We asked our team what the most common questions they get asked at the office are, and “Why do I need a periodontal maintenance, I just want a regular cleaning?” was number one. Patients often feel that dental checkups are always the same. While both regular cleanings and periodontal maintenance are performed as part of the check-up routine schedule, they differ in that one is a preventative measure, and the other is an actual treatment.
Prescribed and Preventative Teeth Cleanings: Understanding the Difference and Why Your Dentist or Hygienist Suggests One Over The Other
“Regular” Standard Dental Cleanings
The dental cleaning that most people think of is clinically called a prophylaxis, a term applied to a preventative care regimen. During a regular teeth cleaning, a dental hygienist or hygiene dentist removes visible plaque and tartar from the visible surfaces of a patient's teeth that has built up above the gum line and polishes the teeth. A regular teeth cleaning is recommended when a patient’s gum tissue is healthy, elastic and has a uniform attachment around teeth. Regular cleanings, which are usually recommended once or twice per year, help prevent bacteria build-up and can prevent oral health problems such as periodontal disease and tooth decay from occurring.
What Is Periodontal Disease?
Periodontal disease, also known as gum disease, is an infection caused by an excessive bacterial build-up, which occurs between the teeth and gums. Periodontal disease is fairly common and affects roughly three out of four patients. When plaque and bacteria are allowed to build up without being removed, it can get pushed beneath the gum line causing pockets between the teeth and gums. When tartar accumulation causes these pockets to reach four millimeters and above periodontal disease is officially diagnosed. Left untreated, periodontal disease can lead to gums that frequently bleed (it’s not the flosses fault) infection, inflammation, bone loss and systemic health problems (diabetes, heart disease, Alzheimer’s Disease). When the dental professional finds these symptoms and diagnosis that patient with periodontal disease, a regular teeth cleaning is no longer the indicated treatment. A special dental cleaning is now required to treat the disease that is active in the patients’ mouth/system.
A periodontal maintenance is similar to a regular teeth cleaning in that it removes tartar buildup from the teeth. Unlike a normal, “regular” preventative cleaning, periodontal maintenance is a treatment prescribed to combat the periodontal disease. It is far more involved than the regular cleaning and involves scaling and root planing. What does this mean? Your dental healthcare provider must now not only remove bacteria and plaque from the visible, easily accessible surfaces of the tooth but also from below the gum surface and deep between the teeth. Healthy gum tissue hugs the necks of the teeth like an elastic turtleneck, tissue that has been impacted by periodontal disease has lost its elasticity and hangs more like a saggy cowlneck.
During a periodontal maintenance appointment, the hygienist or hygiene dentist will remove tartar and plaque build-up from in between your teeth and gums and use instruments to clean the entire length of each tooth, stopping where the gum, root and bone meet. Your dentist or hygienist should be checking your gum tissue, and the size of the periodontal pockets annually, more often once periodontal disease has been detected. If you hear your dentist or hygienist reading number out loud while poking at your gum tissue, this is what they are doing. By carefully monitoring the depth of each pocket in your gums, the dental professional can hopefully diagnose disease early, and irrigate the pockets with antiseptic medications to reduce inflammation or infection if present.
Periodontal maintenance appointments are only scheduled for patients that have been diagnosed with periodontal disease and treated at some point with periodontal scaling and root planing or have had localized periodontal surgery. These types of specialized cleanings are usually recommended every three to four months to prevent the dangerous bacterial growth from returning and maintain gum health.
I Was Diagnosed with Periodontal Disease, Now What?
The first step is to understand the diagnosis. Ask your dentist or hygienist to clarify what they are diagnosing, then schedule your scaling and root planing treatment sooner rather than later. Gum tissue will not heal on its own like a cut on your hand, much like tooth decay gum disease will continue to spread until eradicated. Your dental professional will most likely want to see you about a month after the scaling treatment is completed to check your gum tissue and healing. You are never truly free of periodontal disease once diagnosed. Your gum tissue can become healthier and more elastic but you will still always be more prone to active periodontal disease and require periodontal maintenance rather than a “regular” preventative cleaning from then on.
My Insurance Says That I Have 2 Free Cleanings Per Year, That’s All I Want.
Firstly, those cleanings that are included with your dental coverage are not free. You and your employer are paying for them through your monthly premium. Secondly, if you are diagnosed with periodontal disease you don’t want just a regular cleaning. If you have already been through a “deep cleaning,” or scaling and root planing you probably don’t want to go through it again. While usually not awful, it’s not super pleasant either, and insurance only covers a portion of this type of treatment, so you had an out of pocket expense too. Most insurance companies are finally starting to listen to dentists when it comes to periodontal health and are covering a part of the cost of periodontal maintenance. In some cases, they are even covering periodontal maintenance four times per year. While it is usually not covered at 100% like the “free” cleanings, it is generally covered at 80% or above, and a small out of pocket responsibility is definitely more enjoyable than periodontal treatment left unchecked or periodontal surgery.
We hope that this answered your questions about the difference between periodontal maintenance and a “regular” preventative cleaning. If it didn’t, use this post as a tool to get further clarification from your dentist.
Dr. Edward L. Loev, DMD has been caring for his patients for decades from his dental office that overlooks San Francisco’s Union Square. He and his team take pride in providing the best quality and most gentle dental care available. Over the years, they have transformed 100’s of “non-dentist” people into people who actually enjoy their visits and take pride in their smiles. A dental relationship should be a positive one; make sure that you feel comfortable and cared for by your dentist if the experience is “meh…” then ask friends, family, and colleagues about their dentist. If you are in the San Francisco Bay Area and are in need or want of a new dentist, Dr. Loev and his team would love the opportunity to meet you and earn your trust and loyalty call them at 415-392-2072 or schedule an appointment online today.