Periodontal disease—literally, disease “around the tooth” - affects the gums and the bone to which a tooth is attached. It is an advanced bacterial infection that causes tooth loss and gum recession, and is preceded by gingivitis. Symptoms can include bleeding from the gums, bone loss that displays itself on an X-ray, excessive tooth mobility, gum recession, or the existence of any “exudate,” (pus or clear fluid) along or under, the gumline.
Because of the overall threat to the health of the tooth, periodontitis requires a more advanced care routine than is given during a Propyhlaxis. When excessive plaque and tartar migrate below the gumline, it triggers an immune response in the gum tissue that inflames the area. This causes the gum tissue to become more pliable, loosening from the tooth, and causing a “pocket” to form between the tooth and the gum. The result, is the formation of even more plaque and tartar below the gumline that can contribute to the eventual loss of teeth. Seeking to avoid this outcome, your dentist will suggest you undergo regular periodontal maintenance as covered by this code.
With this maintenance, there has already been diagnoses of periodontal disease.
The advanced cleaning of this code, therefore, does not occur in regular prophylaxis. While a prophylaxis may feel identical to regular maintenance when sitting in the hygienist's chair, they are in fact very different. With this code, the cleaning involves the removal of plaque and calculus (tartar) from below the gumline as well as above it. With a prophylaxis, plaque and calculus only needs to be removed from above the gumline.
Regular maintenance is recommended at least every 90 days in contrast to Prophylaxis for a healthy person, which is generally only recommend twice a year.
Scaling and Root Planing (SRP) precedes being placed on a regular maintenance routine, and may also be required as part of your visit for regular maintenance. Should SRP be required, under regular maintenance, it is important to note that it is always coded independently of maintenance and not as part of periodontal maintenance procedures.
No matter how vigilant one's oral care regime, the irrepressible development of plaque, and the porous nature of teeth makes them prone to decay. To avoid complications and teeth loss, periodontal maintenance is highly recommended, and is usually successful at halting advancing disease. While there is no permanent cure once periodontitis has initiated, it can be treated so it remains stable, and you experience no further bone, tissue or tooth loss.