Lifelong supportive periodontitis treatment? Absolutely!
PD Dr. Kristina Bertl, PhD MSc MBA
We are all familiar with our patients’ facial expressions when we tell them that they are suffering from periodontitis and will therefore now need lifelong(!) treatment. And we all of course know how difficult it is to motivate our patients over a number of years. But how important is this lifelong supportive periodontitis treatment? Is it really necessary in to keep the periodontal status stable?
A research group from Brazil and the Netherlands (Bittencourt et al. 2022) investigated this very question and recently published an extremely interesting study. Using a previous study as a basis, they contacted 57 patients who had completed their first two years of supportive periodontitis treatment at least three years previously. After the two years of treatment, every patient had received detailed information on their periodontal health and the need for further treatment. Of these 57 patients, they were able to call back and re-examine 27 patients; on average for these 27 patients it had been roughly four years since their last visit. The re-examination found the following results:
- Only one third of the patients had followed the advice of their dentists and continued with supportive periodontitis treatment, either at the same or a different clinic. All the other patients were not receiving any regular supportive periodontitis treatment.
- The clinical status showed that the values for bleeding and inflammation and the probing depths had returned to the same level as before beginning the active periodontitis treatments!
- The number of probing depths ≥ 5 mm was once again comparable with the values before the start of active periodontal treatment. So, for example, the percentage here before active periodontal treatment was 14%, after active periodontal treatment it was 2%, after two years of regular supportive periodontitis treatment it was still 2%, but after around four years of leaving it to the individuals the percentage was back up to 10%.
In summary, unfortunately, individual responsibility does not seem to work very well for periodontitis patients! It is therefore essential that we aim to establish a dental practice concept where patients are actually contacted and offered appointments on a regular basis.
This study is of course based on a very small number of cases, and the results should therefore be treated with caution. Nevertheless, these results do very clearly demonstrate something we all know from our everyday clinical practice: if, during the course of the supportive periodontitis treatment, patients lose the motivation to regularly attend the recommended appointments, their periodontal status unfortunately very often quickly deteriorates.
- Liana F. Bittencourt, Patricia D. M. Angst, Rui V. Oppermann, Ubele van der Velden, Sabrina C. Gomes. At least 3 years of self‐responsibility for periodontal care after 2 years of supportive periodontal therapy. Clinical Oral Investigations (2022) 26:4987–4994.