A comprehensive dental exam will be performed by your dentist at your initial visit. At regular check-up exams your dentist and hygienist will perform the following procedures:
- Examination of diagnostic x-rays: This is essential for detection of decay, tumors, cysts and bone loss. X-rays also determine tooth and root positions.
- Oral cancer screening: Examine the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
- Gum (periodontal) disease evaluation: Evaluate the gums and bone around the teeth for any signs of periodontal disease.
- Examination of tooth decay: All tooth surfaces will be assessed for decay with special instruments and existing restorations, such as crowns and fillings, will be evaluated for any recurrent decay.
Professional Dental Cleaning
Professional dental cleanings (dental prophylaxis) are usually performed by Registered Dental Hygienists and are performed on patients who are periodontally healthy. If you are a candidate, your cleaning appointment will include a dental exam and the following:
- Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line, and can only be removed with special dental instruments.
- Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation (gingivitis) is the start of periodontal disease.
- Tooth polishing: Remove stain and plaque that is not otherwise removed during scaling.
This is a focused beam of X-Ray particles through bone which produces an image on special film, showing the structure through which it passed. This gives the familiar black and white images that doctors and dentists use to diagnose problems. X-rays are a necessary part of the diagnostic process, and not to use them could lead to undiagnosed disease. Without an X-ray of the whole tooth, and supporting bone and gum tissues, there is no other way to detect infection or pathology that requires attention.
The word periodontal means “around the tooth”. Periodontal disease attacks the gums and the bone that support the teeth. Plaque is a sticky film of food debris, bacteria, and saliva. If plaque is not properly removed within about 24 hours, it hardens and becomes known as calculus (tartar). When plaque and calculus are not removed, they begin to destroy the gums and bone. Periodontal disease is characterized by red, swollen, and bleeding gums. Four out of five people have periodontal disease and don’t know it! Most people are not aware of it because the disease is usually painless in the early stages.
Not only is it the number one reason for tooth loss, research suggests that there may be a link between periodontal disease and other systemic diseases such as stroke, bacterial pneumonia, diabetes, cardiovascular disease, and increased risk during pregnancy. Smoking also increases the risk of periodontal disease. Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.
Treatment methods of periodontal disease depend upon the type and severity of the disease. Your dentist and dental hygienist will evaluate for periodontal disease and recommend the appropriate treatment.
Periodontal disease progresses as the sulcus (pocket or space) between the tooth and gums get filled with bacteria, plaque, and tartar, causing irritation to the surrounding tissues. When these irritants remain in the pocket space, they can cause damage to the gums and eventually, the bone that supports the teeth.
If the disease is caught in the early stages of gingivitis, and no damage has been done, one to two regular cleanings will be recommended. You will also be given instructions on improving your daily oral hygiene habits and having regular dental cleanings.
If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planing (deep cleaning) will be recommended. It is usually done one quadrant of the mouth at a time with local anesthetic. In this procedure, tartar, plaque, and toxins are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (root planing). This procedure helps gum tissue to heal and pockets to shrink.
Medications, special antibacterial mouth rinses, and an electric tooth brush may be recommended to help control infection and promote healing. If the pockets do not heal after scaling and root planing, periodontal surgery may be needed to reduce pocket depths, making teeth easier to clean. Your dentist may also recommend that you see a Periodontist (specialist of the gum and supporting bone).
It only takes twenty four hours for plaque that is not removed from your teeth to turn into tartar. Daily home cleaning helps control plaque and tartar formation, but those hard to reach areas will always need special attention. Once your periodontal treatment has been completed your dentist and dental hygienist will recommend that you have regular maintenance cleanings (periodontal cleanings), usually four times a year. At these cleaning appointments, the pocket depths will be carefully checked to ensure that they are healthy. Plaque and calculus that is difficult for you to remove on a daily basis will be removed from above and below the gum line.
In addition to your periodontal cleaning and evaluation, your appointment may also include:
- Examination of diagnostic x-rays (radiographs): This is essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
- Examination of tooth decay and evaluation of existing restorations for recurrent decay.
- Oral cancer screening: Examine the face, neck, lips, tongue, throat, check tissues, and gums for any signs of oral cancer.
- Oral hygiene recommendations: Review and recommend oral hygiene aids as needed. (Electric toothbrushes, special periodontal brushes, fluorides, antibacterial rinses, etc.)
- Teeth polishing: Remove stain and plaque that is not otherwise removed during scaling. Good oral hygiene practices and periodontal cleanings are essential in maintaining dental health and keeping periodontal disease under control.