For most people, minor dental procedures are not much to worry about. We routinely get cavities filled or even a deep teeth cleaning without a second thought. However, some patients don’t have the luxury of this casual approach to necessary dental services. For them, dental prophy is a potential lifesaver.
What is dental prophylaxis?
Dental prophy, also referred to dental prophylaxis, is utilized when a dentist determines that a patent is pre-disposed to bacterial infection. The dentist will then prescribe antibiotics for use prior to the dental procedure.
For vulnerable patients, antibiotic prophylaxis may be necessary for even minor dental procedures (e.g., filling cavities).
What’s the difference between prophy vs. perio maintenance?
There is often confusion surrounding prophy and perio maintenance as procedures for preventing the spread of bacteria and halting periodontal disease.
Prophy in this case deals with the cleaning of a healthy mouth. The American Dental Association (ADA) defines a prophy as:
“Dental Prophylaxis – D1110 – Removal of plaque, calculus and stains from the tooth structure in the permanent and transitional dentition. It is intended to control local irritational factors.”
Stains and minor blemishes in the teeth are generally located above the gumline. Your dentist can easily polish or brush them away during a regular dental visit.
This type of cleaning is useful when there is no sign of periodontal disease, including:
- Bone loss
- Gum recession
- Structural instability (i.e., loose adult teeth)
Prophy in this case does not have much to do with dental or antibiotic prophylaxis. A healthy adult with a healthy mouth can stay that way with just two of these types of cleanings annually – no antibiotics required.
Periodontitis (a.k.a. periodontal disease) is a chronic bacterial infection caused by dental biofilm that is filled with bacteria. This biofilm causes bone destruction and tissue deterioration to such an extent that tooth loss is often the result.
Periodontal disease and its bacteria quickly overwhelms the body’s immune response. This leads to a breakdown of tooth structures. This disease can be episodic, triggered by stress, systemic disease, or other dental issues.
The ADA differentiates perio maintenance from prophy in the frequency of it, the location of the dental debris, and the reoccurrence of bacteria, noting:
“This procedure is instituted following periodontal therapy and continues at varying intervals. It includes removal of the bacterial plaque and calculus from supragingival and subgingival regions, site specific scaling and root planning where indicated, and polishing of teeth. If new or recurring periodontal disease appears, additional diagnostic and treatment procedures must be considered.”
In effect, perio maintenance is a type of cleaning that differs from dental prophy in its scope and depth. The complexity and scope of the infection necessitates regular scaling and root planing as well as the potential for treatment with antibiotics.
Dentists generally recommend regular dental cleanings (prophy) to alternate with perio maintenance for those with periodontal disease. This means that instead of two cleanings a year, patients with periodontal disease will receive up to four.
In a discussion about antibiotic prophylaxis, perio maintenance may come up. Patients with periodontal disease have a tendency to bacterial infection. It is possible that they may require dental prophylaxis prior to perio maintenance.
Who needs dental prophylaxis?
Contrary to what was believed in the past, there are actually only a small percentage of patie