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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 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.
Periodontal
Health Diagnosis
Gum health is assessed by measuring the spaces between the teeth
and gums, noting any bleeding areas, X-ray evaluation of the supporting
bone, as it “melts” away with advancing infectious gum disease,
and microscopic evaluation of the bacterial plaque which varies
considerably from person to person. The sad part is that since
gum disease is painless, many people are walking around not knowing
they have it. “Cleanings” for people who have infected gums
cannot be helped with “simple cleanings”, but need “deep cleanings”
(slang again for scaling and root planing), as well as home care
learning, as the bacterial plaque starts building up again right
after the “cleaning”. Sometimes the destruction of the gum
and bone is such that gum surgery is necessary to help reshape the
damaged areas so as to be more cleansable afterwards.
The
state of gum health is influenced by several factors, such as
general health (immune system), nutrition, habits such as smoking,
dexterity and motivation to use effective home care measures to
rid the daily build-up of bacterial plaque.
It can
also influence the state of a person’s health, as research clearly
indicates that the inner arterial and heart walls entertain breeding
bacteria which are introduced into the blood stream via the “open
door” of infected gums. Periodontal bacteria is
known to be involved in arterial and heart disease, premature and
low birth weight babies and diabetes complications.
So,
you see, a “cleaning” is not a cleaning. Many dental
practices, which are basically 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 - 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.
"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. Truthfully, the word “cleaning” in dentistry does
not even exist as a dental term – it has been used through the years
to signify having the hard material (calculus/tartar) removed from
one’s teeth and polishing them when long ago it (calculus/tartar)
was thought to be the cause of gum problems. 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 and weakened immune systems.
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.
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.
Start by appointing yourself for a periodontal evaluation.
This is a 50 minute appointment which consists of a review of your
health condition and nutritional status, oral cancer exam, radiographic
evaluation (annual x-rays), periodontal (gum measuring) and dental
examination, microscopic bacterial evaluation, oral hygiene evaluation,
diagnosis and report of your oral situation, 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--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).
A
thorough periodontal maintenance appointment 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.
See
also Periodontal Disease, Home-care
Instructions, Home-care Products
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