Patient self-care of periodontal pocket infections. Prevention of gingivitis can be seen as both primary and secondary prevention. This review article is focusing on self-care of residual periodontal pockets for the long-term result of periodontal treatment. The foundation is to control sub- and supragingival biofilm, where control of the latter is based on home-care measures performed by the patient, namely, toothbrushing and interdental cleaning. With proper home-care, gingivitis can be prevented, and recurrence of periodontitis avoided.

 

It is stated in the article that the best result will be achieved by using interdental brushes compared to other interdental cleaning devices, although the patient´s prerequisites must also be regarded in this choice. Mouth rinse can favour the reduction of inflammation and plaque levels when mechanical cleaning does not reach all the way. Chlorhexidine is considered the gold standard for reduction of plaque and gingivitis, but other agents have shown positive effects as well.

For a successful periodontal maintenance care, the self-performed care needs to be combined with professional maintenance care. The patient´s adherence to supportive maintenance care influences the long-term treatment result. Professional maintenance care in combination with poor oral hygiene will not lead to a positive long-term treatment outcome, but a successful result is dependent on both factors being affirmative.

The authors continue by highlighting that evaluation of self-performed oral hygiene, as well as scaling and root planing, are obvious parts of the maintenance visit, but that the patient's medical history and risk factors for periodontal disease also need to be assessed on a regular basis, as they influence the pathogenesis. Modifiable risk factors, such as smoking, need to be addressed through a change of behaviour in order to allow a successful treatment outcome and retention of the treatment result.

Studies have shown continuous motivation and improvement in the patient´s adherence to the given oral hygiene instructions to be valuable factors for success of maintenance in the longer perspective. Behavioural and lifestyle changes may be required since periodontitis is a chronic disease. It is, therefore, significant to merge clinical and behavioural science for long-term treatment success.