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Risk-Based Recare for Perio Maintenance

In 2018 the American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP) published a new classification system for periodontal health and disease, changing the way oral health professionals consider clinical parameters. A major component of the new classification system is the use of staging and grading to focus on disease complexity and progression based on an individual’s risk factors and protective behaviors. Implementation of the new classification system provides oral health professionals with another opportunity to educate patients on their role in maintaining and/or improving their oral health.


One way dental hygienists can integrate staging and grading into patient education is through risk assessment to determine an individual’s periodontal maintenance recare interval.

Periodontal probing is a clinical procedure that allows the clinician to estimate the structural status of the periodontal tissues by mechanically probing the gingival sulcus region. Probing depth allows the clinician to make certain assumptions about the state of health of the periodontium. watanyou / iStock / Getty Images Plus
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The AAP describes periodontal maintenance as the treatment provided to individuals after the completion of initial (nonsurgical) periodontal therapy with the intention of preventing further disease progression and maintaining the health of the periodontium.

Periodontal probes for measuring pocket depths zlikovec / iStock / Getty Images Plus
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Risk assessment is the process of evaluating which of the following factors to determine the overall protective or destructive influence on a patient’s oral health?

periodontal probing depth showing healthy and diseased gum. dental and health care concept yomogi1 / iStock / Getty Images Plus
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Using evidence-based clinical decision making, the dental hygienist can weigh the impact of different risk variables to determine the patient’s overall risk of disease progression.

Bleeding gums or Periodontal - pathological inflammatory condition of the gum and bone support. Dental 3D illustration alex-mit / iStock / Getty Images Plus
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Patients who have responded well to previous treatment, comply with self-care, and have no additional systemic or behavioral risk factors, may have their classification adjusted to Grade A, which suggests longer intervals of 6 months to 12 months between periodontal maintenance appointments.

Patient getting her interdental spaces examined zlikovec / iStock / Getty Images Plus
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The periodontal maintenance team includes which of the following?

Happy dentist at the office with her team and holding a tablet computer andresr / E+
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As personalized precision dentistry is the way of the future, oral health professionals need to be prepared to conduct proper risk assessments and identify independent risk factors, developing that knowledge into implementable therapeutic care tailored to each individual.

Two women doctors standing with clipboard at hospital and discussing cases dikushin / iStock / Getty Images Plus
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Risk-Based Recare for Perio Maintenance
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This information is from the article Determining Recare Intervals for Periodontal Maintenance By Courtney P. Rudick, RDH-EA, MS, CHES, Melissa S. Lang, DDS, MS and Takanari Miyamoto, DDS, MSD, PhD, MBA. To read the article, click here.
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