodontal one. Periodontal patients with strict maintenance programmes have better outcomes in terms of tooth retention and dental implant survival. Is this the stuff of legend? Is this really necessary given the effectiveness of modern dentifrices and brushing aids?
The answer is a resounding YES!
A successful maintenance program needs:
1-an accurate periodontal diagnosis which a dentist or periodontist can provide
2-a dental state that is stable ie. no pockets greater than 5mm and no caries
3-a clear well thought out prescription to follow
The outcomes of maintenance programs have been studied extensively but a successful maintenance program is yet to be defined. One can safely say that the primary outcome variable for a successful maintenance program is tooth/implant loss. Cobb et al, Lang et al, Tonetti et al and Fardal et al as well as many others demonstrated higher tooth/ implant loss when:
- High levels of inflammation (exemplified by erythema, bleeding on probing and pocketing more than 5mm) is unaddressed
- Plaque control is poor
- Maintenance program is not adhered to
- Smoking persists
- Treatment or maintenance of high risk groups is not overseen by a periodontist
The following are examples of excellent stability and bone regeneration following periodontal treatment under my care and followed by a strict hygienist led maintenance program. All this treatment was carried out within the auspices of Antwerp Dental Group in Cambridgeshire and The Implant Experts in Kent. I must congratulate my colleagues Katie Collier, Roberta Wright, Amie Holder and Erika Sabkauskiene for being truly world class hygienists without whom these impressive results would be impossible.