Welcome to the second part of our series on treating periodontal disease.
In Part 1, we explored the active treatment phase, where initial therapeutic interventions set the foundation for controlling periodontal infections and inflammation.
In Part 2, we will delve into the critical Maintenance Phase. This phase represents a paradigm shift in periodontal care, where the focus moves from active treatment to ongoing prevention and health maintenance.
Consistent follow-up and supportive periodontal therapy are key to ensuring long-term stability, preventing relapse, and empowering patients to maintain their oral health. Let us explore best practices for sustaining periodontal health through effective maintenance strategies.
Periodontal Maintenance Phase
The goal of maintenance is to monitor for signs of active disease progression. Consistent follow-up care ensures that the localized disease remains controlled, allowing for early inflammation intervention. Our goal is to halt disease progression and help our patients live longer healthier lives.
Miscommunication with the Patient
Another frequent issue is failing to properly communicate with the patient about why treatment focuses on specific teeth. Patients may assume their condition is not severe when only a few teeth are treated, or they may need clarification about why the whole mouth is not receiving treatment.
Explaining the rationale behind localized care is essential—why only certain teeth require treatment, how this approach prevents unnecessary interventions, and the long-term benefits. Use words the patient understands and words that describe and add value to explain the mouth-body connection.
Change words such as “Periodontal Disease” into “Gum Disease.” Stop telling patients you will perform a “Deep Cleaning” and help them understand this is NOT a routine “cleaning” appointment but “Gum Therapy to treat infection and inflammation.”
Explain to your patient, “Prevention costs a little money, but treating disease costs a lot more.” Treating disease sooner rather than later will help save time and money and support a longer, healthier life.
Clear communication builds trust and ensures the patient understands the importance of treating the disease early, even when it is localized.
A Thorough and Customized Approach
A thorough and customized approach to diagnosis and treatment sequencing is crucial. This approach ensures that all affected areas are treated. Proper follow-up care and routine maintenance are necessary to ensure that localized disease does not progress or recur, further protecting the patient’s overall health.
Our goal during the first appointment when gingivitis and periodontitis are diagnosed is to educate the patient. We want our patients to understand how the mouth is connected to the body. Explain that if oral inflammation is left untreated, it can lead to other systemic diseases such as diabetes, heart attack, stroke, Parkinson’s Disease, and/or Alzheimer’s Disease.
The next step is explaining a treatment plan for SRP and adjuncts such as diode lasers and antimicrobials. At the end of SRP, always include a 4—to 6-week re-evaluation. This follow-up is what we call the “End Point Balance,” and it is the only way to be sure there is a halt to inflammation and infection and confirm the prevention of disease(s). The 4—to 6-week revaluation is the endpoint for Phase I therapy.
At the 4 to 6-week re-evaluation, determine the patient’s next interval for preventive care: either 3 months, 4 months, or sometimes, 6 months: Periodontal Maintenance or Prophylaxis.
Post-op Instructions & Homecare
Effective patient education is essential for maintaining the health of treated teeth after gingivitis treatment and periodontal therapy. Clinicians must provide detailed post-treatment instructions that focus on pain control and healing post-op.
Patients must understand the importance of proper brushing and flossing techniques to prevent plaque buildup in vulnerable areas.
At the end of each appointment, while the patient is in the chair, show them what they need to do at home for proper home care. These instructions are part of self-efficacy.
Self-efficacy is about a belief; it is about the patient feeling competent to complete a task and achieve the goal of total body health. Self-efficacy is about confidence and knowing how to do a task quickly and efficiently. Help patients understand their role in healthy habits and home care. Support patients in accomplishing their overall health goals as well as their oral health goals.
Conclusion
Treating localized periodontal disease requires a precise and tailored approach. Taking time to complete a thorough diagnosis is essential to accurately assess the severity of gum disease.
Proper treatment sequencing ensures that gum disease is addressed without overtreating healthy areas or leaving other diseased mouth areas untreated. By focusing on localized care as necessary, using a holistic approach, and taking a team approach, dental professionals become partners with the patient in maintaining overall health. This is how we become partners in helping our patients live longer, healthier lives.
Our goal is to provide targeted, effective treatment that halts disease progression in the mouth and our patient’s body. Clinicians need to stress the importance of patient compliance and routine preventive care (basic cleanings and periodontal maintenance) to ensure long-term success.
When dental professionals use this approach, they treat the current condition and optimize the patient’s total health for the future.
Dental professionals must regularly review and refine their approach to treating gingivitis and periodontitis. By focusing on personalized treatment plans and comprehensive patient care, they are more likely to ensure the success of their care and improve patient outcomes.
Our goal in dentistry is no longer “cleaning teeth” or “treating a tooth;” it’s about helping patients live longer, healthier lives.
The dental practice owner needs to encourage the team and be certain they can educate their patients about prioritizing prevention and long-term care of their total health.
This encouragement leads to more effective management of periodontal disease and healthier, happier patients.
By following these guidelines, you offer a comprehensive and informed approach to improving the treatment of patients with gum disease.
Debbie Seidel-Bittke, RDH, BS is the founder of Dental Practice Solutions and a clinical dental hygienist with years of experience. As a hygiene department coach and frequent speaker at national dental conferences, she specializes in helping practices implement effective systems and a team-based approach to patient care. Debbie, a former assistant professor at USC School of Dentistry and hygiene department program director, is committed to improving hygiene departments and patient outcomes.
You can reach Debbie by email at debbie@dentalpracticesolutions.com, by phone at 623-252-1941, or by visiting her website at www.dentalpracticesolutions.com. Explore her courses for more on treating gingivitis and periodontitis here.
Read more from Debbie:
Trojan Today: “Treating Periodontal Disease: A Paradigm Shift, Part 1” by Debbie Seidel-Bittke
Trojan Today: “Illuminating Dentistry: The Power of Photobiomodulation and Red LED Lights in the Dental Office” by Debbie Seidel Bittke
Trojan Today: “Dental Products: Enhancing Patient Care & Practice Profitability” by Debbie Seidel-Bittke, RDH, BS
Trojan Today Classic: “Hygiene Department Time Management: Breaking it Down to a Formula” by Debbie Seidel-Bittke
Trojan Today Classic: “The Pulse of Your Dental Practice” by Debbie Seidel-Bitke