Periodontal Maintenance

A routine oral prophylaxis (routine teeth cleaning) includes scaling or polishing procedures to remove plaque, calculus and stains from the crowns of teeth.  A routine cleaning is performed on healthy tissue or in the presence of inflammation, gingivitis, the response of healthy tissue to the toxic deposits of bacterial plaque and calculus.  A routine cleaning is performed every 3,4 or 6 months to maintain healthy gums or reverse a gingivitis to return the mouth to health.

Periodontal maintenance is initiated following the treatment of periodontal disease, the loss of tooth support to gum and bone decay resulting in unsupported and exposed root surfaces.  Periodontal maintenance includes the removal of bacterial plaque and calculus from the crowns and exposed root surfaces of teeth above the gum-line and deposits on the root surfaces of teeth below the gum-line.  Periodontal maintenance is performed every 3 months to prevent the progression of periodontal disease.

Once tooth support has been lost, it cannot be restored.  Tooth loss in periodontal patients has been shown in studies to be inversely proportional to the frequency of periodontal maintenance.  Ten years following completion of periodontal therapy, patients who had received periodontal maintenance had significantly less progressive gum and bone decay and reduced tooth loss compared to patients who had not received periodontal maintenance.  In fact, numerous studies have demonstrated the effectiveness of periodontal maintenance and have shown that progressive periodontitis can be prevented or limited by optimal personal oral hygiene and thorough periodontal maintenance.  Since patients are rarely completely effective in removing plaque at home, 3 month periodontal maintenance eliminates or reduces the toxic effects of bacterial plaque on teeth and supporting tissues.

Patients with a history of periodontitis require continuing periodontal maintenance since brushing and flossing alone has not been shown to control the progression of attachment loss.  Occasionally, despite the best efforts of the dentist and hygienist, some patients may suffer tooth loss despite continuous periodontal maintenance.  Additional diagnostic information, such as microbial and genetic testing, as well as antimicrobial therapy and periodontal surgery my be required for these patients.  For a free periodontal exam which includes an update of your medical and dental histories, extra-oral and intra-oral soft tissue examination, dental examination, periodontal evaluation, implant evaluation, and radiographic review, visit Adult Dentistry of Rochester.

Tags: Oral Prophylaxis, Periodontal Maintenance, Teeth Cleaning, Periodontal Disease, Gingivitis, Gum Disease

Are You At Risk For Periodontal Disease?

There are several factors that increase the risk of periodontal disease, an infection that causes decay in the gum and bone supporting teeth.  These risk factors are:

Smoking or chewing tobacco - not only is periodontal disease more prevalent in smokers, periodontal treatment is less successful in those individuals who smoke.

Diseases that affect the whole body - such as diabetes, blood cell disorders, and, HIV-AIDS are among the diseases that can lower resistance to infection, making periodontal disease more likely and severe.

Medications - steroids, anti-seizure drugs, cancer therapy drugs, blood pressure drugs and birth control pills - can affect the gums.  Some of these medications have the side effect of reducing salivary flow which lowers the cleansing and buffering effect of saliva resulting in increased plaque accumulation and acid attack which causes tooth decay and gum disease.

Teens, pregnant women, and those taking birth control pills face changes in the body's hormone levels which can cause the gum tissue to be more inflamed by the toxins in bacterial plaque.

Genes play a role.  Some patients may have a gene that causes the gums to become more inflamed in response to bacterial plaque.  The result is more severe and rapid progression of periodontal disease.  If your parents wear dentures or you have a family history of tooth loss due to gum disease, then you may carry this gene.

The specific types of bacteria that cause periodontal disease are passed from mother to children due to the intimate physical contact of child rearing, or between partners through the saliva.  You help your children avoid gum disease by taking care of your own oral health.  Some parents mistakenly think that they are caring for their children by neglecting their own health.  For a free periodontal exam and consultation with Dr. Dulski to assess your risk for periodontal disease, visit Adult Dentistry of Rochester.

Tags: Periodontal Disease, Gum Disease