Are They Getting Any Better?

It may not be getting any worse but is it getting better? The effects of chronic inflammation.

One of the statements Kim, Jamie and I hear a lot when we coach clients is this:

“I have a lot of patients that have 4-5mm pockets that bleed, but they’ve been like that for a long time. They’re maintaining and aren’t getting any worse so why should we recommend anything different than maintenance?”

Our question is then: “But are they getting any better?”

The definition of maintain is:

1) to continue, carry on

2) to keep in existence

3) to keep in good repair, condition

All these definitions imply that maintenance is to keep something in a GOOD state, not a state of disrepair. Chronic, long-term inflammation is a state of disrepair.

When patients are maintained in a state of disrepair (periodontal infection or dental infection) they may not be getting any worse but they are not getting any better. They are maintaining chronic inflammation and infection.

Now, to be fair, there are plenty of patients that have residual pockets over 3mm after active perio treatment that are perfectly healthy. These are patients that do not exhibit bleeding on probing or exploring, the tissue is generally pink and firm in tone, and the patient has little to no health history risk factors.

When this is not the case, and there is active inflammation, the following correlations have been shown between overall health and chronic periodontitis (references available upon request):

  • Increased risk for heart attack and stroke
  • Increased difficulty in maintaining healthy blood sugar levels for diabetics
  • Increased risk for cardiovascular disease and kidney failure in diabetics
  • Increased difficulty in managing other inflammatory conditions such as rheumatoid arthritis and lupus
  • Increased likelihood to have obstructive sleep apnea


So take another look at those patients that aren’t getting worse.

Ask yourself, “Are they getting any better…what care can I provide to help them get there?”

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