Let’s face it, sometimes when we hear medical terms and explanations it sounds like another language. Dentistry is no exception! One of the often misunderstood concepts in everyday dentistry is the differentiation between a regular cleaning (prophy) and a perio cleaning (periodontal maintenance.)
A regular cleaning, or prophy, is a cleaning for individuals who have relatively healthy tissue with pocket depths reaching no deeper than 4mm when we measure the areas around the gums. The standard interval between cleanings for a healthy patient is 6 months and these patients often display excellent home care with no bleeding upon gentle probing. This procedure is “non-therapeutic” and includes cleaning above the gum line to remove soft plaque, calculus, debris, and staining. These are the guidelines from the CDT (the dental procedure codes manual). The dentist and hygienist will utilize x-rays, probing, and exams to monitor for signs of inflammation resulting in attachment loss or bone loss (periodontal disease) for the teeth. If this bone loss or attachment loss has occurred, the prescribed treatment often includes a deep cleaning (scaling and root planing.)
Scaling and root planing is used to reduce inflammation and stop the breakdown of connective tissue and bone loss. During this procedure the debris that causes the inflammation and their toxins are removed from the periodontal pockets. With periodontal disease, the treatment goal is always to reduce or completely remove inflammation and “stabilize” the mouth. All “cleanings” from that point forward are an effort to MANAGE the disease and therefore requires a different protocol. This is when we use a perio cleaning or periodontal maintenance. The interval for cleaning is much shorter, either 3 or 4 months, and often requires a slightly longer appointment.
This is an example of the type of phone call we get from patients who are on periodontal maintenance and don’t understand the difference. “It seems like you did the same thing as the regular cleaning! What am I paying for and why do I have to come in so often?” It may seem as though it is business as usual, but when we look at what a regular prophy is and what can be done, they are completely different treatments. Remember, a prophy is a cleaning above the gum line for healthy patients, but when you are diagnosed with periodontal disease there is a need to maintain the tissues below the gum line. A periodontal maintenance includes cleaning above and below the gum line, reducing the inflammatory process associated with periodontal disease. If there are localized areas of relapse and inflammation, instead of reinitiating the expensive deep cleaning procedure, the hygienist can and regularly does treat them at the periodontal maintenance appointment with no additional charge.
An ounce of prevention is worth a pound of cure, and no place is this truer than in our dental health and care. We encourage you to make it a resolution this year to get those dental cleanings to maintain your dental wellness. Happy New Year!