For many generations people have gone to the dentist for a “cleaning” not giving thought to what exactly that entails. In fact, there are different kinds of “cleanings” specific to each person’s needs. What most people have experienced is called a prophy, in dental language. A prophy is a cleaning for a person who has a healthy mouth and is truly meant for preventing disease. We measure periodontal probings to ensure that the numbers are 3 mm or less, evaluate for bone loss and check for bleeding gums.
Once a person’s mouth starts showing signs of puffy red bleeding gums and doesn't show bone loss on the films, gingivitis is diagnosed. There are different levels of gingivitis and it is very common for all ages. The good news is that is reversible! A typical cleaning for someone with mild or localized gingivitis is still called a prophy. Commonly, it is recommended to have a prophy more frequently until the bacterial infection and inflammation is gone. Oftentimes, overall health can affect your bodies inflammation and will present as gingivitis. Hormones and medications, as well as vitamin deficiency can all contribute to gingivitis. As professionals, we spend time listening to how you take care of your mouth and help you tweak your routine. It takes a team to maintain a healthy mouth, we cannot do it without your help!
In January 2017, a new and needed dental code was created to fill the gap in dentistry, for people who lie in between mild gingivitis and periodontitis (read paragraph below). There is not a nick name for this cleaning, it's official title is "scaling in presence of generalized moderate or severe gingival inflammation. " Say that five time fast! In a mouth that has moderate or advanced gingivitis a this type of cleaning is done. It is no longer "preventative" because we are now reacting to inflammation rather than preventing it. Since it is a new code, it will be interesting how insurance will cover the code. We anticipate it will not be covered the same as a preventative cleaning, but we will see. Every insurance plan, even within the same dental insurance company is different based on your employer chosen plan. We will verify with your insurance benefits to discover if you have a copay, if this type of cleaning is recommended. We have patients who prefer to use a numbing mouthwash immediately prior to this cleaning, because gums frequently are tender with gingivitis. We also use a specialized numbing gel which can be applied (without a needle) to numb a localized area of gum tissues. We will do our best to make sure your cleaning is comfortable for you.
The next phase past gingivitis is a disease caused by a bacterial infection. Gingivitis transforms from a reversible problem to an infection to reaches the bone that surrounds and supports teeth. The infection is called periodontal disease, or periodontitis and it causes bone loss, which is irreversible. After an exam, clinical and radiographic evidence will confirm signs of periodontal disease which is treated according to its severity. Signs of periodontal disease may include sore gums, bleeding gums, tooth mobility, teeth shifting in position, deep pockets, recession showing the roots of teeth, bad breath, pus and loss of bone seen by your dentist on an x-ray. A patient may be aware of some or none of the symptoms, but your dentist will inform you of the findings after a thorough exam including a prognosis. This is a disease, and not something to feel ashamed of, and we will not shame you. In fact, it is very common. We routinely see adults who haven't been in for a few years, and after an exam, are diagnosed with periodontal disease. In some cases only localized areas of the mouth need to be treated. In other cases the infection is affecting the entire mouth. Treatment for periodontal disease begins with a “cleaning” called Scaling and Root Planing. n this procedure, the depths of the periodontal pockets are accessed to treat the infection. Many people prefer to be numbed with local anesthetic for comfort, but the choice is yours. Sometimes all areas needing treatment will be treated at one visit, sometimes at two visits. The appointment length is longer than a prophy and will depend on your needs. Some adjuncts we use include antibiotics under the gums, laser therapy, and antibacterial prescription mouthwashes. Once research has proven it's effectiveness, we forsee oral probiotics to be included in periodontal therapy. We will discuss what type of toothbrush is best for you and the other healthy habits to maintain good results. Periodontists may also be part of the care team for people who have periodontal disease, for those who need help that is not provided at a general practice. We have trusted specialists we refer to if a consultation is needed. Our goal is to help you keep your teeth your entire life. Teeth are important for quality of life (eating and speaking and smiling) but the most important thing to know is that periodontitis affects your whole body! In the scientific literature, there is a lot of strong research pointing to the correlation of periodontitis with diabetes and coronary artery disease. An unhealthy mouth increases inflammation throughout the body. Periodontal disease cannot be cured and thus must be “maintained” with 3-4 month interval cleanings called Periodontal Maintenance. The great news is not only your mouth, but your overall health can improve with gum disease treatment and the resulting improvement.
Here at Life Smiles, a family dentistry in Plymouth, MN, we treat every mouth individually and you can be assured your mouth will get the cleaning that it deserves!