Efficient antimicrobial treatment in periodontal maintenance care

BACKGROUND: The goal of follow-up care after periodontal therapy is to preserve the function of individual teeth and the dentition, ameliorate symptoms and simplify future surgery or make it unnecessary. Effective follow-up periodontal care depends on early diagnosis and treatment, as well as patient education. RESULTS: The main determinants of successful periodontal maintenance therapy are dental professionals' ability to combat periodontal infections and patients' compliance with prescribed follow-up care. Mechanical and chemical antimicrobial intervention is the mainstay of preventive periodontal therapy. Chemotherapeutics alone are unlikely to be effective in the presence of subgingival calculus, underscoring the importance of subgingival mechanical débridement. Also, because toothbrushing and rinsing alone do not reach pathogens residing in periodontal pockets of increased depths, oral hygiene procedures should include subgingival treatment with home irrigators or other appropriate self-care remedies. CLINICAL IMPLICATIONS: When considering possible preventive therapies, dental professionals must weigh the risk of patients' acquiring destructive periodontal disease against potentially adverse effects, financial costs and inconvenience of the preventive treatment. The authors discuss theoretical and practical aspects of follow-up care for patients with periodontal disease. In addition, because it can be both difficult and expensive to control periodontal disease via conventional preventive measures alone, they present a new, simple and more cost-effective antimicrobial protocol for supportive periodontal therapy.