Cleanings

(Teeth) Cleanings

The word "cleaning" in dentistry does not even exist as a dental term. It is a dental slang term that essentially means the removal of soft (bacterial plaque) and hard (tartar or calculus) material from the teeth to attain and/or maintain gum health. People who have healthy gums that don't bleed when measured need only a "simple cleaning" or an oral prophylaxis, as it is dentally known, wherein any slight tartar is removed by the dentist or dental hygienist with dental instruments and the plaque is polished off. People who have unhealthy gums can vary considerably in the degree of "cleaning" needed. All dentists and dental personnel know this, but many dentists who desire high patient volume accommodate the potential patients who call for a new appointment to get them in the door. (See "About Fear & The Dentist )

"But, why can't I just get my teeth cleaned?"

This is a frequently asked question from a new patient calling for a dental exam. Health oriented offices are aware that 80% of all persons (even those who have been having regular dental visits) have some form of periodontal (gum) disease. American Dental Association statistics report 85 to 90% of all adults and 35% of all children will have some form of periodontal (gum) disease within their lifetime.

Given the above information, our office thoroughly examines each new patient to co-discover and diagnose the state of your gum health. The type of cleaning(s) (scaling, polishing and learning improved self-care) is dependent upon the state of your gum health which is influenced by such things as amount and type of bacterial plaque, immune system health, habits such as smoking, traumatic occlusion (bite), nutrition and stress. It could be a one appointment endeavor for a healthy individual, or it might involve several appointments to bring your mouth to its optimal periodontal health. It is now well known that the hard deposits are not the cause of gum disease, but forms due to the presence of soft bacterial plaque, which is the main cause of gum and periodontal disease. Many years ago when we used to provide "cleanings" for our new patients on first visit, it became one of the most frustrating things for both the dental hygienist and new patient who might unknowingly have some form of periodontal disease - known as the "silent disease" because it is not painful. The hygienist would assess the gum condition and inform the patient that they needed more than a "cleaning". The patient, expecting to have his/her teeth "cleaned" would be disappointed in not receiving what they thought would be accomplished, as well as the hygienist who couldn't deliver the main thrust of why they became a dental hygienist in the first place.

Occasionally, a person who has gum disease just wants to have hard deposits and stain removed above the gum level, say prior to a photograph or event such as a wedding. We have no problem delivering this "cleaning" service given that the patient is fully aware that it will not address the underlying gum problem.

It is very important to define what we are attempting to accomplish during the "cleaning" or hygiene visit(s). Is it to remove all the hard materials under the gums which could be very painful for a person with unhealthy gums, or is it to help a person become more healthy? Not just gum health, but general health as it is now documented that the bacteria which reside in dental plaque enter the blood stream via unhealthy gums and contribute to heart and arterial disease, premature and low birth weight babies, lung diseases, weakened immune systems and diabetes. (See "Getting to the Heart of Dental Disease", "Heart, Oral Health and Your" & "Periodontal Disease May Lead to Diabetes" in definitions in the "About Our Services" section)

Because of these facts, the "can I get my teeth cleaned?" question over the phone can have varying answers dependent on facts which we cannot know without an evaluation. We cannot answer the question with honesty because we don't know what we don't know yet.

Rest assured, your teeth will be cleaned and it will be with a unique plan of action for your own mouth so you can have a lifetime of optimal dental health.

Your First Dental Hygiene Appointment at Dr. McBride's office

So, start by appointing yourself for a periodontal evaluation. This is usually done with a new client on the first visit. It is a 50 minute appointment which consists of:

• a review of your dental and general health and nutritional status
• oral cancer exam
• radiographic evaluation (annual x-rays) evaluation of the supporting bone, as it "melts" away with advancing infectious gum disease
• periodontal (gum measuring)
• dental examination
• microscopic bacterial evaluation (bacterial plaque varies considerably from person to person)
• oral hygiene evaluation
• diagnosis and report of your oral status
• presentation of the best treatment options
• supportive oral hygiene and nutritional instruction.

Now that a road map has been established, we make your appointment(s) for hygiene treatment (thorough scaling and polishing of all tooth surfaces- it may require multiple visits, depending upon level of build-up, level of harmful bacteria in plaque, risk of health related infections, depth of pocketing of gums around teeth or recession causing more surface area to clean, and the amount of instruction needed).

Key to Successful Periodontal Treatment - Maintenence

A thorough periodontal maintenance visit in our office consists of:

1 - A program outlined and monitored by the doctor - the doctor is reviewing the chart and guiding the treatment.
2 - Oral cancer exam.
3 - Radiographic (x-ray) evaluation (annually).
4 - Periodontal (gum measuring) and dental examination.
5 - Initial and follow up microscopic bacterial evaluation.
6 - Oral hygiene evaluation and instruction. --(may require distribution over multiple visits)
7 - Report of present oral situation.
8 - Thorough scaling and polishing of all tooth surfaces. --(may require multiple visits)
9 - Treatment by a hygienist who is interested in your continued oral health and is genuinely committed to this goal.
10 -"Report Card" of outlined areas to focus on during the time between maintenance appointments.

So, you see, a "cleaning" is not a cleaning.

As indicated, some dental practices, which are primarily production oriented, rush patients through to get their teeth "cleaned" without offering time to allow the hygienist to develop a relationship wherein the patient can learn of the important things stated above. Any true state of health requires patient motivation from a level of understanding of the problem, and action towards its solution with adequate time allowance for its development. Most gum disease is not treated by a "quick fix". The healthiest gums I see are around the teeth of those dental patients who see hygienists working in a dental office that has a genuinely developed with a written purpose regarding wellness (See "Dental Health & Wellness" under "About Our Services") - they have a passion for truly helping their patients develop and sustain health and do so because they are supported by that purpose. They recognize and understand that good "coaching" is at least as important as the "cleanings" they do.

Every person's dental health status is different. So it is logical that every person will require their own customized approach to becoming and /or maintaining dental health. This is why diagnosis is so important. We can determine beforehand what outcome each person is aiming for and the plan of action the person would prefer to take based upon an understanding of what's best for their dental status.