Periodontal care

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Dentist and  dental specialists strive to improve the overall health of patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us.

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Bad Breath Might be a Sign of a More Serious Oral Condition

Repairing decayed teeth. Repairing teeth damaged by decay — removing diseased tissue, filling cavities or repairing defective fillings — will also reduce the level of decay-causing bacteria. Such bacteria are often responsible for bad breath since they also release volatile sulphur compounds (VSCs), characterized by a foul “rotten eggs” odor. After treatment, these odors can diminish significantly.

Treating gum disease. Periodontal gum disease is a progressive infection caused by bacterial plaque. The basic treatment is to remove as much offending plaque and tartar (hard deposits) as possible. This may require extensive cleaning techniques (like root planing) to remove plaque from tooth root surfaces beneath the gum line, as well as antibiotic therapy. Periodontal therapy not only restores health to gum tissues, it may also alleviate bad breath caused by bacteria.

Extracting third molars (wisdom teeth). The opercula (flaps of gum tissue) around wisdom teeth have a tendency to trap food debris, which fosters bacterial growth. If this leads to chronic infection we may recommend removing the wisdom teeth. This not only reduces the chances of infection but may also alleviate bad breath caused by the bacterial growth.

Treating candidiasis. This is a yeast infection arising as a result of antibiotic use that suppresses normal oral flora. It’s also a source of bad breath. Treating the infection and restoring normal balance in the mouth may help alleviate bad breath as well as prevent disease.

You may see a pattern here: many of these conditions that simultaneously contribute to bad breath stem from high levels of bacteria, which flourish in plaque built up on tooth surfaces due to inadequate oral hygiene. Effective daily brushing and flossing (along with semi-annual office cleanings) removes much of the offending bacterial plaque. As a result you’ll experience better oral health — and maybe fresher breath too.

Professional Teeth Cleanings 

Even if you brush and floss your teeth faithfully, it is important that you have your teeth professionally cleaned on a regular basis. (Of course, if you aren't quite so meticulous about your oral hygiene, it's even more important!) After a thorough cleaning, your teeth will feel smooth and squeaky-clean, and they will probably look a lot brighter too. But professional teeth cleanings aren't done for looks alone.

Why do your teeth need this kind of attention? Essentially, it's because over time they tend to build up a layer of plaque (a sticky, bacteria-rich film) and hard deposits (called tartar, or calculus) that are very difficult to remove without special tools. When these deposits are allowed to remain on the tooth surfaces or below the gum line, they provide ideal conditions for bacteria to grow and multiply. The acids produced by some bacteria cause tooth decay and gum disease; if left uncontrolled, this can lead to inflammation and infection of the gums, and possibly influence systemic (whole body) diseases.

Dentists have a special term for preventive procedures like tooth cleaning: prophylaxis, from the Greek word meaning to protect or guard against. In this case, the focus is on preventing tooth decay and gum disease. Performed in conjunction with a routine dental examination, a professional cleaning can go a long way toward controlling these two common maladies. While your teeth are being cleaned, it's also a good opportunity to take a close look at your oral health in general and check for a few specific problems.

The Professional Cleaning Procedure
Teeth cleaning is often performed by a dental hygienist — a highly trained technician who uses a special set of tools designed just for this purpose. Because everyone's teeth are a little different, your cleaning will be tailored to your particular needs. However, many cleanings follow a similar pattern.

First, the dental hygienist will do an oral examination to evaluate the health of your oral tissues. Then the cleaning will take place using either an ultrasonic scaler or metal instruments referred to as curettes to remove the plaque and calculus from the tooth surfaces. The ultrasonic scaler is a hand-held tool with a tiny tip that vibrates at a very high frequency. Hardened deposits are broken up by the rapid movement of the tip, which does not damage the tooth. A constant stream of liquid (called lavage) serves to cool the tip and aid in plaque removal; at the same time, it also washes away the debris.

Some hygienists prefer curettes, which are hand-held instruments that are curved and tapered to fit around and in between the teeth. If your teeth are sensitive, using hand-held instruments may be more comfortable for a professional cleaning. In the capable hands of a hygienist or dentist, it takes only moderate pressure to remove any stubborn buildup and scrub the teeth clean, regardless of which instruments are used.

Finally, your teeth are polished with a low-speed rotary brush fitted with a soft rubber tip. A slightly gritty, toothpaste-like gel is applied, and the tip spins around and polishes the teeth, making them smooth and shiny.

A Requirement for Good Oral Health
Most people don't feel any noticeable discomfort during dental cleanings; some even report they enjoy the experience — especially the dramatic results when it's done! If you haven't had a cleaning in a while, however, it may take you a few moments to get used to getting your teeth cleaned. If you experience any discomfort, however, it may be possible to apply a topical numbing gel or another type of anesthetic.

If your gums are irritated due to bacterial buildup, they may become sore or bleed slightly during the cleaning. It may be possible to prevent this from occuring in the future with oral hygiene measures you can perform at home (such as improved flossing techniques or special mouthrinses); it might also indicate that you need more frequent in-office cleanings. This type of regular maintenance will help you avoid more involved dental procedures down the road — and it will give you the best chance of keeping your teeth for life!

Periodontal Therapy

It is not a given that we must lose teeth as we age. If we maintain good oral hygiene and have regular professional cleanings and oral examinations, chances are we can keep our natural teeth for life. That involves not only caring for the teeth themselves, but also the structures that surround them: the gums and tooth-supporting bone. Gum disease, which is a bacterial infection, threatens these supporting tissues. That is why dental professionals are always on the lookout for early signs that patients may not notice. When signs of trouble become apparent, periodontal therapy may be suggested.

Periodontal therapy can take various forms, but the goal is always to restore diseased tissues to health. Gum (periodontal) disease can spread from the gums to the bone that supports the teeth, and may even cause tooth loss in the most severe cases. There are very effective therapies to combat this, ranging from scalings (deep cleanings) that remove plaque and calculus (tartar) from beneath the gum line, to surgical repair of lost gum and bone tissue.

Periodontal Therapy Procedures
Periodontal therapy includes both surgical and non-surgical techniques to restore health to the tissues that support the teeth (gums and bone) and prevent tooth loss. They include:

Scaling and Root Planing. These deep-cleaning techniques are the best starting point to control gum disease. Plaque and calculus (tartar) are removed from beneath the gum tissues, using hand scalers and/or ultrasonic instruments.
Gum Grafting. Sometimes it's necessary to replace areas of lost gum tissue so that tooth roots are adequately protected. This can be accomplished by taking healthy gum tissue from one area of the mouth and moving it to where it is needed, or by using laboratory-processed donor tissue.
Periodontal Plastic Surgery. When used to describe surgery, the word “plastic” refers to any reshaping procedure that creates a more pleasing appearance of the gum tissues.
Periodontal Laser Treatment. Removing diseased gum tissue with lasers can offer significant advantages over conventional surgery, such as less discomfort and gum shrinkage.
Crown Lengthening Surgery. This is a surgical procedure in which tooth structure that is covered by gum and bone tissue may need to be exposed either for cosmetic reasons (too make the teeth look longer and the smile less gummy) or to aid in securing a new dental crown.

Dental Implants. Today's preferred method of tooth replacement is a titanium dental implant, which is placed beneath the gum line and into the jawbone during a minor surgical procedure. The implant is then attached to a realistic-looking dental crown that is visible above the gum line and indistinguishable from a natural tooth.

Your Role in Periodontal Health

Dental plaque is the main cause of periodontal disease, so it's essential to remove it every day with effective brushing and flossing. This doesn't mean scrubbing, which can actually cause your gums to recede. Proper techniques can be demonstrated for you, if you have any questions.

Of course, there are some areas of the mouth that a toothbrush and floss just can't reach, which is why it's so important to have regular professional cleanings at the dental office. Your regular dental exam is also a time when early signs of gum disease can be detected — before they become apparent even to you.

Eating a nutritious diet low in sugar, and staying away from tobacco in all forms, will also increase your periodontal health — and your chances of keeping your teeth for life.

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