Is Monthly Service Often Enough?

In the absence of optimal oral hygiene, to prevent the presence of gingivitis would require prophylaxes to be done every two to three weeks. (Ramfjord 1987)

The cause and effect relationship between supragingival plaque and gingivitis was demonstrated by (Dr. Harold) Loe and his colleagues in 1965. When plaque was allowed to accumulate gingivitis developed within in 21 days. (Dr. Phyllis Beemsterboer, Plaque & Calculus, UCLA PIC)

In a later study done in 1986, Loe and his coworker found that in regard to periodontitis, not all people develop the disease to the same extent or even at all. Also, the inflammatory process could be halted and clinical health restored but the damage caused by periodontitis was not reversible. It is important to realize that genetic predisposition plays a role in the way people’s tissue responds to plaque and calculus and that susceptibility to periodontitis varies.

It has been established that a plaque free mouth is a basic requirement for periodontal health and that the presence of supragingival plaque will result in gingivitis, and may lead to periodontal disease if present for a long period of time. (Ramfjord,S.P.; Morrison, EC et el J periodontal January 1982:53:23-30)

Moresque et al (1980) scaled and root planed and monitored sites in 14 periodontal patients. The results found indicated that a single session is capable of altering the proportions of certain bacteria forms. However, return of pathogens to pretreatment levels generally occurs in approximately 42 days.

Van Wenkelhoff et al (1987) observed the recolonization of deep periodontal pockets in 8 adult periodontitis patients after a single dose of sepra and subgingival debridement. They found the total percent of spirochetes and P. gingivitis was reduced. However, absolute counts of these microorganisms were not changed at 8 weeks.

There is no clear answer in the literature regarding “Is monthly treatment enough” but it is clear that plaque formation leads to gingivitis and gingivitis often leads to periodontitis. There is enough information to conclude that, in a frail, at risk population, services to prevent the onset of gingivitis should be delivered at least every 30 days.

Supportive Periodontal Therapy

Supportive Periodontal Therapy (SPT) is an extension of periodontal therapy (A Bowers DDS, MS: 2011). It is a compound of procedures performed at selected intervals to assist the periodontal patient in maintaining oral health. It is initiated and performed by a dentist or a dental hygienist under the supervision of a dentist. The therapeutic goal of SPT is to prevent the reoccurrence and progression of periodontal disease in patients who have previously been treated for periodontitis.