New patients receive a comprehensive examination which includes a screening for oral cancer, gum and bone disease, blood pressure, and systemic disorders. A routine oral exam is performed on established patients to determine any changes in dental and health status since the previous visit.
Your gum tissue is measured with a fine instrument ruler to calibrate in millimeters pocket depth between the tooth and the connective gum tissue around the tooth. Pocket depths more than 4 millimeters, could indicate disease and infection. The deeper the pocket, the greater the extent plaque bacteria collects and infection in gum disease develop.
X-rays are taken as needed.
Tooth scaling and root planing occur as needed.
Routine cleanings also include a professional polishing (Prophy) that removes only the soft sticky plaque that is above the gum line.
In order to remove plaque, tartar and calculus deposits from your teeth, a tooth scaling must occur. In some cases plaque and tartar are present below the gum line and a sub-gingival tooth scaling must occur.
After scaling the teeth, roots may need to be planed to smooth the root surface. Soft tissue will re-attach itself to a smooth tooth surface.
Dr. may also recommend medications to help control infection, pain, or to encourage healing.
Proper brushing of teeth can be done in three steps:
- Brush teeth gently using a circular motion along the outside and inside of the tooth surface while holding the brush at a 45 degree angle.
- Make sure to brush each tooth individually and to use the front half of the brush in a circular motion vertically behind the front teeth.
- Place the brush against the top of your teeth use a gentle back-and-forth motion to brush. After brushing all your teeth be sure to brush your tongue in order to remove odor-producing bacteria.
Break off about 18 inches of floss and wind some of it around your middle finger (3 turns). This finger will take up the floss as it becomes dirty. Shorten the length between the two fingers to 6 inches and wind some floss (1 turn) around the opposite middle finger. Hold the floss tightly between your thumbs and index fingers.
Guide the floss between your teeth using a gentle rubbing motion. When the floss reaches the gum line, curve it into a C shape against one tooth. Gently slide it into the space between the gum and the tooth. Hold the floss tightly against the tooth as you gently rub the side of the tooth with an up and down motion. Before retrieving it, clean the adjacent tooth surface.
As you finish cleaning each contact wind the dirty floss once around the first middle finger and slide more new length of floss to proceed to the next contact.
Gingivitis is an early stage of gum disease. Gingivitis develops as toxins, enzymes and other plaque byproducts by irritating the gums, making them tender, swollen and likely to bleed easily. Gingivitis generally can be stopped with proper oral hygiene and minor treatment from your dentist. If this is achieved, your gums can return to a healthy state.
When the bone tissue starts to deteriorate, this is known as a form of gum disease called Periodontitis. This happens when the byproducts of plaque attack the tissues that hold your teeth to the bone. The gums begin falling away from the teeth and form pockets in the gums which allows more plaque to collect below the gum line. When this occurs, the patient becomes more sensitive to hot and cold and the roots of the teeth are more vulnerable to decay.
Advanced periodontitis occurs when a major amount of gum and bone tissue has been lost and the teeth are losing more and more support due to the loss of periodontal ligament and bone. Some teeth are unable to be saved and must be extracted. If left untreated, advanced periodontitis can cause severe health problems elsewhere in the body.