If you’ve recently had a deep cleaning, you may be wondering when you should plan your next routine checkup and prophylactic (preventative) cleaning. What most people don’t realize is that from here on out, and almost indefinitely, they’ll need to plan for a special type of periodontal cleaning planned at more frequent periodontal maintenance visits. The ultimate goal is to maintain your oral health and prevent disease relapse or progression.

What is Periodontal Maintenance?

A periodontal maintenance cleaning is a special type of teeth cleaning that is provided to patients who have been diagnosed with periodontal disease and have already undergone a scaling and root planing, which is a special type of periodontal cleaning for someone with active gum disease. The goal of a periodontal maintenance cleaning is to maintain the health of the gums and bone and to prevent the disease from recurring. 

Perio maintenance cleanings typically involve more frequent visits than a regular preventative cleaning. 

Periodontal Maintenance vs. Routine Dental Cleanings

A regular dental cleaning, also known as prophylaxis cleaning, is a routine and prevention-based professional teeth cleanings that is done to prevent gum disease and keep your smile healthy. Routine cleanings typically involves the removal of plaque and light tartar buildup, as well as polishing away surface stains. This type of cleaning is completed by your dental hygienist and recommended for healthy individuals who have no signs of periodontal disease, such as bone loss or deep gum “pockets.”

On the other hand, a periodontal maintenance cleaning is a type of cleaning that is provided to patients who have been diagnosed with periodontal disease in the past and have already undergone treatment such as scaling and root planing. The goal of periodontal maintenance cleaning is to maintain the health of the gums and prevent the disease from recurring or additional tissue detachment from taking place. This type of cleaning typically involves more frequent and thorough cleaning—including under the edges of the gums inside of the pockets—as often as every 3-4 months. 

What To Expect From A Periodontal Maintenance Procedure

A periodontal maintenance cleaning may include isolated areas of scaling or root planing, but the focus is to clean out the periodontal pockets around the teeth. At the completion of the periodontal cleaning, the teeth are usually polished, similar to a regular cleaning. The frequency of periodontal maintenance cleaning is determined by your dentist or hygienist, depending on the patient's condition and progress. 

Most patients need to schedule their perio maintenance visits every 3-4 months. The length of these therapeutic periodontal cleanings is about the same as a traditional dental checkup. In fact, many people confuse the two because, from the patient’s perspective, they often feel exactly the same. 

At your visit, your hygienist will likely take new periodontal pocket measurements to compare your soft tissue health and bone levels with previous visits. The ultimate goal is to maintain the current pocket depth and prevent them from getting any deeper. If the right conditions are met, some tissue can reattach around the tooth, leading to reduced pocket depths. Particularly in cases that involve laser-assisted periodontal therapies. 

Other Perio Cleanings 

A deep cleaning, also known as scaling and root planing, is a thorough cleaning of the teeth below the gum line to remove plaque and tartar buildup in those deep “pockets.” This procedure is usually performed by your dental hygienist over at least two visits. Most people will also receive local anesthetic (numbing medication) on the side of their mouth being cleaned that day. Periodontal maintenance cleanings typically follow your scaling and root planing procedure. 

Occasionally dentists will have their hygienist complete what’s called a full mouth debridement. This cleaning is used when there’s so much buildup that your dentist and hygienist can’t get to the teeth or gums for a thorough evaluation because of how much buildup there is. If you have deep pockets and bone loss, you’ll still need a deep cleaning after the debridement.

Isolated areas of periodontal disease may require a modified scaling and root planing, involving fewer teeth.

What Is Periodontal Disease?

Periodontal disease is caused by a natural immune response to plaque bacteria along your gums. When plaque isn’t removed daily with good oral hygiene practices, your gum tissues in that area tell your immune system that there’s an infection in your mouth. As a result, antibodies start rushing to that space, leading to inflammation and an increased risk of bleeding. Unless it’s treated early, gingivitis will evolve into periodontal disease, where the gum and bone tissues begin to pull away from those teeth. 

Unlike symptoms of oral cancer or gingivitis, periodontal disease tends to be generalized across multiple, most, or all of your teeth in the affected arch. In most cases, the infection affects both arches of teeth (upper and lower jaws.) The most common symptoms of periodontal disease include warning signs like:

• Red, swollen, or tender gums
• Bleeding gums when brushing or flossing
• Receding gums
• Loose or shifting teeth
• Persistent bad breath or a bad taste in the mouth
• Changes in the way your teeth fit together when biting
• Pus between teeth and gums
• Heavy tartar buildup 
• Visible spaces or gaps between your teeth

Treatment for periodontal disease usually involves one or a combination of the following:

A deep cleaning: Scaling and root planing will be necessary to remove the plaque and tartar buildup below your gumlines. 

Medications: Antibiotics or a prescription mouth rinse can help reduce the severity of the infection.

Periodontal surgery: In more severe cases of periodontal infections, surgery may be necessary to restore damaged tissue and bone. Such as placing a bone graft, tissue graft, or performing crown lengthening/pocket reduction. In some cases, non-surgical laser therapy is also recommended. 

Health and lifestyle changes: Giving up smoking and making a plan to manage your diabetes can help improve the health of your gums and how well you respond to other periodontal treatments.

Periodontal Disease Prevention

First things first, daily oral hygiene is key. Brush your teeth twice a day with a fluoride toothpaste and floss at least once a day to remove plaque and food particles from between your teeth. If flossing is a bit of a challenge, you might want to consider using a water flosser instead. 

It's also important to watch what you eat. A diet that’s high in starch and processed carbs can lead to extra plaque buildup along your teeth and gums. 

But the most important thing you can do to prevent periodontal disease is to see your dentist and hygienist for preventative cleanings every six months. They can spot early signs of gum disease and provide extra attention in those areas before it becomes a bigger problem or leads to tooth loss. 

By putting in the time to care for your teeth every day and keeping up with your prophylactic cleanings, you can help stop periodontal disease long before it ever has a chance to start.

Talk With Your Dentist or a Periodontist

After you receive treatment for periodontal disease (such as a deep cleaning,) there’s a high probability that you’ll need to schedule regular periodontal maintenance cleanings every 3-4 months. If your mouth somehow miraculously reaches a 100% recovery and you no longer have periodontal pockets, you can switch to a prophylactic/preventative cleaning schedule. Unfortunately, that’s quite rare. The thing to remember is that periodontal situations need to be monitored consistently so that relapse doesn’t occur and lead to bone and tooth loss. 

It’s important to note that the treatment will depend on the stage and the type of periodontal infection, and your dentist or a periodontist will determine the best course of treatment for optimal oral health.

Overcoming Gum Disease with Periodontal Maintenance Cleanings

Maintaining optimal oral health requires both periodontal maintenance and routine dental cleanings. According to the American Dental Association, both procedures play crucial roles in dental hygiene but serve distinct purposes. Routine dental cleanings, performed by a dental hygienist, involve scaling to remove plaque and tartar, ensuring healthy teeth and gums. These professional dental cleanings are essential for preventing common dental issues such as cavities and gingivitis. On the other hand, periodontal maintenance is a more specialized treatment aimed at individuals with a history of periodontal disease. Periodontal maintenance goes beyond routine cleaning to manage and prevent the progression of periodontal disease.