Dental Exams and Cleanings
Preventing Problems Before They Start
By routinely seeing your dentist for exams and cleanings, you can:
- Prevent tooth decay, gum disease, and bad breath
- Save money by avoiding costly and extensive dental procedures
- Keep your teeth white by reducing staining from food and drinks
- Shorten the time spent in your dentist’s office
- Have a smile that will last a lifetime
During your exam, your dentist will thoroughly examine your teeth and gums for signs of tooth decay, gum disease, and other health problems. Your dentist may also want to take X-rays to see what is happening beneath the surface of your teeth and gums. Whether these X-rays are traditional or digital, the images provided will help your dentist discover dental issues not visible to the naked eye.
Your dental hygienist will begin your cleaning by exploring the surface of your teeth to determine if you have any cavities and to examine the quality of existing fillings. The dental hygienist will then perform a periodontal exam to make sure your gums adhere tightly to your teeth, and no periodontal disease or bone loss may be occurring.
Next, your hygienist will carefully clean your teeth with a variety of tools to remove any hard mineral buildup (tartar) from your teeth. Then your hygienist will floss your teeth, use a polishing compound, and apply fluoride. Cleanings usually aren’t painful, but if you have any anxiety about your dental exam, be sure to let your hygienist know. They may offer several sedation options to ensure your comfort. If your dentist or hygienist finds tooth decay or gum disease, they will talk to you about changing your brushing or flossing habits. In severe cases, they may recommend antibiotics or other dental treatments. If your teeth and gums appear to be healthy, your dentist will probably recommend that you continue your brushing and flossing routine as usual.
What causes gum disease?
Gum disease is caused by a buildup of plaque (a sticky form of bacteria that forms on the teeth). If the plaque is not removed (by flossing, brushing, and regular dental checkups), it will continue to build up and create toxins that can damage the gums. Periodontal disease forms just below the gum line and creates small pockets that separate the gums from the teeth. Periodontal disease has two stages: gingivitis and periodontitis.
- Gingivitis — This is the early stage of gum disease, when the gums become red and swollen, and bleed easily. At this stage, the disease is treatable and can usually be eliminated by daily brushing and flossing.
- Periodontitis — If left untreated, gingivitis will advance into periodontitis, and the gums and bone that support the teeth will become seriously and irreversibly damaged. Gums infected with periodontitis can cause teeth to become loose, fall out, or be removed by a dentist.
Certain factors can increase a patient’s risk of developing periodontal disease, including:
- Smoking or using chewing tobacco
- Certain types of medication such as steroids, anti-epilepsy drugs, cancer therapy drugs, calcium channel blockers, and oral contraceptives
- Bridges that no longer fit properly
- Crooked teeth
- Old fillings
While it is possible to have periodontal disease and not know it, some symptoms can include:
- Gums that bleed easily
- Red, swollen, tender gums
- Gums that have pulled away from the teeth
- Persistent bad breath or bad taste
- Pus between your teeth and gums
- Permanent teeth that are loose or separating
- Any change in the way your teeth fit together when you bite
- Any change in the fit of partial dentures
Treating Gum Disease
Treatments for gum disease can vary depending on the severity of each individual case. Typical treatments include:
- Non-surgical treatments such as at-home periodontal trays, and scaling and root planing (deep cleaning)
- Periodontal surgery and laser gum surgery
- Dental implants
Preventing Gum Disease
Regular dental checkups and periodontal examinations are important for maintaining your health and the health of your smile. You don’t have to lose teeth to periodontal disease, and by practicing good oral hygiene at home, you can significantly reduce your chances of ever getting gum disease. Remember to brush regularly, clean between your teeth, eat a balanced diet, and schedule regular dental visits to help keep your smile healthy.
The first line of defense against gum disease is a unique type of cleaning called “scaling and root planing.” In this procedure, an ultrasonic cleaning device is used to remove plaque and tartar from your teeth where regular cleaning devices can’t reach: under the gum line, on the tooth, and around the root. Then, the rough surface of the tooth and the root are smoothed out (planed). This provides a healthy, clean surface that makes it easier for the gum tissue to reattach to the tooth.
If you address your gum disease before it becomes severe, scaling and root planing may be the only treatment you need. However, as with any dental procedure, after-care is vital. In order to keep your teeth in good shape and resist future occurrences of gum disease, you must brush and floss daily, eat a healthy diet, avoid tobacco use, and have regular dental checkups. Even after a successful scaling and root planing, if you don’t attend to your teeth properly, it’s quite likely that you’ll develop gum disease again.
Surgical Treatment Options
- Pocket Depth Reduction
In a healthy mouth, the teeth are firmly surrounded by gum tissue and securely supported by the bones of the jaw. Periodontal disease damages these tissues and bones, leaving open spaces around the teeth that we call pockets. The larger these pockets are, the easier it is for bacteria to collect inside them, leading to more and more damage over time. Eventually the supportive structure degrades to the point that the tooth either falls out or needs to be removed. During pocket reduction procedures (also known as “flap surgery”), we fold back the gum tissue and remove the bacteria hiding underneath, as well as the hardened plaque and tartar that have collected. We may also remove any tissue that is too damaged to survive. We then sew the healthy tissue back into place. Now that the tooth and root are free of bacteria, plaque, and tartar, and the pockets have been reduced, the gums can reattach to the teeth.
When the bone and tissue supporting the teeth have been lost due to severe gum disease, we can restore these areas with a regeneration procedure. During this process, we begin by folding back the gum tissue and removing the bacteria, plaque, and tartar. Depending on your situation, we may then perform a bone graft to stimulate new bone growth, or we may apply a special kind of protein that stimulates tissue growth to repair the areas that have been destroyed by the disease.
- Soft-Tissue Graft
A frequent symptom of gum disease is gum recession (also called gingival recession). As the gums recede, more of the roots are revealed. This can make teeth appear longer and can also create sensitivity to hot or cold liquids or food. It also exposes the tooth to increased damage from gum disease, as bacteria, plaque, and tartar attack the surface of the tooth and the root. During a soft-tissue graft, tissue from the top of your mouth or another source is sewed to the gum area, covering the roots and restoring the gum line to its original, healthy location. This procedure can also be performed for cosmetic reasons.