Facts about Scaling and Root Planing
Periodontal diseases (also known as gum diseases) are infections of the gums and bone that hold our teeth in place. Periodontal diseases are often painless. However, in some instances, if left untreated it can lead to tooth loss. You may not be aware that you have a problem until your gums and supporting bone are damaged.
The good news is that periodontal disease can usually be treated with a deep cleaning called scaling and root planing.
What causes periodontal diseases?
Periodontal diseases are caused by plaque, a sticky film that is always forming on your teeth. Plaque contains bacteria that produce harmful toxins. If teeth are not cleaned well, the toxins can irritate and inflame the gums.
Inflamed gums can pull away from the teeth and form spaces called pockets. The pockets trap plaque and bacteria which cannot be fully removed with brushing. If the infected pockets are not treated, the disease can progress. The bone and other tissues that support the teeth can be damaged.
Brush your teeth twice a day and floss (or use another “between-the-teeth” cleaner) daily. If plaque remains on the teeth, it can harden into a rough surface called tartar or calculus. Tartar/calculus can only be removed when teeth are cleaned at the dental office.
How do periodontal diseases develop?
Gingivitis is the early stage of periodontal disease. Affected gum areas become red. They may appear swollen and may bleed easily, especially when you brush or floss your teeth. The condition is reversible, however, gingivitis may lead to a more serious condition called periodontitis. Periodontitis can do lasting damage to the gums, bones and other structures that support the teeth. There are various treatments that can help. At more advanced stages, the disease may require more complex treatment to prevent tooth loss. In the worst case, teeth can become loose and may need to be removed by the dentist. How periodontitis is treated depends on how far the condition has developed and how well your body responds to therapy over time.
Diseases such as diabetes, blood cell disorders, HIV infections, and autoimmune disorders can lower the body’s resistance to infection. This can place a person at greater risk for more severe forms of periodontal diseases. Smoking may also increase your risk of developing periodontal disease, and treatment may be less successful if you continue to smoke.
Types of periodontal diseases
There are many types of periodontal diseases. People of all ages can be affected, from children to seniors.
Gingivitis is the mildest form of periodontal disease. It causes the gums to become red and swollen and to bleed easily. There is usually little or no discomfort at this stage. Gingivitis can be reversed with treatment in the dental office and good oral care at home.
Chronic Periodontitis is a form of periodontal disease that results in swelling and redness in the tissues around the teeth. Patients suffer loss of tissue and bone that may become more severe over time. In chronic periodontitis, pockets form and/or gum tissue pulls back. This is the most common form of periodontitis in adults but can occur at any age. It usually gets worse slowly, but there can be periods of rapid progression.
Aggressive Periodontitis is a highly destructive form of periodontal disease that occurs in patients who are otherwise healthy. Common features include rapid loss of tissue and bone. This disease may occur in some areas of the mouth, or in the entire mouth.
Periodontitis as a Manifestation of Systemic Diseases is a form of periodontitis that is the result of a specific disease or disorder. Patients who have certain blood diseases or genetic disorders frequently show signs of periodontal disease.
Necrotizing Periodontal Diseases result in the death (or necrosis) of tissues surrounding the tooth and connecting bone. This most commonly comes with pain, bleeding, and a foul odor. These infections, in part, are caused by stress, tobacco use, malnutrition and HIV infection.
How are periodontal diseases diagnosed?
If you schedule regular dental exams, your dentist can catch periodontal diseases before the gums and the bone supporting your teeth are severely damaged. If left untreated, periodontal diseases usually get worse over time. During a periodontal exam, the dentist will check your gums for problems. The dentist or hygienist uses an instrument called a periodontal probe to gently measure the depth of the spaces between your teeth and gums. In a healthy mouth, this space is very small, less than three millimeters. When periodontal disease is present, the gums develop a deeper pocket that bleeds, collects more plaque bacteria, and is difficult to keep clean. Besides checking your gums, your dentist will assess your general dental health, and perform an oral cancer screening. Dental X-rays are usually taken to check the condition of the bone supporting the teeth and to detect other problems not visible during the clinical examination. If gum disease is diagnosed, your dentist may provide treatment or you may be referred to a periodontist (a specialist in periodontal diseases).
How are periodontal diseases treated?
Periodontal treatment methods depend upon the type and severity of the disease. If the disease is caught early (when it is gingivitis), and no damage has been done to the supporting structures under the teeth, you may simply be given instructions on improving your daily oral hygiene after having a professional cleaning.
Even with these measures, some patients develop more severe periodontal disease that must be treated. The first step usually involves a special cleaning, called scaling and root planing. In this treatment, plaque and tartar/calculus are carefully removed down to the bottom of each periodontal pocket. This treatment may be done over several visits, depending on your needs. The tooth’s root surfaces are then smoothed, or planed, to allow the gum tissue to heal and reattach to the teeth. This is sometimes called a “periodontal cleaning” or “deep cleaning” and may take more than one visit.
Your dentist also may recommend medications to help control infection and pain or to aid healing. These medications could include a pill, a mouth rinse, or a substance that the dentist places directly in the periodontal pocket after scaling and root planing. If you smoke or chew tobacco products, it is important to quit. Your dentist may also advise you to talk to your physician about any other health problems that may be affecting your oral health.
Once the scaling and root planing treatment is complete, another appointment will be made within a few weeks. At this appointment, the dentist or hygienist will look at your gums to see how they have healed and measure the periodontal pockets again. If the disease continues to advance to the point where the periodontal pockets get deeper and the supporting bone is lost, more treatment may be necessary.
Teeth may be sensitive for some time after periodontal therapy. When unwanted deposits are removed from root surfaces, your teeth may be sensitive to temperature changes, acids produced by bacteria in your mouth, and even touch.
This soreness can make you want to avoid cleaning the areas that were treated. But it is very important to keep brushing gently and flossing to remove the plaque. If this plaque is not routinely removed, root decay (cavities) may occur. Your dentist may be able to provide various treatments or recommend dental home care products to reduce sensitivity.
Periodontitis will not go away by itself.
Left untreated, surgery may be needed to save affected teeth. Preventing and treating the disease in the early stages are the best ways to keep your smile healthy.
You don’t have to lose teeth to periodontal disease. Brush, clean between your teeth, eat a balanced diet, and schedule regular dental visits for a lifetime of healthy smiles. Keeping your gums and teeth healthy takes a partnership between you and your dental providers. Without your help, by brushing and flossing and the proper oral hygiene at home, a healthy smile is not possible.
Will My Treatment Be Covered by My Insurance?
Check your benefits plan when planning treatment with your dental office. However, treatment should be determined by you and your dentist, not by your benefits plan. If your treatment is not fully covered by insurance, ask the dental office if they have payment options to cover the rest. Keep in mind that having periodontal treatment now may be less expensive than replacing a tooth lost to disease.
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