As with any chronic disease diagnosis, the initial action for the clinician is to arrest and reduce the immediate negative impact of the disease. Once stability has been achieved and the immediate threat of destruction has been controlled, we must educate and engage the patient in ongoing disease management moving forward. At subsequent Perio maintenance appointments, patients will often ask one of two questions: “Can I go back to a regular cleaning?” or “What is the difference between a Perio maintenance and a regular prophy?” These are legitimate and common questions, and how we answer them and the timing of sharing this information is essential.
To help patients understand the difference between a prophy and Perio maintenance cleaning, use simple language. Explain that a prophy is meant to “prevent” disease in a healthy mouth, while a Perio maintenance cleaning is intended to “maintain” the disease in a remissive state. In this case, Periodontal disease, which is a chronic bacterial disease of the gums and bone surrounding the teeth. The bacteria can travel to other parts of the body if left untreated, which can lead to tooth loss and contribute to other systemic issues. It is important to schedule Perio maintenance every 3-4 months to reduce the bacterial load to a level that the immune system can manage. If patients want to learn more about periodontitis and its connection to overall health, this resource is a great place to start: periodontitis | American dental association (ada.org)
If your patient is a visual learner, you may want to include visual aids such as diagrams, pictures, or models to help them understand the difference between a prophy and Perio maintenance cleaning. This will make it easier for patients to grasp the concept and will also serve as a helpful reference for them in the future. For example, ARESTIN-Education-Card.pdf (arestinprofessional.com).
The goal is to use patient-friendly language and avoid technical jargon as much as possible. This will make it easier for patients to understand the information and will make them feel more comfortable asking questions or seeking clarification. Ultimately, building trust and establishing a stronger patient-provider relationship can lead to better patient compliance and improved outcomes.
The best time to have these conversations with the patient is at the first encounter. Before probing, it is crucial to educate new patients about the types of cleanings. Informing them that a comprehensive examination of their gums will be done to check for infection and to determine the type of cleaning needed. Telling them what the numbers mean before probing keeps the patient engaged during the process. Once diagnosed and initial therapy is performed, there must be an explanation of the need to return for follow-up Perio maintenance. Here is an example:
Patient: “My teeth were just cleaned; why do I need to come back in a month for another cleaning?”
Hygienist: “Perio maintenance is a therapeutic cleaning following scaling and root planing. You have been diagnosed with periodontal disease for which there is no cure. Today we removed the hard deposits on your tooth and root. It takes 4-6 weeks to fully heal and gain reattachment. We will need to re-measure to check for healing. The application of medication may need to be administered to further the healing process. We will also polish and go over a customized homecare regimen as well.”
Patients should be advised that missing their follow-up appointments will risk reinfection. If a patient has been coming in for regular Perio maintenance and is healthier and compliant, they may ask, for example, “Can I go back to a regular cleaning”? I would answer that by saying, “If someone has diabetes and they do not check their sugar often, do you think that person would be at risk? The answer is yes. Periodontal disease is the same way. It can be maintained but not reversed. It can remain stable but not without professional intervention and patient compliance. If the patient misses appointments, as we see often, they always need additional therapy to get them back to a healthy and stable status.
At each subsequent Perio maintenance visit, hygienists should use the same repetitive language of how important it is to stay on a 3-4mrc to prevent further regression and to keep the disease in remission. Explain that special instruments will be used to access areas even floss cannot reach. Reiterate the need for probing at every visit to offer clinical judgment of disease status. Encourage the patient to take ownership of their health by introducing new ways to improve oral hygiene. Remember that identifying changes in stability earlier on prevents full-blown disease. It takes working as a team. We can ensure success and improved clinical outcomes by emphasizing the importance of oral hygiene and effective home care at each subsequent visit.
For a prophy appointment, the same is true as far as educating and homecare; the difference is probing once a year as opposed to every visit. Make sure the patient knows the difference. Use your professional judgment, as every case is different. Open communication is key.
I hope this blog helps you effectively communicate the difference between prophy and Perio maintenance to your patients. It is important to emphasize the need for regular care intervals and to provide personalized explanations based on each patient’s unique needs and concerns. Sharing this knowledge with non-clinical team members or creating scripts that the entire team can use can be a terrific way to ensure consistency in communication.