Background There is weak evidence to support the benefit of periodontal maintenance therapy in preventing tooth loss. In addition, the effects of long-term periodontal treatment on general health are unclear.

Materials/Methods Compliant and partially compliant patients (15-25 years follow-up) in private practice were observed for oral and systemic health changes.

Results 219 compliant patients (128 females, 91 males) were observed for 19.1 years (range 15-25, SD ± 2.8). Age at reassessment was 64.6 years (range 39-84 SD ±9.0). 145 patients were stable (0-3 teeth lost), 54 were downhill (4-6 teeth lost) and 21 patients extreme downhill (>6 teeth lost). 16 patients developed hypertension, 13 developed diabetes II, and 15 suffered myocardial infarcts (MI). A minority developed other systemic diseases. Risk factors for MI included overweight (OR 9.04,95% CI:2.9-27.8, p=0.000), family history with cardiovascular disease (OR 3.10, 95 % CI:1.07-8.94, p=0.029), diabetes I at baseline (p=0.02) and developing diabetes II (O.R. 7.9, 95 % CI: 2.09-29.65, p=0.000). 25 partially compliant patients (8 females, 17 males) were observed for 19 years. This group had a higher proportion of downhill and extreme downhill cases and MI.

Conclusion Patients who left the maintenance program in a periodontal specialist practice in Norway had a higher rate of tooth loss than compliant patients. Compliant maintenance patients in specialist practice in Norway have a similar risk of developing diabetes type II as the general population. A rate of 0.0037 myocardial infarcts per patient per year was recorded for this group. Due to the lack of external data, it is difficult to assess how this compares with untreated periodontal patients.