How often should supportive periodontal therapy visits be scheduled?

The evidence does not support a single fixed interval for all patients; instead, risk-based scheduling is more appropriate. A systematic review found that evidence for a specific recall interval (e.g., every 3 months) for all patients is weak, and that the merits of risk-based recommendations over fixed regimens should be explored ^[1]. A large cohort study identified minimum thresholds below which tooth loss risk rose significantly: approximately one visit every 7.4 months for stage I-II periodontitis, and every 6.7 months for stage III-IV or grade C disease ^[2]. Stage III-IV patients who skip more than one year of maintenance in a five-year period face an odds ratio of 2.55 for periodontitis-related tooth loss compared to those who miss only one year ^[2].

Several patient factors should push the interval shorter. Former and current smokers, diabetics, and elderly patients warrant more frequent visits than these minimum thresholds suggest ^[2]. Smoking and residual deep pockets have also been shown to negatively influence bleeding on probing reduction during supportive care ^[3]. The systematic review on recurrence notes that regular supportive periodontal care appears important for reducing tooth loss over the long term, though no superior method of managing recurrence has been identified ^[4].

In practical terms, the current evidence supports individualising recall frequency based on staging, grading, and systemic/behavioural risk factors rather than prescribing a uniform three-month interval for every patient ^[1][2].