Checkups and Cleanings
Regular check-ups and cleaning are important.
Through regular check-ups we can assess and monitor the condition of your gums, plaque and tartar build-up, oral hygiene, fillings, crowns and bridges, implants and other dental work.
Even if you have dentures, regular check-ups are important to check the health of the tissues in your mouth and condition of the denture itself.
One of the most important roles is for us to check your gums and teeth through our staff of Registered Dental Hygienists. We check for signs of Periodontal disease (also called “gum disease”) since over 85 % of the population may have Periodontal disease in one form or other. Research proves that up to 30% of the population may be genetically susceptible to gum disease.
So what is gum disease?
“Gum Disease” or Periodontal Disease, is primarily a bacterial infection of the ligaments and bone that support the teeth in the jaw. Periodontal disease is an inflammatory disease and attacks the gums, bone and other supporting structures of the teeth and is the # 1 cause of tooth loss.
Each of us is different in our individual ability to resist disease. Sometimes other diseases, such as diabetes, worsen the effects of periodontal disease. You may have Periodontal disease and not even realize it because sometimes the signs and symptoms can be so subtle in the initial stages. Some patients are more susceptible than others to Periodontal disease. If caught in its early stages, Periodontal disease can be controlled and stabilized, although we may not be able to reverse the effects of bone destruction caused by periodontal disease.
Who is susceptible ?
Over 85 % of the population may have Periodontal disease in one form or other. Research proves that up to 30% of the population may be genetically susceptible to gum disease.
These people may be many times more likely to develop periodontal disease. Certain individuals are more susceptible to gum disease such as smokers, kids at puberty, women at pregnancy, diabetics, people with high stress and poor nutrition, certain medications, people with poor oral hygiene, genetic factors and certain diseases that affect the body's immune status.
Conversely, new research has shown that when severe gum disease is present it can adversly affect health and outcomes in heart disease, stroke, respiratory disease, pregnancy, osteoporosis and conditions of the immune system. Periodontitis is primarily a bacterial infection and can drag down your immune system and the resources of your body.
What are the signs?
The signs of gum disease vary from individual to individual and also whether your gum disease is at an initial or advanced stage.
You may have some, all, or none of these signs:
Gums that bleed when you brush or floss your teeth with normal force; gums that bleed without cause; red, swollen or tender gums; gums that have receded or shrunken away from your teeth and have calculus or tartar buildup; pus between your teeth when you press your gums with your finger; discomfort on chewing; teeth that seem loose or that change position, changes in the way your partial dentures fit (if you wear them), bad breath or a chronic bad taste in your mouth; teeth that are overly sensitive to hot or cold (may be due to other causes too)
Clinically your dentist can diagnose gum disease by the clinical presentation in your mouth and also with the help of X-rays and the use of a special instrument called a periodontal probe to measure the depth of the pocket between the teeth and your gums. The periodontal pocket measurement, clinical presentation and x-rays help us measure the location, extent and severity of the condition.
This picture shows one half of a tooth with gum disease and bone loss on the left. The right side of the tooth has healthy gums and good bone. Look at the difference.
Periodontitis is often considered a “silent disease”- individuals rarely experience pain and may not be aware of the problem.
How does Periodontal disease happen?
Gum disease is caused by the interaction of bacterial plaque, a colorless film that forms on the teeth. Bacterial plaque interacts (along with sugars & starches in the diet) to form acids, bacterial toxins and other by-products in the mouth, irritating the gums and causing them to become red, tender and swollen. It also causes the gums to bleed easily. If not removed daily, plaque hardens to form calculus (also called tartar) around the necks and down the roots of teeth. The tissue that attaches the gums to the teeth can be destroyed by the irritants in the plaque. The gums pull away from the teeth and small pockets form between the teeth and gums. These pockets become filled with more bacteria, plaque and tartar and as they deepen it becomes impossible for you to clean them out yourself
This is the stage when bone destruction may get involved. Eventually, the bone and gum structure supporting the teeth may be destroyed so extensively, that there is no remaining support for the teeth.
If plaque and tartar are not cleaned away, even gentle brushing can cause your gums to bleed. This is a sign of Gingivitis. Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is reversible with professional treatment and good at home oral care.
The more severe form of gum disease is called Periodontitis. With this form of gum disease, the gums begin to pull away from your teeth. Pockets form between your teeth and gums. These fill with germs and pus and deepen. When this happens, you may need gum surgery or "deep" cleaning to save your teeth. If nothing is done, the infection goes on to destroy the bone around your teeth. The teeth may start to move or get loose. If we cannot thoroughly debride the area and irreversible loss of supporting structures has taken place, your teeth may need to be removed to save whatever bone is left and to minimize further damage to supporting structures.
So what do I need to do?
A thorough examination is important in diagnosing periodontal disease. In some cases, we recommend an in-office oral exam and cleaning twice a year for adults, but depending on your general health and gum status, you may be asked to come in every 3 months or be referred to a specialist. We may take X-rays and use a special instrument called a periodontal probe to measure the depth of the pocket between the teeth and your gums. The periodontal pocket measurement and to some extent x-rays help us measure the location, extent and signs of gum disease.
Treatment depends individually on how advanced your particular case is and involves a stabilization phase and a maintenance phase. It may involve more frequent cleanings, scaling, curettage and root planing. It will involve improving your personal home care with modifications in your brushing technique or even the use of an electric toothbrush or an oral irrigator. If your periodontal disease is advanced it may involve more radical measures, including tooth extraction to prevent further bone loss.
If tooth and bone loss does occur we can consider replacing the missing teeth with dental implants or bone grafting after the stabilization phase.
A referral may required for a specialist for assessment or specialized surgical procedures in some severe cases.
You may be advised to use an electric toothbrush, special toothpaste or other homecare aids to maintain the health of your gums and teeth. Ask your dentist or hygienist to show you the correct way to use toothpaste, brush and floss - this is important!
Home care is a very important component for the success of any treatment outcome. It is crucial to the maintenance phase. The main home-care steps in fighting gum disease are brushing, flossing, and seeing your dentist regularly. Brush and floss at least thrice a day or after every meal. Eat a well balanced diet, avoiding sticky foods and junk foods.