Periodontal Maintenance & Therapy
A periodontal maintenance procedure (PMP) is defined as a procedure that is recommended following periodontal treatment (such as scaling and root planing) and continues at varying intervals, determined by the clinical evaluation of the dentist.
These intervals can be as frequent as every two months and they can be extended as long as six months, depending on the patient. Keeping up your PMP interval is important because periodontal disease can recur without adequate follow-up.
PMP includes removal of plaque and tartar above and below the gums, scaling and root planing of specific areas, and polishing. PMP is always completed following active periodontal treatment such as scaling and root planing or more extensive gum surgery.
Scaling and Root Planing
Scaling and root planing is a special type of treatment that goes deeper below the gum line to remove contaminated debris and bacteria, most often performed on patients with active periodontitis.
This seems to be a procedure that causes much confusion for patients trying to understand the difference between "just a cleaning" and scaling and root planing, and the need/reason for this procedure.
A professional polishing, or prophy, removes only the soft sticky plaque and hard crusty calculus that is above the gum line on the crown of the tooth. Scaling and root planing is done to remove soft sticky plaque and hard crusty calculus that is loaded with bacteria, around and below the gum line on root surfaces. It is a method of treating gum disease when pockets formed around the teeth have a measurement of greater than 3mm and there is evidence of bleeding and tissue attachment loss.
Scaling is a procedure that meticulously removes contaminated biofilm, plaque, calculus, microorganisms and toxins from around the gum line down to the bottom of each periodontal pocket, in order to obtain a healing response.
Root planing involves smoothing the root surfaces of your teeth with thin instruments so gum tissue can more firmly reattach to roots that are clean and smooth, to prevent tooth loss and sensitivity problems. This procedure makes it more difficult for plaque, calculus and bacteria to accumulate along these root surfaces.
Because this procedure goes deeper than a regular cleaning, your mouth may be numbed. The cleaning may take one to six visits to complete. Depending on the extent of the disease, you may need one or more quadrants of the mouth to be treated with scaling and root planing.
Why might root planing be necessary?
Home Care After Scaling and Root Planing
Rinse with warm salt water every few hours (1/2 tsp. salt in 8 oz. water) for the remainder of the day to encourage healing and sooth discomfort. Be careful not to bite or chew your lip, cheek or tongue while they are numb. Avoid chewing for 2 hours after this procedure or until numbness has worn off. Keep your fingers and tongue away from the areas that have been treated. Take Tylenol or ibuprofen according to directions on the manufacturers label for a couple of days to help with the discomfort; do NOT take aspirin because it may prolong bleeding.
Rinse your mouth with Closys or Chlorhexidine, if prescribed by your dentist, to reduce oral bacteria. Do not smoke or chew tobacco for 72 hours after the procedure to allow for healing. Gently brush and floss your teeth after each meal. How you care for your teeth and gums at home after treatment is critical to reducing the risk of recurring periodontal disease.