Dental Cleanings:
Prophylaxis and Periodontal Health
The dental profession refers to the dental cleaning appointment as a dental prophylaxis, or prophy. It's most significant functions are prevention of dental disease and patient education. It is likely the most important and valuable visit a patient may ever make to the dentist.
The routine dental cleaning is anything but routine, and should include:
- Personal oral hygiene evaluation, home care review and recommendations.
- Toothbrushing and flossing instructions.
- Supra gingival (above the gum) scaling to remove plaque and tartar from all visible tooth surfaces.
- Debridement of tartar beneath the gum, as conditions warrant.
- Topical fluoride treatment to the age of thirteen.
- Polishing the teeth.
- Nutrition assessment, if needed
- Periodontal charting, and scheduling of additional periodontal care as indicated.
The dental prophylaxis is the cornerstone for a lifetime of dental health.
Ultrasonic and Hand Scaling
Plaque is the colonization of natural oral bacteria on food debris that remains on the surface and in the crevices of the teeth and gums. Combing with minerals in the saliva, it ultimately forms a hard, rough sediment known as dental tartar or calculus which attracts further plaque buildup. Calculus must be removed by a dental professional for the prevention of periodontal disease.
Removal of calculus may be performed by a licensed dental hygienist or dentist, either by manual scaling of the teeth, or with an ultrasonic device. The choice of technique is a personal preference by the hygienist or wishes of the patient. Most states permit trained dental hygienists to administer local anesthetic and nitrous oxide (laughing gas), often necessary for deep periodontal scaling and root planing.
Light or moderate tartar buildup is commonly removed by manual scaling instruments of various shapes and sizes The skills of the hygienist are especially important for this procedure.
The ultrasonic scaler, commonly called by the brand name, Cavitron, is often indicated for the efficient removal of heavy, tenacious tartar and stain The hygienists may follow its use with hand scaling for a more finite smoothing of tooth and root surfaces.
Caution is warranted for people who wear pacemakers, as the ultrasonic sounds may interfere with the function of the pacemaker.
Root Planing
Accumulation of plaque causes inflammation of the gums and an ensuing breakdown of the periodontal attachment (the fibrous connection of the teeth to the supporting structures). Pockets between the teeth and soft tissue become deeper, and the underlying bone recedes Increased pocket depth encourages the formation of more calculus, plaque and further tissue breakdown. The ongoing bacterial colonization byproducts, perpetuate the disease process.
Root planing is a procedure to treat periodontal conditions (moderate to advanced gum disease) by thoroughly scaling the roots of teeth to establish a smooth, calculus free surface. The process may be performed by a dental hygienist, dentist or periodontist (gum specialist), and usually requires local anesthesia to prevent pain. Thorough periodontal scaling customarily involves several dental visits.
More advanced conditions may necessitate periodontal surgery for complete debridement of the roots and recontouring of the hard and soft tissue to arrest the disease process or to restore, in select situations, lost bone.
Polishing
The dental prophylaxis is refined by a final polishing of the teeth to remove stain and create a sensation of fresh breath and a clean mouth. It may be accomplished by spraying high pressured water mixed with baking soda paste onto the surface of the teeth (prophy jet polishing), or a rubber cup and polishing paste. Many states permit a certified dental assistant to polish teeth with a rubber cup and to apply fluoride for children.
The Dental Recall Appointment
Patients should schedule their recall appointments on a regular basis for the early diagnoses of dental disease. The hygienist or dentist may recommend a prophylaxis visit every two to six months. Even if your dental insurance plan only covers the procedure twice a year, its money well spent. Recall frequency depends on many factors and should be determined on an individual basis. Some people tend to have more buildup of calculus than others and some may be more prone to periodontal inflammation or the development of tooth decay. Patients with inadequate oral hygiene practices will require more frequent cleanings.
Dental Cleaning for Children
The
dental prophylaxis is especially important for children to establish
good oral hygiene practice and to appreciate the importance of
dental health.
Easy dental prophy appointments help create self esteem and will
lessen anxiety should dental restorative care become necessary
in the future. A child's first dental visit should be around
age 2-3 years old.
The regular application of topical fluoride, early detection of orthodontic (bite) problems, and an evaluation for pit and fissure sealants are part of preventive dental health.
Dental Conditions and Patient Concerns
Halitosis (Bad Breath)
Halitosis may be caused by many factors, the most common of which are dietary predilections and inadequate oral hygiene. If dietary adjustments do not resolve the issue, one should first consider a visit to the dentist, improved oral hygiene, and gastrointestinal or systemic disorders, such as diabetes.
Poor oral hygiene, advanced tooth decay or periodontal disease may result in bad breath that may range from offensive to fetid. For many, bad breath is caused by the accumulation of bacteria lodging in the ridges of the tongue. Incorporating a small plastic rake (tongue scraper) into a regular oral hygiene program will prove a godsend to those who experience this problem.
A germicide mouth rinse, containing chlorine dioxide, may be beneficial.
Poor dental hygiene may result in acute necrotizing ulcerative gingivitis (ANUG). Once called trench mouth, the condition is fairly uncommon in advanced countries, but may develop in teenagers and young adults. Though not contagious, it can, and should be treated.
Perhaps the best gift you can give a loved one is a visit to the dentist.
Dental Conditions and Patient Concerns
Discolored & Crooked Teeth
Perhaps no aspect of dental care has been so far advanced in the past decade as aesthetic dentistry. With the introduction of adhesive restoration treatment and conservative tooth reduction techniques, cosmetically appealing restorations are often routine and less invasive.
Dental bleaching has become a popular and successful approach in the management of extrinsic stains on enamel. It does not affect previously placed restorations.
Porcelain veneers have taken the place of bonding in most instances, and may offer a dynamic alternative to crowns (caps). The technique is often indicated for managing crooked or extensively discolored teeth, sometimes instead of adult orthodontics.
Find out what modern aesthetic dentistry has to offer!
Frequently Asked Questions
What should I expect at my first visit to Portola Plaza Dental Group?
Your first visit to Portola Plaza Dental Group starts with all the necessary paperwork being filled out and recorded. Next, a thorough review of your medical history information is performed. During this time any special requirements or requests are addressed. Finally, a complete exam consisting of a soft tissue evaluation, hard tissues (teeth), bite analysis, and cancer screening is performed. Once all the information is recorded, an individualized treatment plan is formulated for you to keep your dental health in it's optimum state.
I've heard that mercury is used in dental amalgam (silver) fillings. Can this hurt me?
Although no scientific data has shown silver fillings to harm an individual, Portola Plaza Dental Group places no silver fillings in teeth. We believe that the newer composite (white) fillings are not only mercury free, but are healthier and stronger for the tooth. They look a whole lot better too!
