Integral to long-term dental health is the status of gingival tissues, those surrounding the teeth. Achieving health in those tissues is a participation sport. Without the active participation by the patient on a daily basis through flossing and brushing, any of our treatment will be compromised. Other habits such as smoking will also markedly curtail the desired healing response.
Once again, we approach our treatment plan by careful diagnosis. Our hygiene department will conduct a periodontal evaluation which topographically charts the pockets and recession of the gingival tissues. It will help us direct treatment both in the office and at home. Furthermore, it provides a baseline against which we can longitudinally monitor the effectiveness of our combined care.
As evidenced by articles in the Journal of American Medical Association, the health of the gingival tissue has a direct negative impact on the other organs in our body. The heart, lungs, and kidneys are all affected by bacteria entering our blood systems through the open sores of diseased gum tissue. A healthy oral environment is often mirrored by a healthy body.
Moreover, a recent study by Aetna and the Columbia University College of Dental Medicine demonstrated that proper periodontal care can result in lower overall medical costs and reduced health risks for patients with diabetes, coronary artery disease, or cardiovascular disease. The old adage “an ounce of prevention is worth a pound of cure” comes to mind.
Periodontal Evaluation
After your first teeth cleaning with the hygienist, we will do a procedure called a “periodontal evaluation.” This is a very important and informative procedure that allows us to evaluate the overall health of your teeth and gums. The hygienist will use an instrument which will measure the amount of recession as well as read the amount of bone loss you have, if any. The information that is gathered during this procedure allows us to better evaluate the needs of individual patients and how best to bring them to optimum oral health. Sometimes this information will be an indication of the patient’s need to seek treatment with a gum specialist called a “periodontist.” Unlike a general dental office, the periodontal office has the ability to correct most defects that without treatment could lead to the loss of teeth.
Brushing
Apply a small ribbon of fluoride toothpaste to a soft-bristle toothbrush. Holding the toothbrush at a 45 degree angle towards the gum line on the cheek side of your lower arch, move the brush gently and slowly in a wiggle-like motion, starting at the back of the mouth and moving toward the center and across the front to the back tooth on the opposite side from where you started, making sure to thoroughly encompass the biting surface and in between each tooth. This should take about 30 seconds. Take the toothbrush and place it at a 45 degree angle on the tongue side of the last tooth just cleaned, slowly heading back to where you started, taking another 30 seconds to complete the arch. Repeat this procedure on the upper arch. We recommend brushing your teeth in this manner for two full minutes at least twice daily. Depending on your personal needs you might be advised to brush more often. When the bristles on the toothbrush become frayed, they are no longer effective and should be replaced-generally every three months or sooner. Brushing your tongue and your palate are important steps in your brushing routine. We recommend the use of a tongue scraper.
Flossing
The areas between the teeth and under the gums cannot be reached by brushing alone. The bacteria that cause cavities, gingivitis and periodontal disease are also present in these areas. It is very important to floss your teeth daily to limit the accumulation of these bacteria and keep everything healthy. We recommend using the shred-type floss to allow the maximum benefit. Using a piece of floss approximately 12” long, wrap the floss around the middle finger of each hand. Using your forefingers and thumbs, gently glide the floss in a c-shape between each tooth. With a “shoeshine” motion, slide the floss gently under the gums along the back side of the tooth in front of the floss. Come up out of the gums then slide the floss along the front of the tooth behind the one you just flossed. This ensures that the floss cleaned below the gums on both sides of each tooth. Floss your teeth prior to brushing so that any food particles and bacteria removed can be brushed away. Ideally, it is best to floss before bed, but it is most important to floss at a time that is convenient enough so that you will be sure to do so. We also suggest you begin flossing at the area that is most difficult for you, making the job easier as you go along instead of more difficult.
Dental Prophylaxis (Cleaning)
After your initial X-rays and consultation with the doctor, you will be scheduled for a dental prophylaxis or “cleaning” with one of the hygienists on staff. The procedure, which we call a “prophy,” will remove the hard substance on your teeth called “calculus” or “tarter.” At the end of the appointment, the hygienist will instruct you on home care techniques, adapting it towards the individual patients’ needs.