Long term maintenance

Refer to Section 6 of the full guidance

The key to successful prevention and treatment of periodontal diseases is life-long effective personal oral hygiene.

Life-long preventive professional care may be necessary for the patient to maintain healthy gingival tissues.

Regular reinforcement of the importance of effective plaque removal and, where applicable, smoking cessation advice is also required.

In patients who have no history of periodontitis, each routine appointment should comprise assessment and, if appropriate, treatment as follows:

  • Carry out an oral examination, including assessment of plaque levels.
  • Carry out periodontal screening at every routine recall appointment.
  • Use Oral Hygiene TIPPS to address inadequate plaque removal. Where applicable, give smoking cessation advice.
  • Remove supra-gingival plaque, calculus and stain, and if necessary subgingival deposits using an appropriate method.
  • Assign an individual risk level based on the patient’s medical history and oral health status. Explain to the patient what this means for them and schedule the next appointment based on the risk level.

Patients with periodontitis who have successfully responded to treatment, signified by marked improvement in oral hygiene, reduced bleeding on probing and a considerable reduction in probing depths from baseline, are maintained by a long term programme of supportive therapy.

Each recall appointment should comprise assessment and treatment as follows:

  • Carry out an oral examination, including assessment of plaque levels.
  • Ensure that full mouth periodontal charting is performed annually in patients who scored BPE 4 in any sextant at baseline and in patients who scored 3 in more than one sextant at baseline.
    • Where the patient scored BPE 3 in only one sextant, carry out full periodontal charting of that sextant
  • Use Oral Hygiene TIPPS to address inadequate plaque removal. Where applicable, give smoking cessation advice.
  • Remove supra-gingival plaque, calculus and stain using an appropriate method. Carry out RSI at sites of ≥4 mm probing depth where sub-gingival deposits are present or which bleed on probing. Local anaesthesia may be required.
  • Assign an individual risk level based on the patient’s medical history and oral health status. Explain to the patient what this means for them and schedule the next appointment based on the risk level.

N.B. Patients with periodontitis who respond successfully to non-surgical treatment and supportive periodontal therapy (probing depths of ≤3 mm and minimal bleeding on probing) may be transferred to dental prophylaxis. These patients no longer require annual full periodontal charting but should any recurrence of disease be detected by BPE screening, further non-surgical and supportive therapy will be required.