In The Periodontist’s OfficeThe best way to prevent periodontal disease (and cavities as well) is by good tooth brushing and flossing techniques, performed daily, and regular professional examinations and cleanings. Unfortunately, even with the most diligent home dental care, people still can develop some form of periodontal disease. Regular dental visits are also important. A professional cleaning at least twice a year is necessary to remove calculus from places your toothbrush and floss may have missed. A full mouth series of x-rays is advised every 2 - 3 years. This will alert the dentist to early bone loss and other disorders of the oral cavity. A periodontal examination once or twice a year should reveal any incipient or progressive problems. Periodontal Screening and Recording (PSR) using a probe to measure gum pockets, is encouraged. Your periodontist will identify any areas where deep pocketing has occurred, where the health of the gingiva appears compromised, and where there is undue mobility of teeth. Once gum disease starts, professional intervention is necessary to prevent its progress. A periodontal evaluation may be the only way to detect periodontal disease, since it often has no symptoms. Once periodontal disease develops, more intensive treatments are needed. A periodontal exam may be especially important if you:
When is Treatment Needed for Periodontal Disease? Healthy gums enhance the appearance of your teeth, like a frame around a beautiful painting. Periodontal treatment is necessary when various conditions affect the health of your gums and the regions of your jawbone which hold your teeth in place. Retaining your teeth is directly dependent on proper periodontal care and maintenance. When your gums become unhealthy, they can either recede or become swollen and red. In later stages, the supporting bone is destroyed and your teeth can shift position, loosen, or fall out. These changes not only affect your ability to chew and speak; they also adversely affect your smile. Scaling & root planing (deep cleanings) If you have been diagnosed with some form of gum disease, the first step in trying to eliminate the infection and get the disease under control is done through a non-surgical approach called scaling and root planing. Scaling and root planing (sometimes called a deep cleaning) is a very thorough cleaning done under anesthetic (you are numb), so we can aggressively get under the gum line and into the deep pockets in an attempt to clean out as much of the plaque, calculus (tarter), toxins, and bacteria as possible that have caused the pockets. The deeper the pockets, the harder it is to completely eliminate the factors (i.e., plaque, calculus, toxins, and bacteria) leading to the disease. Studies have shown you can effectively clean 4mm deep pockets, but as the pocket depths increases the ability to clean and smooth the roots of your teeth significantly decreases. What can I expect? Normally with this procedure your whole mouth is cleaned in one extended appointment with the hygienist. On occasion, depending on your time schedule and the difficulty of your case, this may be broken into shorter appointments. After your cleaning you may have some mild discomfort or soreness which can normally be relieved with something like Tylenol® or Ibuprofen. As the inflammation goes down some of your roots may become exposed causing possible thermal sensitivity to hot or cold. This sensitivity will get better, but it may take time for it to Four to six weeks following this deep cleaning you return to our office for a re-evaluation. At this appointment, which has no charge, you receive another exam similar to your first visit to the office in order to determine how you have responded to your initial therapy. Sometimes scaling and root planing is enough to completely correct mild to moderate periodontal problems, greatly reducing both the inflammation, bleeding, and pocket depths in your mouth. More Advanced Treatments If residual disease and deep pockets remain however, you most likely will need some form of surgical treatment and intervention. Our goal is to help you keep and maintain as many of your natural teeth for as long as possible without compromising adjacent teeth. Treatments include:
Making Treatment More Comfortable Today, we’re making it more comfortable than ever to treat your gum disease. One of the biggest advances is the anesthetic wand. What is an anesthetic wand? The syringe, a 150-year-old technology, was one of the first methods to deliver local anesthetics. Today, much of the fear, anxiety and pain have been taken out of dental anesthetic injections. Improved equipment, such as the anesthetic wand, make periodontal treatment more pleasant. The wand is a computer-controlled, local anesthesia system that enables periodontists to deliver a painless injection of local anesthetic, virtually eliminating discomfort, and providing a more pleasurable experience for the patient. |
So What Can I Do?Proper Brushing Correct tooth brushing, mouth cleansing, and flossing should be everyone's defense against periodontal disease.
To properly brush your teeth, use short, gentle strokes, paying extra attention to the gumline, hard-to-reach back teeth and areas around fillings, crowns or other restoration. Concentrate on thoroughly cleaning each section as follows:
Flossing should finish the process. A mouthwash may also be used. If brushing after each meal is not possible, rinsing the mouth with water after eating can reduce bacteria by 30%. Toothpaste IngredientsA modern toothpaste has a variety of ingredients to provide effective protection against various dental conditions. The most common active ingredients in toothpastes include:
Additional ingredients such as enzymes, vitamins, herbs, calcium, mouthwash may also be included in the formulas. How to Choose a Toothpaste Toothpaste. The objective of a good toothpaste is to reduce the development of plaque and eliminate periodontal-causing microorganisms without destroying the organisms that are important for a healthy mouth. All brands should show ADA approval. Even a good toothpaste, however, cannot be delivered past 3 mm below the gum line, where periodontitis develops. Toothpastes are a combination of abrasives, binders, colors, detergents, flavors, fluoride, humectants, preservatives, and artificial sweeteners. Avoid highly abrasive toothpastes, especially for individuals whose gums have receded. Fluoride toothpastes are proven to prevent cavities. Consult your dentist or hygienist about your oral health and your greatest needs. Then look for products within that category (for example, within the tartar control brands or within the desensitizing toothpaste brands). If you have a tooth sensitivity problem avoid the use of whitening toothpastes. Triclosan. Triclosan is an anti-bacterial substance that may help reduce mild gingivitis.
Metal salts. Metal salts, such as stannous and zinc, serve mostly as anti-bacterial substances in toothpastes. Stannous fluoride gel toothpastes do not reduce plaque, however, even though they have some effect against the bacteria that cause it, but slightly reduce gingivitis.
Peroxide and baking soda. Toothpastes with these ingredients claim to have a whitening action, but while they may help remove stains there is little evidence they whiten the actual color of the teeth. In addition, these substances appear to offer no benefits against gum disease. Antibacterial sugar substitutes (xylitol), and detergents (delmopinol) Flossing The use of dental floss, either waxed or unwaxed, is critical in cleaning between the teeth where the toothbrush bristles cannot reach. In spite of this, nearly two-thirds of people do not floss. To floss correctly, the following steps may be helpful:
Use a floss that does not shred or break. Avoid a very thin floss, which can cut the gum if brought down with too much force or not guided along the side of the tooth. A floss threader is an invaluable aid for the person who has bridgework. Made of plastic, it looks like a needle with a huge eye, or loop. A piece of floss is threaded into the loop, which can then be inserted between the bridge and the gum. The floss that is carried through with it can then be used to clean underneath the false tooth or teeth and along the sides of the abutting teeth. Another handy device for cleaning under bridges is a Proxabrush, which is an interdental cleaner. This is a tiny narrow brush that can be worked in between the natural teeth and around the attached false tooth or teeth. Special toothpicks such as Stim-U-Dent may be effective for wide spaces between teeth but should never replace flossing. Standard toothpicks should never be used for regular hygiene. Who invented the first electric toothbrush? According to a number of online reports, Innovator Philippe Guy E. Woog invented the electric toothbrush in 1954 for E.R. Squibb and Sons. Squibb introduced the motorized contraption as the Broxodent brush in 1959 at the American Dental Association's centennial celebration and began marketing it to the public in 1960. The Squibb Corp. introduced its Woog Orasystem with a two-page ad that featured a tiger on one page, and, on the right-hand page, the headline declared, "If your patients ate like he did, they wouldn't need the Woog Orasystem." The text for the ad started off, "If your patients ate raw meat and chewed bones as a regular part of their diets, you could be sure their teeth and supporting periodontium were getting a healthy workout." The Broxodent was an oscillating motor, electric toothbrush which first appeared in 1956 in Switzerland and was introduced to the United States at the centennial celebration of the American Dental Association in 1959. The dental profession almost immediately realized the importance of this contribution to oral health. It literally changed the brushing habits of large sections of the population throughout the world and provided stimulation to, and cleansing of, oral tissues. Practically the impact has been so great that more than 150 other brands of automatic toothbrushes have been introduced since Philippe Woog's invention and the survivors today of these numerous brands are essentially imitators of the original Broxodent ® design. Consumers did not take to the electric toothbrush very well until General Electric introduced a cordless rechargeable model in 1961, perhaps because they didn't feel comfortable using a toothbrush attached to an electrical outlet. After the rechargeable model went on the market, sales increased significantly. Dr. Woog's work has been the subject of over 160 clinical papers. What types of electric toothbrushes are there? Some electric toothbrushes vibrate at ultrasonic frequencies. Others have sets of bristles that move one way and then another, have heads that move from side to side, or have heads that rotate. When used correctly, rotation/oscillation movement provides better cleaning than other toothbrushes. It is more effective at removing plaque from hard-to-reach areas. Benefits A Great Britain research project published in 2005 found a rotation/oscillation brush removed about 11 percent more plaque over three months than a manual brush did, and also was about 6 percent more effective at reducing gingivitis. After more than three months, gingivitis was reduced 17 percent. The brush proved to be more effective at removing plaque on back molars and between teeth, as well as under the gum line. The project reviewed 42 studies since 1964 with more than 3,800 total participants. Considerations The rotation/oscillation brush also provides a distinct benefit for people with conditions such as arthritis that cause pain in hands and wrists. People who find toothbrushing to be a painful activity likely will not do it often enough or effectively enough, and this goes for flossing, as well. People with limited mobility due to multiple sclerosis and other neurological disorders also may have better success with an electric brush. No matter what brush is used, people still must floss at least once a day to remove food residue and plaque, because no brush can reach between teeth as effectively as floss. If you have dexterity problems or a physical disability, you may find it difficult to use your toothbrush or dental floss. Your dentist or periodontist can suggest options such as an electric toothbrush or floss holder or a toothbrush with a larger handle. |