Hygiene

Treatment of Periodontitis

Periodontal Disease (gum disease) is a bacterial infection of the gums and bone surrounding a tooth.  When plaque bacteria is not controlled by brushing, flossing, and routine preventive cleanings, it begins to harden on the tooth creating tartar or calculus.  As this expands, an inflammation of the gingival tissue and bone loss occurs.  If left untreated, Periodontal Disease can destroy the gum and bone surrounding a tooth, causing it to become loose.  Then a tooth, which may be otherwise healthy, is lost to Periodontal Disease.  Periodontal Disease has also been shown to contribute to other serious medical conditions.

Without removing the cause of the infection, the body is unable to overcome the disease process on its own.  The plaque bacteria must be removed for the area to have a chance of healing. Depending on the severity of the case, there are two accepted treatment paths, non-surgical and surgical.

A non-surgical procedure that removes the hard calculus layer of bacteria from below the gum line is called Scaling & Root Planing.  At Golden View Dental, we perform this treatment generally in one session with local anesthetic for the patient’s comfort. The hygienist will, during this appointment, go deep below the gum line with hand-held scalers and Ultrasonic Instruments to remove the bacterial growth in the deep pockets around the tooth.  Laser Bacterial Reduction and irrigation is performed and the patient is verbally given oral hygiene and post-op instruction, as well as a prescription for an antibiotic. After the procedure is completed, the patient will be placed on a 3-month Periodontal Maintenance recall, where additional cleanings will be done and the healing process of the periodontal pockets will be checked.

Scaling and Root Planing (Deep Cleaning) vs. Prophylaxis (“Regular” cleaning)

Scaling and Root Planing, also known as a deep cleaning, is very different from a regular cleaning. A regular cleaning focuses on the surfaces of the teeth above the gum line. A dental deep cleaning, or Scaling and Root Planing, is needed in order to remove bacteria, calculus (tartar), and debris that has collected under the gum line.

Periodontal maintenances vs. Prophylaxis (“regular” cleaning)

Patients often ask why they are having “Periodontal Maintenance” when all they want is to have their teeth cleaned. If your dentist or hygienist has recommended that you be scheduled for Periodontal Maintenance, or if you have noticed that there is a difference in billing for these procedures, here is a brief explanation:

Prophylaxis, or Regular Cleaning: A regular cleaning is recommended for patients who do not have bone loss, periodontal disease, or infection around the teeth. There should be no bleeding, mobility of the teeth, receded areas or gaps where the spaces around the roots of the teeth are exposed. In other words, the mouth should be healthy with no bone or gum problems. A regular cleaning, or prophylaxis, removes soft plaque, tartar, and stains from the teeth above the gum line, and only slightly below. A regular cleaning is usually done 2 to 3 times a year, depending on how quickly stain, plaque, and tartar accumulate. It is considered a preventive procedure by your insurance carrier, since regular cleanings will help prevent periodontal disease.

Periodontal Maintenance: If you have periodontal disease which has resulted in bone loss, gum “pockets” deeper than 4 millimeters, bleeding gums, exposed root surfaces, or if you have had periodontal surgery or root planing to treat periodontal surgery or disease, a regular cleaning is not appropriate. Periodontal Maintenance scaling is needed to maintain gum and bone health. This procedure includes removal of plaque and tartar from above and below the gum line, all the way down the length of each tooth to where the root, gum and bone meet. Rough areas of the roots are smoothed if needed, pocket depths are carefully monitored, and inflamed pockets will be irrigated with antimicrobial medicines. Periodontal Maintenance is usually performed 3 to 4 times a year, depending on several factors: how quickly the plaque and tartar accumulate, how much bleeding or inflammation is present, how stable the present condition is, how well you are able to maintain your teeth at home on a daily basis, and any health risk factors you may have.

Laser

Diode lasers are now used for non- invasive periodontal treatment. A laser is concentrated light (infrared spectrum) and uses a light touch with a glass fiber. Lasers are precise and perform several functions at once. Using lasers not only removes diseased tissues and kills bacteria, but also seals blood vessels and nerve endings, which reduces post treatment pain and swelling. Lasers are used in hygiene appointments primarily when periodontal (gum) disease/infection is present. They are used in procedures ranging from Root Planning and Scaling and periodontal maintenances, to the routine prophylaxis when gingivitis is present. Quick, efficient, and painless, bacterial reduction keeps your mouth in good shape and prevents the reoccurrence of gum disease. Laser treatments also reduce bleeding and inflammation, keeping your gums firm, healthy, and clean.

Lasers also perform several other beneficial treatments; they can be used to desensitize the nerve endings of sensitive teeth, and used in treating canker sores and fever blisters (cold sores). If the infections are caught early enough, lasers can shorten the time of the outbreak, decrease discomfort and reduce swelling. The doctors of Golden View Dental also use laser treatment to level gum tissue heights (gingivectomies) and perform frenectomies painlessly.

Irrigation

Since periodontal (gum) disease is a bacterial infection, the practice of using antimicrobials and antibiotics to control the disease makes sense. Many offices, including Golden View Dental, have incorporated irrigation to deliver antimicrobials subgingivally (under the gums), especially after periodontal treatments such as Root Planning and Scaling and Periodontal maintenances.

Perio Protect trays

Perio Protect is a new, home care treatment program for patients with Periodontal disease using a dentist-created and FDA- cleared medical device that can deliver doctor-prescribed medications to the source of periodontal infections. This program helps patients manage their periodontal disease at home on a daily basis. These medications address the pathogens that cause gum disease. The basic idea is to get medication under the gums and into the pockets where bacteria grow, all in a comfortable, non- invasive way.

The perio tray is easy to use. You put the medication into the trays, wear the trays at home as instructed by the dentist/hygienist and, well, that’s it, until you return to the dental office for a recall visit. It’s comfortable, effective, and convenient. The Perio Protect Method’s combination of Perio Tray delivery with thorough cleanings from a dental office is the least invasive approach available.

Perio Trays are custom fit for individual use. They have a special seal and extension system that corresponds to the conditions of the gums around each tooth. The seals and extensions help direct and maintain medication under the gums the site of the infection.

For most people, treatment time amounts to 10-15 minutes a session. As healing occurs and conditions improve, modifications to the frequency and duration of usage will be made. Gradually a decrease in patient usage will be made as infection is under control and the disease is well managed. Then the patient, utilizing a new tray, will follow a home care maintenance schedule to keep the bacteria at bay.

Fluoride Varnish

Fluoride varnish is applied for reduction in tooth sensitivity and for strengthening the teeth’s enamel shell in prevention against cavities. Here at Golden View Dental, we recognize the benefit of this product for patients of all ages, which is why we provide and encourage the placement of this product regardless of the coverage of most insurances.

Oral ID

The Oral ID uses fluorescent technology to help dental practitioners save lives by identifying cancerous, precancerous, and other abnormal lesions at their early stages. Oral ID emits visible light (435-460nm) that enhances a dentists’ ability to identify tissue abnormalities. When Oral Id’s blue light shines on healthy oral tissue, it fluoresces. In contrast, abnormal tissue appears dark due to lack of fluorescence.

The mortality rate for oral cancer has not changed significantly in 30 years. Some 63% of oral cancers are found at Stage III and IV, which have a less than 50% survival rate. However, early discovery has an 80-90% survival rate. A two-minute oral exam with Oral ID could literally save a patient’s life. This is why at Golden View Dental we stress the need to utilize this oral cancer detection tool, regardless of age and lifestyle.

Dioxirinse (Active Chlorine Dioxide mouthwash) *Best antimicrobial rinse

DioxiRinse Mouthrinse is a two-component antimicrobial mouthrinse system that releases active chlorine dioxide, the fastest known bacteria, virus, and yeast killer, immediately upon mixing the two components. It destroys (oxidizes) bacteria that cause bad breath and gum disease, but is so gentle that it does not irritate painful or bleeding gums. DioxiRinse is ideal in assisting with reducing germs associated with mouth irritations, oral infections, gum disease, plaque buildup, dental procedures and oral surgery to promote healing. *contains NO alcohol or bleach