Research Corner - Periodontitis stage and grade modifies the benefit of regular supportive periodontal care in terms of need for retreatment and mean cumulative cost
Mr Alex Pollard, our Honorary Editor, has kindly written a precis of a really thought-provoking article that was recently published:
Periodontitis stage and grade modifies the benefit of regular supportive periodontal care in terms of need for retreatment and mean cumulative cost
This study by Saleh et al. (2024) was a fascinating read and serves as a great reminder of why we focus so much on tailoring supportive periodontal care (SPC) to individual needs. The researchers looked at how the stage and grade of periodontitis affect the need for retreatment and the overall cost of care. They went back through the records of 442 patients who had completed active periodontal therapy (APT) at least 10 years earlier, with an average follow-up of nearly 22.7 +/- 6.7 years (wow!).
Several things stood out in the results. For starters, nearly two-thirds of patients in long-term SPC ended up needing further active treatment—62% of those with less severe (Stage I/II) disease and 72% with more advanced (Stage III/IV) periodontitis. The grade of the disease also played a role: 71% of Grade C patients, 68.2% of Grade B, and 57.2% of Grade A patients needed additional interventions like surgery or subgingival instrumentation.
Also interesting was that advanced cases—Stages III/IV and Grade C—required significantly more surgical retreatments than less severe cases. As usual, factors like smoking, diabetes, and irregular SPC visits made it more likely for patients to end up back in the chair for retreatment.
From a financial perspective, the study showed that regular SPC was more cost-effective for advanced cases. Compliant patients with Stage III/IV or Grade B/C disease had lower cumulative treatment costs compared to those who didn’t stick to their maintenance schedule. On the other hand, patients with milder disease (Stage I/II or Grade A) might not need as many SPC visits—one per year might be enough in some cases, saving both time and money without impacting their outcomes.
This study really reinforces the importance of tailoring SPC to each patient. Advanced cases clearly benefit from a more intensive approach to maintenance, while those with milder disease may be okay with a lighter touch. For all patients, though, educating them on the importance of SPC is absolutely key—it can prevent tooth loss, minimize retreatments, and reduce overall costs in the long run.
For me, it’s another reminder of why we do what we do. Helping people keep their teeth isn’t just about oral health—it’s about quality of life, reducing the need for invasive treatments, and making sure patients get the best care in a way that works for them. It also reminds us that periodontitis follows us on our life journey and most patients relapse for one reason or another, often due to changes in habit and routine due to life stresses - we need to remain vigilant of this. This study is a great example of how a thoughtful, personalized approach can make all the difference.