Preventive, Cleanings and Exams

Prophy (Regular Cleanings)

A prophy includes a series of procedures where plaque, calculus, and stains are removed from all surfaces of the teeth above the gumline. This is done with hand instruments, ultrasonic scalers, and coronal polishing. Only a licensed dental professional is qualified to determine the need for oral prophylaxis. Only a dentist, dental hygienist, and trained dental assistant can perform the procedure.

Periodontal Maintenance

A periodontal maintenance procedure (PMP) is defined as a procedure that is recommended following periodontal treatment (such as scaling and root planing) and continues at varying intervals, determined by the clinical evaluation of the dentist.

These intervals can be as frequent as every two months and they can be extended as long as six months, depending on the patient. Keeping up you're your PMP interval is important because periodontal disease can recur without adequate follow up.

PMP includes removal of plaque and tartar above and below the gums, scaling and root planing of specific areas, and polishing. PMP is always completed following active periodontal treatment such as scaling and root planing or more extensive gum surgery.

Scaling and Root Planing

Scaling and Root Planing is a special type of treatment that goes deeper BELOW the gumline to remove contaminated debris and bacteria, most often performed on patients with active periodontitis.

Woman smiling in dental chair

This seems to be a procedure that causes so much confusion for patients in trying to understand the difference between "just a cleaning" and Scaling and Root Planing, and the need/reason for this procedure.

Scaling and Root Planing is done to remove soft sticky plaque and hard crusty calculus that is loaded with bacteria, around and BELOW the gumline on root surfaces. A professional polishing or prophy removes only the soft sticky plaque and hard crusty calculus that is ABOVE the gumline on the crown of the tooth. It is a method of treating gum disease when pockets formed around the teeth have a measurement of greater than 3mm and there is evidence of bleeding and tissue attachment loss.

1. Scaling
Scaling is a procedure that meticulously removes contaminated biofilm, plaque, calculus, micro-organisms, and toxins from around the gumline down to the bottom of each periodontal pocket in order to obtain a healing response.

2. Root Planing
Root planing involves smoothing the root surfaces of your teeth with thin instruments so gum tissue can more firmly reattach to roots that are clean and smooth to prevent tooth loss and sensitivity problems. This procedure makes it more difficult for plaque, calculus, and bacteria to accumulate along these root surfaces.

Because this procedure goes deeper than a regular cleaning, your mouth may be numbed. The cleaning may take one to six visits to complete. Depending on the extent of the disease, you may need one or more quadrants of the mouth to be treated with scaling and root planing.

Some Reasons Why Root Planning May Be Necessary

• To control the growth of harmful bacteria. (bacteria ABOVE the gumline are less aggressive bacteria whereas the bacteria BELOW the gum are more DESTRUCTIVE and DANGEROUS!
• Helps pocket wall reattach firmly to the clean root surface to create a pocket depth that can be better maintained by patient
• Prevent further bleeding of the gums from disease
• Reduces inflammation
• Reduces discomfort
• Prevent bone loss
• Prevent gum disease related tooth loss
• Reduce systemic disease

Home Care after Root Planing and Scaling

1. Rinse with warm salt water every few hours (1/2 tsp. salt in 8oz water) for the remainder of the day to encourage healing and sooth discomfort.
2. Be careful not to bite or chew your lip, cheek or tongue while they are numb. Avoid chewing for 2 hours after this procedure or until numbness has worn off.
3. Keep your fingers and tongue away from the areas that have been treated.
4. Take Tylenol or ibuprofen according to directions on the manufacturer label for a couple of days to help with the discomfort; do NOT take Aspirin because it may prolong bleeding.
5. Rinse your mouth with Closys or Chlorohexidine, if prescribed by dentist, to reduce oral bacteria.
6. Do not smoke or chew tobacco for 72 hours after the procedure to allow for healing.
7. Gently brush and floss your teeth after each meal.

How you care for your teeth and gums at home after treatment is critical to reduce the risk of recurring periodontal disease.

Little girl wearing glasses with arms crossed smiling

Little girl wearing glasses with arms crossed smiling

Are Cavities in Kids' Teeth Inevitable?

Many people think so, but we are seeing more and more of our younger patients growing up without them.

Why is that? Well, there are a number of factors. Some may be beyond a parent's control, and others involve lifestyle choices and habits that can be changed through increased awareness and education.

If your child has already had a cavity, chances are that more will occur. That's because there are probably conditions that allow them to develop. But if you are vigilant, you might be able to avoid a cavity. For instance, a white spot along the gumline can be an indicator that a cavity is forming. We can often help avoid further decay in such cases - through a combined therapy such as fluoride, mouth rinses and changes in eating habits - if we see the patient soon enough.

Another sign is plaque. If you can scrape a fingernail along your child's front teeth and remove a sticky whitish substance (plaque), your child is at greater risk of forming cavities. We recommend brushing at least twice a day so plaque can't form. Toothpaste with fluoride helps preserve essential minerals found in teeth. Be careful, though, not to put too much toothpaste on the brush and be sure your child spits it all out.

An effective preventive habit is regular dental checkups. We can assess your child's risks and help anticipate oral issues. Some children have special health care needs that we can address with special equipment and/or techniques. Others routinely take medications that make them more prone to cavities.

Regular checkups for infants and toddlers allow us to talk about appropriate diet management. Talking directly with older children gives us the chance to find out about their dental behavior and offer suggestions and advice.

Maintaining Space: When a Child Loses a Tooth Too Soon

If you have children or are around children who still have their baby teeth, here's something useful to know. A child's mouth is rather pliable and each tooth is a "guide" for the permanent tooth to follow. If a baby tooth is lost because of an injury or if it was removed due to decay, the remaining teeth may begin to occupy a portion of that vacant space.

That can pose a problem when the permanent teeth come in, possibly causing them to drift or erupt incorrectly and grow in crooked. Crooked or crowded teeth can cause children problems with speaking or chewing. And crooked teeth are costly to correct down the line.

Once again, an ounce of prevention is worth a pound of cure. We have a simple solution that will help your child develop more even and regular permanent teeth through the use of a space maintainer. There are several different kinds including removable and fixed ones, depending upon the child's circumstances.

A space maintainer will hold the neighboring teeth in place until the permanent teeth begin to develop. At that time, we remove the space maintainer. Of course, not all instances of a lost tooth require a space maintainer. And the decision to install one depends on several additional factors.

The important thing to remember is this: if your child or a child you know experiences a loss of a baby tooth, it is important that a dentist takes a look to determine if an intervention is needed.