Adherence to supportive periodontal treatment

Periodontol 2000. 2019 Feb;79(1):200-209. doi: 10.1111/prd.12256.

Abstract

Like any other chronic disease, periodontal disease can be treated, but not eradicated. Personal maintenance of periodontal health requires the continuous elimination of bacterial accumulation at the gingival level, which demands periodical professional assistance. Of upmost importance is the patient being able to actively follow the counsel of the care providers. Thus, patient compliance, adherence, and persistence are paramount for the long-term success of periodontal therapy. Unfortunately, in medicine as well as in dentistry, most studies show that, sooner rather than later, an unacceptable percentage of patients quit maintenance care. However, different studies have shown that there are behavioral techniques which may significantly improve the degree of motivation, compliance and persistence of patients with oral hygiene and supportive periodontal treatment. The right interval between maintenance visits has not been determined yet, but should be implemented according to patient needs, which do not necessarily coincide with the standard three-month interval historically accepted as adequate. Adherence to periodontal maintenance results in reduction of plaque and bleeding on probing, and potentially slowing down or halting the disease progression. Finally, based on numerous retrospective studies, patient compliance could be considered a disease-modifying factor positively affecting tooth survival. However, a lack of randomized clinical trials means this last statement is still open to question.

Keywords: adherence; behavioral science; compliance; maintenance care; maintenance intervals; periodontology; supportive periodontal treatment; tooth loss.

Publication types

  • Review

MeSH terms

  • Dental Care
  • Dental Plaque*
  • Humans
  • Oral Hygiene
  • Periodontal Diseases*
  • Retrospective Studies