Online Dental Education Library
Our team of dental specialists and staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us.
Periodontal Disease
When to See a Periodontist
Periodontal treatment may be sought in several ways. Your general dentist or a hygienist may recommend a consultation with a periodontist if they find signs of periodontal disease through the course of a checkup or other dental care appointment. You may also decide to see a periodontist on your own, as a referral is not necessary to be seen at our office.
In fact, if you experience any of these symptoms, we encourage you to schedule an appointment at our office without delay:
- Unexplained bleeding while performing regular cleaning or consuming food is the most common sign of a periodontal infection.
- Ongoing halitosis (bad breath), which continues despite rigorous oral cleaning, can point to periodontitis, gingivitis or the beginnings of a gum infection.
- Longer-looking and loose-feeling teeth can indicate recession of the gums and/or bone loss as a result of periodontal disease.
Patients with heart disease, diabetes, osteopenia or osteoporosis are often diagnosed with correlating periodontal infections. The bacterial infection can spread through the blood stream, affecting other areas of the body.
- Bleeding while brushing or eating normal foods
- Bad breath
- Loose teeth and gum recession
- Related health concerns
What is Periodontal Disease?
Periodontal disease is a chronic infection of the periodontal or gum tissue. This infection is caused by the presence of a bacterial film, which is called dental plaque, that forms on the teeth surfaces. Bacteria that found in dental plaque produce toxins which irritate the gums. They may cause them to turn red, swell and bleed easily. If this irritation is prolonged, the gums separate from the teeth, causing pockets (spaces) to form. Plaque can also harden into a rough, porous substance known as calculus (or tartar). This can occur both above and below the gum line.
As periodontal diseases progress, the supporting gum tissue and bone that holds teeth in place deteriorate. If left untreated, this leads to tooth loss. With periodontal disease, bleeding, redness and swelling do not have to be present. Further, pain is usually not associated with periodontal disease. This disease damages the teeth, gum and jawbone of more than 80% of Americans by age 45. Each case is looked at individually, because in addition to plaque there are co-factors such as genetics, smoking, and overall health, which contribute to disease severity. Once periodontal disease is detected, our goal as therapists is to provide information and treatment necessary to control/ or arrest the active infection, and help keep the disease in an inactive or controlled state.
However, don’t be fooled!
With periodontal disease, bleeding, redness and swelling do not have to be present. The periodontal disease symptoms of inflammation may only be evident with sub gingival probing. Further, pain is usually not associated with periodontal disease.
After a thorough, professional tooth cleaning, you know that your teeth look brighter and feel fresher. But tooth cleaning isn't just about appearances. It's the primary means of preventing and treating periodontal (gum) disease. Many studies have demonstrated a possible link between periodontal health and overall (systemic) health — which means regular tooth cleaning may benefit not just your mouth, but your whole body.
Why do teeth need special cleaning? Over time, dental plaque (a naturally occurring bacterial biofilm) and stains build up on tooth surfaces. Dental calculus (also called tartar), a harder deposit, can then form both above and below the gum line. A thorough dental cleaning removes these substances from the teeth, and helps keep disease-causing bacteria from proliferating.
Tooth cleaning is usually accomplished by the non-surgical technique of scaling, sometimes called “root debridement.” It's typically a relatively painless procedure in which small dental instruments are used to physically remove deposits from the surfaces of teeth. At one time, scaling was performed entirely with manual tools. But in the last several decades, the ultrasonic scaler has changed all that.
What Is An Ultrasonic Scaler?
There are different types of ultrasonic scalers, but all of them work in a similar fashion: electromagnetic forces in the unit's hand-held “wand” cause its tiny tip to vibrate rapidly. These vibrations, which occur at a rate faster than the speed of sound, effectively blast away plaque, calculus and stains from the tooth surfaces.
A small stream of water and/or antibacterial mouthwash, which emerges near the tip of the scaler, is called lavage. Lavage is used to cool the ultrasonic scaler's tip and flush away debris from the area being treated. The vibrating tip causes some of the water to break into millions of tiny bubbles, an effect called cavitation. This ruptures the walls of bacterial cells and helps create an environment that's less hospitable to harmful bacteria.
Ultrasonic Scaling vs. Hand Scaling
Studies show that a thorough ultrasonic cleaning takes about one-third less time as compared to hand scaling — which means you need less time in the chair. Many patients prefer ultrasonics to other types of scaling, possibly because it requires the clinician to use less force than a hand scaler to get the same effect. In ultrasonic scaling, only the tip of the tool touches the tooth surface, and only for a short time.
It's also possible to remove deposits of plaque and tartar from under the gum line by using an extremely small tip on an ultrasonic unit, which can cause less discomfort and result in a deeper and better cleaning. Sometimes an ultrasonic scaler is used first, and then any stubborn areas are scaled by hand.
The Experience of Ultrasonic Scaling
Anyone who has a substantial buildup of tartar or is prone to gum disease can benefit from ultrasonic scaling. It can also help to remove stains from coffee and cigarettes, for example. Yet, for all its power, most people experience little or no discomfort during the procedure.
If you have very sensitive teeth, it may be possible to alleviate some discomfort by using slimmer tips on the scaler. Alternatively, a topical anesthetic may be applied, or conscious sedation can be administered. The power range, the flow of lavage water and the frequency of tip vibration may also be adjusted for increased comfort.
Special tips are also available to clean composite or porcelain tooth restorations, titanium implants, or areas of demineralization (enamel loss) on your teeth. If you have a cardiac pacemaker, be sure to alert all dental professionals/personnel before ultrasonic scaling treatment, so precautions can be taken.
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Dental Cleanings Using Ultrasonic Scalers Rapidly changing technology has revolutionized periodontal therapy with the integration of power scaling techniques resulting in improved clinical outcomes, patient comfort, and reduced time and physical demands on clinicians... Read Article