Dental Hygiene

Regular prophylaxis (dental cleaning) appointments are an essential part of a good dental care regimen. Dental x-rays are recommended to evaluate teeth for decay (cavities) and bone loss around teeth. It is recommended to evaluate teeth for decay every 6 months minimally. In some cases more frequent dental cleanings are recommended.

During a dental cleaning, soft plaque and calculus, also known as tartar, are removed from the tooth surface above and below the gum line. Calculus is calcified or hardened plaque. Plaque contains numerous bacteria that can lead to gingivitis, periodontal disease (gum disease) and tooth decay. The bacteria in plaque can also cause or worsen other conditions in the body. Oral bacteria is linked to complications with heart disease, diabetes, stroke, ulcers and pre-term births.

Gingivitis is inflammation of oral tissue caused by bacterial plaque. It is identified by swollen, tender, and bleeding gums. Healthy gum tissue does not bleed. Gingivitis is reversible with good oral hygiene and regular dental visits. Thorough plaque removal involves brushing 2-3 minutes at least twice daily and flossing below the gum line at least once a day.

Periodontal disease is a disease of the supporting structures of the tooth called the periodontium. The periodontium includes the bone that surrounds the tooth, the small ligaments and connective tissue that anchor the tooth to the bone.

Bacteria that accumulate below the gum line trigger the immune system. The repeated bacterial attack and immune system response leads to a breakdown in the connective tissue and bone. If periodontal disease progresses, the result is infection and tooth loss. Periodontal disease is treated by removing calculus (hardened plaque) from beneath the gum line. If the space under the gum line is deep it is called a periodontal pocket. A normal space is 1-3mm. A pocket that is 4-5mm is usually a result of gingivitis (inflammation). A pocket that is 6mm or greater indicates periodontal disease.

Anesthetic may be administered to make the removal of the calculus more comfortable. It may take several visits to remove all of the calculus deposits. Once the calculus is removed the tissue will heal and pocket depths should decrease. If plaque is kept off of the teeth with good daily brushing and flossing there is a much better chance of controlling the periodontal (gum) disease. Bone that is lost around the teeth due to gum disease is permanent. Prevention of further bone loss is essential. Smoking, diabetes and a compromised immune system can contribute to periodontal disease.

Sometimes it is recommended to see a periodontist, a specialist in the treatment of periodontal disease. Surgery to help reduce pocket depth or to re-contour or replace diseased bone may be recommended.

It is generally recommended to have your teeth cleaned every 3-4 months if you have gum disease.