Root Planning and Scaling (Deep Cleaning)

Periodontal Disease

Periodontal disease (gum disease) is an infection that affects the gums and bone that support the teeth. Measurements are taken in millimeters to determine the “pocket depth” around the collar of gum tissue. The higher the number, the greater the inflammation and bone loss. Left untreated, periodontal disease may lead to tooth loss. It is possible to not be aware that you have this disease. Some Warning Signs may be:
  • Bleeding gums (healthy gums don’t bleed)
  • Swollen and tender gums
  • Bad breath
  • A change in how the teeth fit together
  • Pus

Causes:

Periodontal disease begins with plaque formation (the sticky, colorless film that forms within 20 minutes.) If not effectively removed with daily brushing and flossing this bacteria then attaches to the tooth in a hardened form called calculus or tartar. The tartar holds toxins which are impossible to remove even with regular brushing.

Links to Systemic Diseases

Now we know there is a link between the general health of our gums and:
  • Diabetes
  • Cardiovascular diseases
  • Stroke
  • Bacterial pneumonia
  • Low birth weight in babies
It is especially important to maintain healthy gum and bone structures as we learn how this can aid in our whole body health.

Increased Risk

There are several factors that may put someone in an increased risk category. Poor homecare – where the bacteria is not effectively removed daily with brushing and flossing, or if food particles catch between the teeth causing a constant irritant. This creates inflammation, bleeding and eventual bone loss.
  • Smoking – Studies show that smokers and tobacco users have a higher incidence of periodontal disease. People in this category tend not to bleed due to the vasoconstriction property of the nicotine. Periodontal disease can be quite a surprise.
  • Systemic diseases – Diabetes, blood disorders, auto immune disorders and HIV/AIDS lower the resistance to infection. Periodontal disease can be more severe in these cases.
  • Hereditary factors – If parents have lost teeth to periodontal disease, the children may be more prone.
  • Medications – Many medications can cause dry mouth. A lack of saliva can make effective plaque removal more difficult. This increases the tissue inflammation and potential of periodontal disease.

Treatment

Once the dentist and hygienist have determined that Periodontal Therapy is necessary, an individualized program will be developed for you. Anesthetic will be used to ensure your comfort. Your periodontal program will include:
  • Measuring and recording the gum pockets, recession of the gums, tooth mobility and bleeding points indicating active infection.
  • A periodontal evaluation of contributing factors such as medical or general health concerns, oral hygiene/homecare practices, crowded teeth or other bite related issues, hereditary factors, smoking etc.
  • Thorough removal of the tartar and plaque buildup above and below the gumline.
  • A 30-day re-evaluation appointment. Evaluating the success of the therapy provided, the recommended homecare effectiveness along with the individualized healing response is critical. This is when non-responsive areas can be retreated, an antibiotic placement in isolated, specific sites will be considered or even a referral to a Periodontist (the gum specialist) will be discussed.

Expectations after Periodontal Therapy

Once the recommended periodontal therapy has been completed we expect to see a decrease in the pocket measurements, tight pink tissue and gums that don’t bleed. Impeccable homecare with morning and nighttime brushing using an electric toothbrush is ideal. Research shows that electric brushes do a much better job of cleaning than a manual brush. Flossing at least once a day will minimize the reoccurance of the disease. Periodontal disease starts in between the teeth.

Maintenance

Maintaining a 3-month periodontal maintenance appointment with the hygienist will ensure prompt attention to any areas of concern should changes occur. Bacteria begins to form in the base of the pockets within 90 days in numbers that begin to destroy the underlying bone. For this reason the periodontal maintenance appointment is scheduled every 90 days to retreat the infected pockets before further destruction occurs. The ultimate goal of providing this therapy is to maintain a healthy foundation of gum and bone so teeth will not be lost. In most cases this is preventable with regular care. Although wonderful advances have been made in dentistry, providing us with more choices in treatment options than ever before… there is still nothing better than your own teeth!