Keep Your Teeth Healthy
Dental Prevention Services
We need teeth cleanings for two reasons:
• To prevent diseases in the rest of the body like heart disease, dementia, and complications of diabetes
• To prevent tooth loss
The mouth is an area that’s completely different from the entire body, and it takes quite a beating from the food we eat and the talking we do all day long. And this unique environment requires special care.
Teeth cleanings remove the buildup of plaque and tartar. This buildup is for the most part natural — kind of like how a boat picks up barnacles just by being in the ocean. But too much buildup leads to gum disease. The reason tartar needs to be removed is because your body sees it as a foreign invader. As with any other foreign invader, like a flu bug or an infection, your body “sends in the troops” using the immune system to fight off the infection. There is a battle in your mouth at all times, and the war is never over.
Teeth cleanings level the playing field by keeping things in check. Gum disease is when your body’s immune system is responding to this tartar buildup with inflamed and bleeding gums. The immune system response is successful at killing off invaders like infection and flu bugs, but at a cost: like a war, there are innocent bystanders that get slaughtered. As gum disease progresses, so does the destruction to your bone and tissues in your mouth.
Your immune system is meant only to fight off infection for a short period of time — chronic activation of the immune system means it can get worn out and it won’t be as strong to fight off an illness. Chronic activation of the immune system can lead to diseases in the rest of your body. That’s why preventing gum disease reduces risk of stroke, heart disease, and dementia.
At a certain stage, this damage is irreversible, so prevention is the best way to maintain overall health and keep beautiful teeth for a lifetime — and teeth cleanings are a critical piece of this prevention.
What Is a Teeth Cleaning?
A professional teeth cleaning is done by the hygienist at a dentist’s office. The hygienist uses tools to remove tartar from your teeth — both above and below where the gum meets the tooth.
Your hygienist should explain what work is being done, why it’s being done, and why your teeth may be sensitive or why your gums are bleeding. You can ask for a mirror or an intra-oral camera (a more hi-tech version of the mirror) which will allow you to watch your hygienist working and understand what’s being done to your teeth. It’s one thing to hear your hygienist say, “You really need to pay more attention to your back molars.” But it’s quite another thing to actually see your hygienist scraping tartar from your back molars so you can following up with proper brushing and flossing at home.
Your dentist or hygienist should give you an updated primer on proper brushing and flossing technique. Follow through after a teeth cleaning is everything, so use this opportunity to get a full demo of what you should be doing at home to keep your mouth disease-free and healthy.
What to Ask For?
While you’re there for your teeth cleaning, ask your dentist for a diagnosis for stage of gum disease. This will give you some idea of where to go from here. You can have direction until you know where you’re starting from. You can ask: “Am I type I, II, III, IV, or V for gum disease?”
Understand What Gum Disease Is?
Imagine when you’ve cut your hand — it swells up. The same thing happens to gums that are inflamed by the buildup of tartar, even more so than swelling in other parts of the body because gums have an incredibly rich blood supply. Discuss this with your dentist and make sure to talk about your own status when it comes to gum disease.
Know Why a Pocket Reading Is So Important For Overall Health
Where the gum and the tooth meet isn’t actually where they attach — they are attached further down. This creates a small pocket, which you can picture like a moat all the way around your tooth.
The size of this little pocket can change in two ways:
1. At the bottom of the pocket are ligaments that hold the gum and tooth together. These ligaments are eaten away by the enzyme produced by the body produces when the body feels it’s under attack. This makes the pocket deeper.
2. The top flap of the pocket can grow in size due to inflammation.
Pockets can get deeper from the top or the bottom — but however it happens, it’s not good for your health. That’s why a “pocket reading” is an important indicator of your health. A pocket reading is a measurement of the size of your pockets.
Deeper pockets are indicators of disease. Ideally, you’re preventing your pockets from deepening with proper oral hygiene at home and regular teeth cleanings, which will prevent your gums from being inflamed.
Ask For Your Pocket Reading
Ask to hold a mirror so you can watch your dentist measure your pocket — you’ll see a little probe with ruler lines on it being inserted into your pocket. Ask your dentist for your pocket reading. Again, this is good to know. Just as you want to know what your blood pressure is, you want to know what your pocket reading is and be aware of how it’s changing.
Know the Different Types of Teeth Cleanings
There are different types of teeth cleanings, depending on how healthy your gums are. Make sure you’re not over-treated or under-treated.
No Gum Disease
This is the best and what you should aim for at each teeth cleaning. There’s no bleeding when the dentist flosses your gums or puts the probe inside your pockets to measure them.
Treatment: Maintain, maintain, maintain. It is infinitely easier (and healthier) to maintain good health and prevent disease than it is to become unhealthy and to have to seek treatment. Ask your dentist how to maintain this good health. You will still need regular teeth cleanings, but in exceptional cases, you might be able to get a cleaning once per year, and this is perfectly fine.
Having no gum disease for a lifetime will reduce your risk of heart disease, dementia. If you have diabetes, it will reduce complications. The reduced inflammation in your body will make you better at fighting infection and maybe even make it easier to lose weight. Keep up the good work!
Type I: Gingivitis
Gingivitis is very common. Around 80% of people in the United States have gingivitis. If you have gingivitis, your gums bleed when you floss them or when the dentist measures your pockets. There might be some redness along the edge of the gum where it meets the tooth. Gingivitis means your gums are reacting to an infection and they’re diseased. Healthy gums don’t bleed when touched.
Treatment: you’ll need to be doing better at home with flossing and brushing and you might need to increase your frequency. Ask your dentist or hygienist for a demo of proper brushing and flossing technique. You might also need different instruments — gum disease can be aggravated by a toothbrush that is too old.
Type II: Early Periodontitis
At this stage, you’ve had gingivitis for some time and it has progressed to something more serious. Your dentist might tell you that you have deep pockets. Your gums are bleeding when flossed or probed. It’s possible you may even have some ligament damage to the place where your gums attach to your teeth. Gum recession is also common at this stage. Gum recession is when gums pull down, away from the tooth, after healing from inflammation. Receding gums aren’t pretty and they lead to tooth sensitivity because the root of the tooth starts to become exposed as the gum pulls down. Gum recession is 100% irreversible. It’s permanent and no surgery can fix it.
Treatment: Early periodontitis is the beginning of a very dangerous path. If you’re at this stage, I would recommend a deep cleaning, called a scale and root planing. A root planing is required at this stage because there’s so much tartar buildup that brushing and flossing on your own will be inadequate now. With this much tartar buildup, it’s impossible to clean down to the surface of the tooth — until it’s removed by a professional in a deep cleaning.
Ask your dentist which sections of your mouth are affected because you might not need the deep cleaning everywhere. Scale and root planings are done in quarters — upper right, upper left, lower right, and lower left. You will need a deep cleaning in one, two, three, or all four of these quadrants.
A scale and root planing gives you the chance to prevent the tartar from building up and taking hold again. This is why follow through is critical after the deep cleaning. Ask your dentist for a demo of the proper flossing and brushing technique you’ll need to use at home.
Type III, IV, and V: Moderate to Severe Periodontitis
At this stage, you also have deeper pockets and bleeding gums. As the severity increases, it gets more and more difficult to get healthy again. In these severe stages of periodontitis, you begin to tempt your fate with a point of no return — as in, the point where your gums will no longer respond to treatment. Surgery is frequently required in these stages.
Treatment: You’ll need multiple scale and root planings (read the section about Type II: Early Periodontitis above for information on the scale and root planing procedure). I would recommend considering a second opinion from a periodontist as well, who specializes in these more advanced and serious stages of gum disease.
After your root planing procedures, your follow through at home with proper brushing and flossing is imperative to be able to reverse the disease. Everything done at the dentist will be reversed without your taking care of your teeth every day and after every meal. Ask your dentist: “How am I brushing and flossing?” By asking this, you are verifying the efficacy of how you take care of your teeth at home.
Gum disease is a very complicated, multi-factor disease, and no matter what stage you’re at, and even if you don’t have gum disease, you have to monitor it your whole life — kind of like blood pressure. The mouth is never static — it is always changing depending on the foods we eat, how we brush and floss, and the chemicals we expose it to.
The treatment guidelines above are for gum disease that is caused by plaque. But gum disease can also occur due to hormonal changes from a pregnancy, medications you’re taking, grinding your teeth, poor dentistry, or root canals, you could get gum disease that way.
Summary of Questions to Ask During the Appointment
• What classification of gum disease do I have?
• How deep are my pockets?
• Do you notice any gum recession?
• Am I over-brushing?
• Am I grinding my teeth?
• May I have a demo of how I should floss and brush my teeth?
After the Teeth Cleaning
No matter whether you have gum disease or not, or what stage gum disease you have, your oral hygiene at home is critical. Follow through after your teeth cleaning is everything. Make sure you are:
• Brushing and flossing after meals, or at least twice per day.
• Eating a diet rich in vegetables
• Making an appointment for every three months if you have gum disease, or every six months if you don’t have gum disease and are just maintaining good health.
Gum disease is easy to prevent, but a hard disease to get rid of. Home care is essential — your dentist and hygienist can’t do it all for you at these appointments.
Cosmetic & Family Dentistry
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