Dr. McGonegle Explains the Difference Between a "Cleaning" (or "Prophy") and "Periodontal Maintenance"

We have recently had a few questions about whether patients require a "prophy" (or typical cleaning), or whether "periodontal maintenance" is required in our North County San Diego dental office.  I would like to take a minute to explain the difference between the two procedures. 

The American Dental Association description for Prophylaxis-Adult is: “A dental prophylaxis performed on transitional or permanent dentition, which includes scaling and polishing procedures to remove CORONAL plaque, calculus, and stains.”  Avoiding dental parlance, this simply means the code provides for using dental tools and polishing procedures to remove plaque, tarter, and stains from the portion of the tooth that extends ABOVE THE GUMLINE.  Of course, the key word here is above the gumline.  The reason a patient needs periodontal maintenance is because they build more calculus and have deep pockets that make it more difficult to clean below the gumline.

Once a patient has been diagnosed with periodontal disease, periodontal maintenance takes the place of prophylaxis.  Rather than only addressing the crowns of the teeth as in prophylaxis, periodontal maintenance also cares for your tooth roots, gums and bones.  Periodontal maintenance (PM) is distinctly different than prophy and is used for patients who have active perio treatment.  It is ongoing treatment for periodontists, which is a chronic and non-curable bacterial infection.  The objective of PM is to keep the disease under control.  Periodontal maintenance is provided every three months.  Alternating periodontal maintenance and prophys at 3 month intervals is inappropriate because the prophys are non-therapeutic.* (For further reference, please see www.dentistryiq.com, search “Prophy and Periodontal Maintenance.")