• General Cleaning

• Dental Sealants (preventive care)

• Periodontal Evaluation

• Periodontal Therapy

• Oral Cancer Screening 

• Gum Disease

• Doctor's Comprehensive Oral Examination

General Cleaning

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Professional teeth cleaning by our certified dental hygienist aims to remove plaque, tarter and stains that have accumulated on the teeth. Even with routine brushing and flossing of your teeth and gums, tarter can develop. The professional cleaning of teeth is a crucial part of good oral hygiene and is needed periodically to maintain the health of your teeth and gums. Most dentists recommend having your teeth professionally cleaned every 6 months or less depending on your oral evaluation to reduce the likelihood of periodontal disease progressing. In between routine cleanings, good oral hygiene at home is vital to prevent tarter build-up and gum disease.

Dental cleanings are designed to remove plaque and tarter deposits that have built up on teeth over time.

Plaque is the sticky, soft film that contains millions of bacteria. This bacteria found in plaque is what causes gum disease and tooth decay if not removed by daily brushing and flossing, as well as routine trips to the dentist.

Tarter, or dental calculus, is a hard calcified deposit that forms on the teeth and can contribute to their decay. Dentists use specialized instruments to gently remove these deposits without causing harm to the teeth. All dental instruments are put through a stringent cleaning, disinfecting, and sterilizing procedure to ensure safety and quality control.

The first tool that is generally used to clean teeth is an ultrasonic instrument. This device uses mild vibrations to loosen larger pieces of tarter. It also sprays subsequent mists of cool water to wash away loose debris. The tips of the ultrasonic instrument are rounded and curved, and kept in constant motion. The settings on the device can be adjusted for the patient’s comfort

The majority of dental patients find routine teeth cleaning to be painless. The cooling mist of water, mild vibrations, and the pressure felt during “scraping” does not generally caused discomfort. It’s important to let our hygienist know if the cleaning is beginning to cause pain, so that they can recommend alterative options to make your teeth cleaning more enjoyable.

Teeth cleaning procedures are designed for more than just appearances. Professional teeth cleaning treatments are the primary means of preventing and treating periodontal disease and maintaining tooth health.

Dental Sealants (preventive care)

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Brushing and flossing are the best ways to help prevent cavities, but it’s not always easy to clean every nook and cranny of your teeth – especially those back teeth you use to chew (called molars). Molars are rough, uneven and a favorite place for leftover food and cavity-causing bacteria to hide.

Still, there’s another safety net to help keep those teeth clean. It’s called a sealant, and it is a thin, protective coating (made from plastic or other dental materials) that adheres to the chewing surface of your back teeth. They’re no substitute for brushing and flossing, but they can keep cavities from forming and may even stop early stages of decay from becoming a full-blown cavity.

In fact, sealants have been shown to reduce the risk of decay by nearly 80% in molars. This is especially important when it comes to your child's dental health. In October 2016, the Centers for Disease Control released a report on the importance of sealants for school-aged children, of which only 43% of children ages 6-11 have. According to the CDC, "school-age children without sealants have almost three times more cavities than children with sealants."

How Long Do Sealants Last?

Sealants will often last for several years before they need to be reapplied. During your regular dental visit, your dentist will check the condition of the sealant and can reapply them as needed.

Are Sealants Covered By Dental Plans?

Some plans do cover sealants, so call your dental benefit company to find out what kind of coverage you have.

Periodontal Evaluation

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What Causes Periodontal Disease? 

As plaque and calculus (also known as tartar, calculus is plaque that has hardened and it is what needs to be scraped off during a professional dental cleaning) builds up on teeth, the body reacts to it by becoming inflamed.  If the plaque and calculus is not cleaned off regularly, or there are other health factors affecting someone’s inflammatory response, the body will continue to fight the calculus build up like dirt in an unwashed cut.  This inflammatory response causes the bone and gum tissue to pull away from the tooth, which causes deeper pockets in which bacteria can flourish.

Sadly, there are also many factors that contribute to tipping the balance from a healthy mouth to a diseased state;

• diabetes 
• high blood pressure 
• stress 
• poor nutrition 
• blood cell disorders 
• poor sleep 
• tobacco and alcohol 
• genetics 
• steroid treatment 
• dry mouth syndrome 
• not keeping your regular six month dental cleanings 
• lack of adequate oral health care 
• crowding of teeth 

Why Is It Such a Big Deal? 

There are many reasons to keep your teeth clean and free of bacteria. If periodontal disease is not caught early you can end up losing bone and gum tissue – the support structure for your teeth. No treatment can lead to worsening of the problem and ultimately tooth loss. There is also very strong evidence linking the health of your mouth to your overall health throughout the rest of your body. For example, a link has already been made between severe gum disease, strokes, diabetes and heart attacks. 

Unfortunately, periodontal disease, like many other serious diseases such as diabetes, high blood pressure, and heart disease, have symptoms that are often absent or subtle and only become apparent after much damage is done.  The fact that symptoms are often not obvious is why we take annual measurements of your gum tissue and record bleeding so we can closely monitor changes and treat areas conservatively and early in the disease process.

What Exactly Happens During a Periodontal Check? 

A periodontal exam involves taking six measurements around each tooth to measure the depth of the space between the tooth and gums.  In addition to these measurements, we also measure any recession (movement of the gum tissue down the root of the tooth exposing the root), any loosening or mobility of the teeth, and if there are any visual signs of inflamed gum tissue.

Why Does My Hygienist Do Periodontal Checks? 

All of the information collected at your periodontal check helps us determine if someone has gum disease or even the very beginning stages of gum disease. We complete this exam once a year on our adult patients in accordance with the standards set by the American Dental Association and the American Academy of Periodontology, the body that makes recommendations and oversees the dental specialty of periodontics which focuses on diseases and conditions of the gums and bone in the mouth.

Periodontal Therapy

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A Periodontal Therapy is a “conservative” (non-surgical) program consisting of a series of 2, 4, or 6 visits to control gum disease. ... Our goal is to eliminate bleeding and mouth odor, as well as reduce gum pocket depths to eliminate bacterial re-infection.

Preventing Periodontal Disease is Something That’s Necessary for Your Health

At the most, your toothbrush can only reach 2-3 millimeters below the gum tissue to effectively clean it out. This is why a professional cleaning is needed every 6 months and why a complete periodontal exam is needed to fully assess the health of the gums and bone in the mouth. Many other offices do only a quick spot check or no exam at all. We believe that you need to Know Your Numbers and a complete exam is the only way to properly determine if you have gum disease. 
By doing this exam on a yearly basis, we can catch gum disease in its earliest stages when often time very small interventions are needed to halt or reverse it before permanent damage could occur.

Non-Surgical Treatments:

AAP treatment guidelines stress that periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment.
Non-surgical periodontal treatment does have its limitations. When it does not achieve periodontal health, surgery may be indicated to restore periodontal health.

Scaling and Root Planing

Scaling and root planing is a careful cleaning of the root surfaces to remove plaque and calculus [tartar] from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins.

Most periodontists would agree that after scaling and root planing, many patients do not require any further active treatment. However, the majority of patients will require ongoing maintenance therapy to sustain health.

Gum Graft Surgery:

Exposed tooth roots are the result of gum recession. Gum graft surgery will repair the defect and help to prevent additional recession and bone loss. 

Gum grafts can be used to cover roots or develop gum tissue where absent due to excessive gingival recession. During gum graft surgery, your periodontist takes gum tissue from your palate or another donor source to cover the exposed root. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity.

Benefits Of Gum Graft Surgery?

A gum graft can reduce further recession and bone loss. In some cases, it can cover exposed roots to protect them from decay. This may reduce tooth sensitivity and improve esthetics of your smile. Whether you have a gum graft to improve function or esthetics, patients often receive the benefits of both: a beautiful new smile and improved periodontal health – your keys to smiling, eating and speaking with comfort and confidence.

Laser Treatment:

Lasers can be used to treat periodontal disease. Current controlled studies have shown that similar results have been found with the laser compared to specific other treatment options, including scaling and root planing alone. Scaling and root planning is a traditional non-surgical therapy used to treat periodontal diseases. 

Can The Use Of Lasers In Periodontal Therapy Harm Patients?

Yes and no. Each laser has different wavelengths and power levels that can be used safely during different periodontal procedures. However, damage to periodontal tissues can result if a laser with an inappropriate wavelength and/or power level is used during a periodontal procedure.

Regenerative Procedures:

Procedures that regenerate lost bone and tissue supporting your teeth can reverse some of the damage caused by periodontal disease.

Your periodontist may recommend a regenerative procedure when the bone supporting your teeth has been destroyed due to periodontal disease. These procedures can reverse some of the damage by regenerating lost bone and tissue.

During this procedure, your periodontist folds back the gum tissue and removes the disease-causing bacteria. Membranes (filters), bone grafts or tissue-stimulating proteins can be used to encourage your body's natural ability to regenerate bone and tissue.

Eliminating existing bacteria and regenerating bone and tissue helps to reduce pocket depth and repair damage caused by the progression of periodontal disease. With a combination of daily oral hygiene and professional maintenance care, you'll increase the chances of keeping your natural teeth – and decrease the chances of other health problems associated with periodontal disease.

Dental Crown Lengthening:

You may have asked your periodontist about procedures to improve a "gummy" smile because your teeth appear short. Your teeth may actually be the proper lengths, but they're covered with too much gum tissue. To correct this, your periodontist performs a dental crown lengthening procedure.

During the dental crown lengthening procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. This can be done to one tooth, to even your gum line, or to several teeth to expose a natural, broad smile.

Your dentist or periodontist may also recommend dental crown lengthening to make a restorative or cosmetic dental procedure possible. Perhaps your tooth is decayed, broken below the gum line, or has insufficient tooth structure for a restoration, such as a crown or bridge. Crown lengthening adjusts the gum and bone level to expose more of the tooth so it can be restored.

Pocket Reduction Procedures:

When you have periodontal disease, this supporting tissue and bone is destroyed, forming "pockets" around the teeth.

Over time, these pockets become deeper, providing a larger space for bacteria to live. As bacteria develop around the teeth, they can accumulate and advance under the gum tissue. These deep pockets collect even more bacteria, resulting in further bone and tissue loss. Eventually, if too much bone is lost, the teeth will need to be extracted.

During this procedure, your periodontist folds back the gum tissue and removes the disease-causing bacteria before securing the tissue into place. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone.

Reduced pockets and a combination of daily oral hygiene and professional maintenance care increase your chances of keeping your natural teeth – and decrease the chance of serious health problems associated with periodontal disease.

Oral Cancer Screening 

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It is important that both private individuals, and members of the dental community, realize that a visit to the dentist is no longer about a filling, a crown, or a postponable cleaning, but is actually a matter of life and death. Dental examinations, when properly done and which include a screening for oral cancer, will save lives.

Proper oral cancer screening.

There are two separate issues, discovery and diagnosis. Discovery is the result of a thorough visual and manual examination. It includes a systematic visual examination of all the soft tissues of the mouth, including manual extension of the tongue to examine its base, a bi-manual palpation of the floor of the mouth, and a digital examination of the borders of the tongue, and the lymph nodes surrounding the oral cavity and in the neck. New diagnostic aids, including lights, dyes, and other techniques are beginning to appear on the marketplace. While making the discovery process more effective, it is still possible to do a comprehensive examination through a proper visual and tactile process.

Once suspect tissues have been detected, the only way a definitive diagnosis of oral cancer may be made is through biopsy. Any condition that has existed for 14 days or more without resolution should be considered suspect and worthy of further diagnostic procedures or referral. Certainly, it is common knowledge that two of the most prevalent lesions that mimic oral cancer, are the herpes simplex ulceration, and aphthous ulcerations, each resolving of their own accord in approximately 10-14 days. Perhaps that sentence should be underlined, since one of the most common diagnoses received with referred patients to a major university cancer pathology department is “an atypical herpetic/aphthous lesion” These all too frequently turn out to be squamous cell carcinomas, which have been under observation…. for several months.

Creating awareness, discovery, diagnosis, and referral. When it comes to oral cancer and saving lives, these are the primary responsibilities of the dental community. This is dentistry’s cancer. The most important step in reducing the death rate from oral cancer is early discovery. No group has a better opportunity to have an impact than members of the dental community.

Gum Disease

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Untreated gingivitis can advance to periodontitis and can eventually lead to tooth loss and other health problems.

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 often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.

Factors that may contribute to gingivitis include, diabetes, smoking, aging, genetic predisposition, systemic diseases and conditions, stress, inadequate nutrition, puberty, hormonal fluctuations, pregnancy, substance abuse, HIV infection, and certain medication use.

Periodontitis

Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. 

There are many forms of periodontitis. The most common ones include the following.

Aggressive periodontitis-  occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction and familial aggregation.

Chronic periodontitis - results in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss. This is the most frequently occurring form of periodontitis and is characterized by pocket formation and/or recession of the gingiva. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.

Dr’s Comprehensive Oral Examination

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No matter how vigilant one's oral care regime, the irrepressible development of plaque, and the porous  nature of teeth makes them prone to decay. To forestall the excessive development of plaque that can result in gum and tooth loss, routine preventive care is recommended.

Yet prophylaxis (a dental cleaning), is only part of the equation when it comes to our overall health. In fact, the mouth is often considered a window to the rest of the body because many other illnesses first represent themselves as changes within the mouth. As a result, a comprehensive oral dental exam is recommended each time you visit a new practice to serve as a benchmark of your overall health. 

Since the comprehensive dental exam is designed to set a baseline of your health and to catch any early signs of serious illness that may be otherwise undetected, your dentist will be on the lookout for the following illnesses which can be detected during a comprehensive oral evaluation:

• Diabetes
• Leukemia
• Blood pressure
• Cardiovascular problems
• Oral cancer
• Immune abnormalities
• Sinus problems