Periodontal disease, like any chronic condition, needs to be monitored to avoid worsening or recurrence. The long-term success of periodontal treatment is therefore based on careful monitoring, known as supportive therapy, which begins at the end of active treatment. It will be proposed to the patient as an essential extension. Its duration is unlimited. The objective of maintenance is to maintain the periodontal state obtained at the end of the active treatment or, more rarely, to slow down the evolution of a periodontitis refractory to our treatment.
The maintenance session should be a standardised routine procedure to avoid oversights and facilitate comparisons over time. It starts with a clinical examination which again includes a complete periodontal assessment (measurement of pockets, plaque control and search for inflammatory signs). Often it will be useful to remotivate our patient, whose good intentions are often thwarted by time and life events. Even the most motivated patients can falter in their preventive role.
By constantly reminding patients of the importance of good plaque control for the maintenance of their periodontal health, it becomes possible to maintain long-term stability.
We will also take advantage of each check-up to reset the supra- and juxta-gingival bacterial counter, by means of prophylactic cleaning, by allowing ourselves to descend cautiously to the sub-gingival level at the level of the most unstable sites.
In the months following the periodontal treatment, frequent checks should be made to ensure periodontal "stabilisation" and patient motivation. A bi-annual check-up is recommended. After one year, in patients considered to be stabilised and with good hygiene, we can recommend twice-yearly check-ups. On the other hand, for high-risk patients (poor hygiene, smoking >10cg/day, history of aggressive periodontitis, orthodontic treatment,...), the frequency of maintenance sessions must remain sustained in order to intercept a possible recurrence (minimum 3 times per year).