Like any hygiene appointment, assessment is key. 2. It outlines the primary responsibilities of dental practitioners in relation to infection control, and provides the rationale for those obligations. This brochure explains why periodontal maintenance is different from routine dental cleanings. The ADA’s Guidelines for Infection Control describes the infection control procedures dental practitioners and their clinical support staff are expected to follow in a dental practice. Safety of the dental team and patients or people accompanying patients is essential while treating emergency patients and following this crisis. by Karoline Biami, RDH. Periodontal Maintenance Therapy and Continual Assessment . Non-surgical periodontal treatment does have its limitations. Review the manufacturer’s instructions for use (IFU) for office closure, period of non-use, and reopening for all equipment and devices. Radiographic examination . This is often accomplished through non-surgical periodontal treatment. Periodontal examination to include dental implants . AAP treatment guidelines stress that periodontal health should be achieved in the least invasive and most cost-effective manner. Periodontal maintenance consists of periodic removal of bacterial plaque and calculus from both above and beneath the gum line in patients who have undergone treatment for periodontal disease (periodontitis). Periodontal diseases/diagnosis; dental history; medical history; patient care planning. BSP Guidelines for Periodontal Patient Referral This document sets out referral guidelines for periodontal treatment and maintenance. Establish a definitive diagnosis . restorations, caries, tooth mobility, tooth position, occlusal and interdental relationships, signs of para-functional habits, and, when applicable, pulpal status. Follow-up patients who have received active periodontal therapy (surgical or nonsurgical) are appropriately reported using the periodontal maintenance code D4910. Use this ADA-published brochure to explain why regular, professional treatment is important in controlling periodontal disease. This brochure explains why periodontal maintenance is different from routine dental cleanings. Dentists treating patients with chronic periodontitis, a severe form of periodontal disease that can lead to tooth loss, are advised to use scaling and root planing (SRP), deep cleaning of the teeth, as initial treatment, according to new guidelines from the American Dental Association. The goal of periodontal maintenance is to maintain periodontal pockets by removing biofilm accumulation after initial periodontal therapy (SRP). Radiographs (according to ADA guidelines) Prophy/perio maintenance Prophy/perio maintenance Treatment plan Provisional treatment plan . For example, every member of staff can and should encourage and support patients in smoking cessation. As it is frequently necessary to treat recurrent or persisting disease, maintenance therapy goes beyond a true prophylaxis. D4910 periodontal maintenance According to the Code on Dental Procedures and Nomenclature (the CDT Code), D4910 periodontal maintenance, is performed following periodontal therapy and continues at varying intervals, determined by the clinical evaluation of the dentist, for the life of the dentition or any implant replacements. Studies have shown both modern periodontal and dental implant therapies are effective in maintaining natural teeth and replacing lost teeth, respectively. Scaling and Root Planing. 11 Generate a diagnosis-driven periodontal treatment plan and sequence of treatment . “This is a matter of clinical judgment by the treating dentist. 9. It is usually performed on a two to four-month interval so that removal of bacterial colonies can be completed before they become sizable and aggressive enough to cause more damage … In general, data suggests that patients who have undergone definitive therapy for either localized or generalized periodontitis should be managed by periodontal maintenance (PM), performed at an interval of 3 months for an indefinite period of time following active therapy. When it does not achieve periodontal health, surgery may be indicated to restore periodontal health. Periodontal maintenance is a routine appointment, usually every three months, that includes reviewing any changes in your overall health, a thorough oral evaluation, and deep cleaning, both above and below the gums and provide home care instructions. Beginning with the causes of periodontal disease, this easy-to-understand resource walks patients through the stages, risk factors, warning signs, and several treatment options. 6. The ADA continues to urge dental offices to follow closure recommendations. Although evidence -based guidelines or systematic reviews do not exist on this topic, multiple independent studies have shown that a periodontal maintenance program following active periodontal therapy is effective and reduces tooth loss and recurrence of disease in compliant patients. Whilst important in its own right, oral health is an integral part of general health. Issues at a Glance . Periodontal maintenance procedure - limited to a total of one prophylaxis or periodontal maintenance procedure in any 6 consecutive month period. Clinical practice guidelines are the strongest resources to aid dental professionals in clinical decision making and help incorporate evidence gained through scientific investigation into patient care. This revised booklet is a comprehensive guide to periodontal disease that improves patients’ understanding of all facets of periodontal disease. Suggestions for new and amended item numbers … Emphasizes that professional help is vital to control periodontal disease but the patient must also commit to an excellent oral care routine at home. Guidelines for Submissions to the ADA’s Schedule and Third Party Committee The ADA’s Schedule and Third Party Committee welcomes submissions and comments on the Schedule. Periodontal maintenance is therapeutic in nature and includes “removal of bacterial plaque and calculus from supragingival and subgingival regions, site specific scaling and root planing where indicated, and polishing the teeth.” Periodontal maintenance should always follow definitive periodontal therapy for a period of time, typically one year or longer. Policies. This may vary depending upon patient compliance, as well as the clinical knowledge and judgment of the licensed clinician. Full-mouth probing to identify target areas of inflammation, pocket depth, and calculus accumulation is imperative. Here is the quote from the CDT-5 concerning coding for a prophylaxis after periodontal therapy. During this lifelong therapy, both the patient and the dental team need to be working closely together. 2. 8. Periodontal maintenance therapy periodontal maintenance visits should include: 1. ADA and many state dental associations have urged dental offices to treat only emergency patients; some states or local governments have mandated this. Your patients may not know the difference between a routine cleaning and periodic periodontal maintenance. After a period of non-use, dental equipment may require maintenance and/or repair. These cleanings require more skill and expertise than a regular dental cleaning appointment and X-rays as needed. Once a patient has had any periodontal treatment (non-surgical, surgical, or a combination of both), they will require periodontal maintenance recalls at more frequent intervals in order to try to maintain their disease and try to prevent recurrence. Grossberg, Todes or Kalos detect tooth decay during a maintenance visit,they will refer you to your general dentist for treatment. Dental Hygienist’s Guide to Delivering an Effective Periodontal Program. The dentist can coordinate and encourage a preventive approach to dental health throughout the practice, in the recognition that all members of the dental team can influence a patient’s periodontal health. (ADA) Periodontal Disease : Inflammatory process of the gingival tissues and/or periodontal membrane of the teeth, resulting in an abnormally deep gingival sulc us, possibly producing periodontal pockets and loss of supporting alveolar bone (ADA). Update of medical and dental histories. 10. It describes levels of complexity linked to the appropriate referral of patients in need of periodontal treatment in a secondary care setting. A recent hot topic in the Facebook forum Dental Hygienists Talk, which has more than 10,000 dental hygiene members, revealed that some new hygienists are feeling confused, insecure, or lost when it comes to implementing a periodontal program in their office. Dental Health Week is a community awareness program that aims to educate Australians about the significance of maintaining good oral health habits. policy. Periodontal Maintenance: Preserve the Progress You Have Made details maintenance therapy and reinforces the message that periodontal patients need more frequent visits than other patients. Maintenance care is mandatory for the long-term success of periodontal and implant treatment. Allowance includes periodontal pocket charting, scaling and polishing. COVID … Explains how regular periodontal cleanings reduce bacteria and help pockets shrink. Periodontal maintenance is performed in the presence of active disease whereas a prophylaxis ( D1110 ) or scaling in presence of generalized moderate or severe gingival inflammation ( D4346 ) is performed to prevent disease. The last visit prior to placing the patient on periodontal maintenance is an evaluation appointment with a prophylaxis. Protecting your periodontal health through preventive maintenance has great benefits for your teeth and overall health. Evaluation of current extra- and intraoral, periodontal and peri-implant soft tissues as well as dental hard tissues and referral when indicated (e.g., for treat-ment of carious lesions, pulpal pathosis, or other conditions). Denture Maintenance 35 Denture Repairs 36 Other Prosthodontic Services 37 ... Glossary without the explicit written endorsement of the Federal Executive of the ADA. 12. Oral health is a basic expectation of all Australians. Periodontal maintenance (PM) is a critical factor in the long-term success of both periodontal and dental implant therapy. Emphasizes that professional help is vital to control periodontal disease but the patient must also commit to an excellent oral care routine at home. Patients who require periodontal maintenance have periodontal disease and have been treated non-surgically (D4341/ D4342) and/or surgically (D4240/D4241 or D4260/ D4261). Cost for members is $27; retail $40.50, pack of 50 brochures. If Drs. Appointments for periodontal maintenance do not replace regular dental checkups. Thereafter, the patient will continue their care with a periodontal maintenance appointment (4910) every three months. Dental examination to include occlusal relationships and dental implants . To keep your periodontal tissue healthy and keep your natural teeth for your lifetime—carefully and conscientiously follow the guidelines of the maintenance program that Dr. Abdeen recommends. 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