Posts for: December, 2017
Every good oral hygiene regimen has two parts — the part you do (brushing and flossing) and the part we do (professional cleanings and checkups).
But what’s involved with “professional cleanings” — and why do we perform it? The “why” is pretty straightforward — we’re removing plaque and calculus. Plaque is a thin film of bacteria and food remnant that adheres to tooth surfaces and is the main culprit in dental disease. Calculus (tartar) is calcified plaque that occurs over time as the minerals in saliva are deposited in bacterial plaque. It isn’t possible for you to remove calculus regardless of your efforts or hygiene efficiency. Ample research has shown that calculus forms even in germ-free animals during research studies, so regular cleanings are a must to keep you healthy.
The “what” depends on your mouth’s state of health and your particular needs. The following are some techniques we may use to clean your teeth and help you achieve and maintain healthy teeth and gums.
Scaling. This is a general term for techniques to manually remove plaque and calculus from tooth surfaces. Scaling typically encompasses two approaches: instruments specially designed to remove plaque and calculus by hand; or ultrasonic equipment that uses vibration to loosen and remove plaque and calculus, followed by flushing with water and/or medicaments. Scaling can be used for coronal maintenance (the visible surfaces above the gum line) or periodontal (below the gum line).
Root planing. Similar to scaling, this is a more in-depth technique for patients with periodontal disease to remove plaque and calculus far below the gum line. It literally means to “plane” away built up layers of plaque and calculus from the root surfaces. This technique may employ hand instruments, or an ultrasonic application and flushing followed by hand instruments to remove any remaining plaque and calculus.
Polishing. This is an additional procedure performed on the teeth of patients who exhibit good oral health, and what you most associate with that “squeaky clean” feeling afterward. It’s often performed after scaling to help smooth the surface of the teeth, using a rubber polishing cup that holds a polishing paste and is applied with a motorized device. Polishing, though, isn’t merely a cosmetic technique, but also a preventative measure to remove plaque and staining from teeth — a part of an overall approach known as “prophylaxis,” originating from the Greek “to guard or prevent beforehand.”
If you would like more information on teeth cleaning and plaque removal, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Teeth Polishing.”
While it may not be one of your favorite features in the dental office, the dental drill is nevertheless necessary for treating problem teeth. It’s used primarily for removing decayed or damaged structure and preparing a tooth for fillings or other restorations.
Dental drills have been used for decades and are quite effective — but they have their drawbacks. Their rotating burrs often remove portions of healthy tooth structure along with decayed material. Friction from the drill action can cause discomfort, so local anesthesia is usually needed. Drills can also emit a high-pitched machine noise that’s unsettling to many patients.
There’s a growing alternative to the drill, known as air abrasion. Although the technology has been around since the 1950s, the development of new suction pumps that capture the resulting dust from its use has made it more palatable as an option to the traditional drill.
Also known as particle abrasion, the technique uses a pressurized stream of fine particles (usually aluminum oxide, an abrasive powder) directed at teeth to wear away (abrade) the tooth’s structural surface. We can be quite precise in the amount of surface material removed, so it’s useful for diminishing stains or roughing the surface for bonding materials like composite resin. We’re also able to remove decayed material with very little impact on surrounding healthy structure, and you may not need anesthesia during the procedure.
While this quiet alternative to the noisier drill is quite versatile, it does have its limitations. It’s not that efficient for preparing larger cavities for restoration or for removing older amalgam fillings. The teeth to be treated must be carefully isolated to prevent the fine particle dust produced from being swallowed by the patient or spread into the air. High-volume suction equipment is a must or the procedure will create a “sandstorm” of particles in the room.
Still, for situations suited to it and with proper isolation measures, air abrasion can be effective and comfortable. If the technology continues to improve, the dental drill may soon become a relic of the past.
If you would like more information on procedures using air abrasion, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Air Abrasion Technology.”
Many people use a mouthrinse as part of their daily oral hygiene. If you’d also like to include a mouthrinse in your regimen, the kind you choose will depend on what you want it to do for you.
If your main desire is fresh breath, then a cosmetic rinse that imparts a minty smell to the mouth should fit the bill. That, however, is all they do — cosmetic mouthrinses don’t contribute to oral health beyond your personal satisfaction that your breath is free of bad odors. But, if you want more — added protection against dental disease, for example — then you’ll need to consider a therapeutic mouthrinse.
Therapeutic mouthrinses are usually described as anti-cariogenic (prevents decay) or anti-bacterial, and include both over-the-counter (OTC) and prescription rinses. Their purpose is to either strengthen teeth or reduce the mouth’s bacterial levels. Of the OTC variety, most contain a small amount of sodium fluoride, which can strengthen tooth enamel. They’ve proven highly effective: a number of studies show using a sodium fluoride mouthrinse in conjunction with brushing and flossing reduces the chances of new cavities forming.
A number of OTC rinses also have an anti-bacterial effect, usually provided by active ingredients such as triclosan, zinc or essential oils like menthol. Even a slight reduction in bacteria can help lessen the chances of gingivitis (gum inflammation), an early form of periodontal (gum) disease. Reducing bacteria levels may also help alleviate bad breath.
Some individuals, though, have higher than normal levels of bacteria, or a systemic weakness in fighting certain bacterial strains. If this is your case, you might benefit from a prescribed mouthrinse intended to lower bacterial levels. Most prescription mouthrinses contain chlorhexidine, which has been amply demonstrated as an effective anti-bacterial control of tooth decay and gum disease. Chlorhexidine prevents bacteria from adhering to the teeth and so disrupts plaque buildup, the main cause of dental disease. Its prolonged use will result in the dark staining of teeth in some people, but this can be removed during dental cleanings and teeth polishing. Long-term use is generally not preferred compared to getting the proper attention from regular cleanings and examinations.
If you would like more advice on adding a mouthrinse to your daily hygiene regimen, especially to help reduce your risk of dental disease, please feel free to discuss this with us at your next checkup. Regardless of which type of mouthrinse you choose, they should always be used as a complement to daily brushing and flossing, along with regular dental cleanings and checkups.
For more information on mouthrinses, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Mouthrinses.”