POST TX

The Need for Recall/Maintenance Visits

Now that we have completed your active periodontal therapy (whether it be surgical or non-surgical, we must now concern ourselves with the prevention of a relapse (re-occurence of your original problems). You must remember that we are now only back to "GO", meaning where you were many years ago. We together must be sure you stay that way. It is now YOUR responsibility to determine the future success or failure of the procedures that we have performed on you. To put it bluntly, you must now be very fastidious with your home care in addtion to returning for routine maintenance visits. These maintenance visits are NOT included in the cost of your initial treatment and will incur an additional charge (usually covered by insurance), similar to your recall visits with your general dentist.

Frequency of Maintenance Visits:

As each patient's level of oral hygiene care differs, the frequency of these visits will vary from patient to patient. Thus, these visits can represent the difference between sustained success or relapse (reoccurence) of periodontal disease. REMEMBER, there is NO cure for periodontal disease, just the degree of control by pocket reduction to allow for better oral hygiene and control of the bacterial flora.

What Procedures are performed during Maintenance Visits:

The following procedures will be performed during your 45 minute visit with us:

Periodontal Examination by Dr. Mao or by the hygienist to evaluate your level of care (oral hygiene) and to be sure that the periodontal disease has not returned.
A scaling and light curettage (cleaning under the gum) will be performed by Dr. Mao or the hygienist. Occassionally a root planing will be performed to remove any calcified buildups (tartar), esp. below the gum level (in the pocket).
A review of oral hygiene procedures may need to be performed possibly involving some new techniques (ex: electric toothbrush or proxabrushes)
Your BITE will be evaluated, including the mobility of your teeth. If you have an occlusal appliance (Hawley BitePlane), it will be checked and possibly re-layered.
A review of your medical history is also important. A review of any medications (ex; blood pressure medication or antibiotics) will be evaluated as they may have an affect on your gums and bone tissues.

Special Procedures Performed or Suggested at the Maintenance Visit:

Occasionally, there are more significant changes that have occurred due to lack of care or unforeseen circumstances, such as health issues. This will necessitate one or more of the following procedures:

More extensive scaling and root planing by Dr. Mao or by the hygienist may be necessary if you have an unusual accumulation of plaque and calculus (subgingivally or under the gums) . Most of the time this is due to a longer than usual period between recall visits OR due to excessive calcium intake (ex: water supply or pills or Tums). This may require local anesthetic ("Novocain").

Occlusal Adjustment (bite adjustment) may be necessary to ensure that the relationship between the teeth will remain stable. The decision to do this "grinding" is usually made due to an increase in mobility in your teeth or some recurrent bone breakdown around some of your teeth. Many times this increase in mobility is from grinding/clenching or your teeth. The construction of an occlusal appliance (Hawley Bite Plane) may be recommended.

HEADACHES are also caused by a poor bite combined with grinding and clenching of the teeth and can usually be treated with the Hawley Bite Plane.

Surgical Re-Treatment may be necessary should the pocketing and bone breakdown be excessive. Of course, we usually attempt conservative treatment first, esp. if you have already had periodontal surgery within the not too distant past.

A Bacterial Culture may be performed prior to surgical re-treatment depending on the nature of the periodontal breakdown and the severity of the breakdown. If the culture results show positive, antibiotic therapy will probably be attempted.