A prophylaxis is for someone that has completely health gum tissue with no evidence of bone loss. Periodontal maintenance is for someone who has either bone loss or deep pockets (caused by bacteria) around their teeth or both. Periodontal maintenance is for a patient with gum disease (periodontitis). The signs of gum disease are not always easy to see and can be painless. Once you have periodontal maintenance, you cannot go back to a regular cleaning as the damage to your gum tissue and bone loss has already taken place and you need to maintain the periodontal health usually every 3 to 4 months instead of your typical 6 months. Failure to do so can result in worsening of your periodontal status thus potentially leading to further bone loss, gum recession and tooth loss.