Dental Cleaning & Periodontal Therapy
Being able to restore your teeth with fillings, crowns and the like means nothing if we can’t keep them and the surrounding tissue healthy. That’s why the dental cleaning – known as prophylaxis in industry terms – we provide all of our patients is so critical to your oral health, not to mention your overall well-being.
What is a Dental Cleaning?
A dental prophylaxis is the removal of plaque, bacteria, calculus and extrinsic stains by a qualified dental hygienist. This cleaning is not sub-gingival, meaning your provider will not go underneath your gums to clean out any material – which for the average, healthy patient is not necessary. In our office, we’ll pair your regular cleanings (usually recommended every 6 months) with oral examinations by the dentist and updates on x-rays as warranted. We also check the health of your gums and surrounding tissues at these visits, which take approximately one hour.
What is Periodontal Therapy?
Sometimes a regular prophylaxis just isn’t enough. A number of factors – oral hygiene practices at home, systemic diseases, genetics and pregnancy included – can cause you to fall somewhere on the spectrum of periodontal disease. Periodontal disease is, simply, infection of the gums due to the continued presence of harmful bacteria in the mouth. It can range from mild gingivitis, where the gums are inflamed due to the bacteria but no permanent damage has been done, to severe periodontitis, where you’ve likely already had significant loss of gum attachment, bone loss and tooth loss from the present active infection.
For patients who need more than just a traditional cleaning but haven’t yet developed periodontitis, we recommend gingival scaling. This patient exhibits all the signs of moderate to severe gingivitis: bleeding gums, inflammation, moderate to heavy plaque – but no visible bone loss or major loss of gum attachment.
So what exactly does that entail? Gingival scaling removes tartar and bacteria above and slightly below your gum line using hand instruments and ultrasonic scalers. We then ask you to come back sooner than normal (usually 3-4 months) so our hygienists can diagnose your overall gum health and determine how well the scaling worked. Usually after this treatment, if your homecare has improved, the gingivitis is reversed and traditional cleanings can be performed going forward. If no changes are made and the gingivitis does not resolve we will recommend shorter periodontal recall visits, or potentially progress to more intensive treatment.
In these cases, depending on how far the periodontal disease has progressed, you may need a referral to a periodontist. We are thrilled to have Dr. Becky on site 2-3 days a month to help our patients with many of their more extensive periodontal concerns. If the disease has been caught early enough, we can provide active periodontal therapy in our office, known as scaling and root planing. The process is as follows:
- 2-4 visits of active therapy: Our hygienists will treat each quadrant of your mouth (upper left, lower right, etc.) separately. Often one whole side of the mouth can be treated in one visit, but sometimes the cleaning is complex enough to warrant 4 separate sessions. In these visits, any dental plaque, calculus and associated bacteria will be removed both above and below the gum line. They’ll also use a dental laser During and after this therapy, you’ll be given an antibiotic mouth rinse to use twice daily and detailed oral hygiene home care instructions. At each visit, your hygienist will also recheck and quickly sweep through the previously treated quadrants.
- 4-6 weeks after you’ve finished the active therapy, we’ll bring you back for a re-evaluation and periodontal maintenance visit. Here we recheck your periodontal charting (a series of measurements designed to tell us how well attached your gums are to your teeth, and subsequently their overall level of health), re-evaluate the tissues and perform a periodontal maintenance prophylaxis (both sub and supragingival). Ideally, at this visit we’ve got great news for you – the therapy has worked, your home care has improved (we can’t get you healthy all on our own!) and your overall oral health is looking much brighter.
After these sessions, we need to keep seeing you regularly to avoid a recurrence of periodontal infection. Usually, this means periodontal maintenance visits every 3 to 4 months; since everyone is a little different, our hygienists and dentist will work with you to determine the best course of action.