Dental Cleanings

Gum Health

What is gingivitis?

Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.

Factors that may contribute to gingivitis include: diabetes, smoking, aging, genetic predisposition, systemic diseases and conditions, stress, inadequate nutrition, puberty, hormonal fluctuations, pregnancy, substance abuse, HIV infection, and certain medication use.

What is periodontitis?

Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected.

As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.

There are many forms of periodontal disease. We will discuss your specific type with you at your visit and work with you to treat this condition and get you on the road to improved dental health! Our hygienist, Ashley, is kind, caring and non-judgmental. She enjoys not only helping patients but educating them as well so they can be an active participant in improving their health!

Types of Cleanings

1) Prophy/“Regular Cleaning”

When is a prophy indicated?

A prophy is exclusively for patients with healthy gums that exhibit minimal signs of periodontal disease. Typically, healthy gums have a pink and firm appearance with pocket depths of 1-3 mm. Gum tissue that is healthy does not bleed easily when brushing or flossing.

What is a prophy?

A prophy is purely a preventative procedure and typically recommended every 6 months in order to control local irritational factors. Some patients tend to build calculus faster than others but still have healthy gum tissue; these patients are sometimes recommended to have a prophy every 4 months in order to keep their gums healthy. During a prophy all plaque, calculus and stains are removed from the teeth.

2) Scaling In The Presence Of Moderate To Severe Generalized Gingivitis

When is this type of cleaning indicated?

Scaling in the presence of generalized gingivitis is the type of cleaning needed when a patient does not have healthy gum tissue but still has healthy bone support. Signs that may indicate this type of cleaning include red puffy gums, pockets depths of 4+ mm, and bleeding during brushing or flossing. These initial signs of periodontal disease can be reversed if properly treated and when proper oral hygiene is incorporated at home.

What is scaling in the presence of generalized moderate to severe gingivitis?

This type of cleaning is a therapeutic procedure. The goal is to reverse the periodontal disease in order to prevent further damage of the supportive tissues of the teeth and bring the gums back to health. It includes removing all plaque, calculus, and stains from the teeth. If gum tissue is too inflamed and sensitive, a topical anesthetic is sometimes used in order to keep the patient comfortable throughout the cleaning.

3) Scaling And Root Planing/“Deep Cleaning”

When is scaling and root planing indicated?

When you have signs of gingivitis and loss of supportive tissue and bone, scaling and root planing is needed. Bacterial plaque and calculus accumulate around and under the gums destroying the tissues that support the teeth. This type of periodontal disease is irreversible. Treatment is needed in order to stop the progression of the disease and keep the gums and bone in a stable maintained state.

What is scaling and root planing?

Scaling and root planing is a non-surgical procedure to treat periodontitis, the irreversible form of periodontal disease. This treatment is performed by your hygienist and typically takes two appointments to complete. Local anesthetic is used to minimize any discomfort. The procedure involves thoroughly removing all plaque, bacterial toxins, and calculus from your teeth and root surfaces. Root planing is the process of smoothing all rough areas on your roots’ surfaces. Smooth root surfaces keep bacteria, plaque and calculus from re-adhering underneath the gumline, allowing your gums to heal and reattach themselves more firmly.

After the procedure

Four weeks after completion of treatment, your dental hygienist will want to check the healing of your gums and the depth of your pockets. The good news is that in most cases, red or swollen gum tissue becomes firm and pink again, bleeding is reduced or eliminated and pockets get smaller. If your gum tissue has responded well and remains stable, you may not need any further treatment.

More advanced periodontitis, on the other hand, may require surgical interventions by a periodontist after root planing and scaling to stop the progression of bone loss. However, your scaling and root planing treatment often lessens the amount of surgery you need.

Periodontal maintenance

After scaling and root planing, your future cleanings will be considered periodontal maintenance. These maintenance visits are recommended every 3 to 4 months in order to prevent further loss of supporting tissues of your teeth (including bone loss), and to keep your gums in a stable and more healthy state. A full gum assessment is performed at each visit.