WHAT IS THE DIFFERENCE BETWEEN A REGULAR DENTAL CLEANING AND A PERIODONTAL MAINTENANCE CLEANING?
dental cleaninb vs periodontal checkup
Routine dental cleanings are a fundamental component of maintaining a healthy mouth and strong, life-lasting teeth. Even the best brushing and flossing is unable to remove bacteria and plaque that resides in certain protected nooks and crevices on tooth surfaces and on irregular root surfaces under the gum line.
The purpose of dental cleanings is to remove stubborn residual plaque which we are unable to remove through daily brushing and flossing. This plaque must be removed to prevent it from causing tooth decay and gum disease. The dental appointment usually involves a cleaning, a check-up for tooth decay and an examination for bone loss or other signs of gum disease.
There are two types of dental cleanings: regular cleanings and periodontal maintenance. What is the difference, and why?
ROUTINE DENTAL CLEANINGS:
Routine dental cleanings are the standard cleanings for people who do not have a history of periodontal disease (also known as “gum disease”). In the dental office we call them “prophys,” short for “prophylaxis.” The word “prophylaxis” means the prevention of a disease. In dentistry, these regular cleanings are aimed at preventing tooth decay and periodontal disease.
Prophys are a part of the routine, usually biannual – 6 monthly, check-ups that most people get at their dentist office. The prophy portion of this preventative visit is carried out in most instances by a dental hygienist. It involves scraping off the mineralized plaque deposits called calculus. If plaque is not completely removed on a daily basis through brushing, flossing or any of the variety of other oral hygiene adjuncts such as water picking, proxy brushing, tooth picking etc., minerals from saliva deposits within it form calculus. Once plaque mineralizes into calculus it is virtually impossible for anyone to remove it by him or herself at home.
The dental hygienist is a specially trained person who has the skills to remove calculus without causing damage to the teeth and gums.
Hygienists typically use advanced methods of calculus removal such as ultrasonic scalers and other various hand scalers for calculus removal. The finer calculus, more resistant plaque and tooth stains may then be removed through polishing with the application of an abrasive paste on a special polisher called a rubber cup. The abrasive pastes are then worked in between the teeth with floss. If the patient desires – fluorides may be applied to the teeth to help prevent against tooth decay. Sometimes sealants are also applied. These help to prevent cavities by sealing off the tiny imperfections in the tooth surfaces that trap plaque.
At these appointments new x-rays may be taken and examined by the dentist. Your dentist will generally be the one who decides if x-rays are necessary and how often is appropriate to have these taken. The dentist will come in during your appointment and perform an exam. He will check for any possible tooth decay or infection in the mouth.
When there has been a history of bone loss from gum disease it becomes more difficult to clean your teeth at home. Many of the home-care aids such as the toothbrush and floss simply won’t reach into the depths of the deep pockets caused by bone loss and gum disease. Not only is it more difficult for you to remove plaque from deep pockets: it is also very difficult for your hygienist to clean out plaque when you have deep periodontal pockets.
“Perio-maintenance” is the name used to indicate a specialized cleaning focusing on the removal of plaque and calculus under the gumline. It is the standard of care for people who have deep pockets from bone loss. This type of cleaning is what is done at a periodontist’s office where the hygienists have special training, specialized instruments and lots of experience cleaning deep pockets.
Patients who come to a periodontist, a specialist in the treatment of gum disease, generally start their return to oral health with a procedure called “scaling and root planing.” This procedure requires the use of local anesthesia and again is carried out by a periodontal hygienist who has the skill and training to remove very hard and stubborn calculus from deep under the gum line where it can’t be seen. There is a limit to how deep a periodontal pocket can be and still be thoroughly cleaned, even by a skilled periodontal hygienist.
Many times patients with gum disease will also be treated with some form of gum surgery in addition to scaling and root planning. These procedures are required before a patient will achieve a healthy state that can be maintained with periodontal maintenance cleanings. Scientific studies have shown that the damage caused in gum disease is caused when bacteria under the gumline organize into plaque, a highly organized bacterial colony. It has been found that when your hygienist brakes up plaque colonies under the gum line it takes 3 months before the plaque reforms to a state where it is causing damage once again. For this reason periodontal maintenance appointments are typically required quarterly, or every 3 months.
WHY DO I ALTERNATE CLEANINGS BETWEEN MY GENERAL DENTIST OFFICE AND A PERIODONTIST’S OFFICE?
When they notice signs of gum disease, general dentists will notify their patients that they need to see a periodontist. Once they have had their initial consultation, when necessary – patients will start a periodontal maintenance program in effort to cure periodontal disease.
Both of the dentists will begin to work together to ensure their patient is on the path to optimal oral health. This requires that patients alternate their cleanings between their periodontal office and their regular dentist’s office. A periodontist does not perform certain procedures that a general dentist does such as filling cavities, root canals or placing a patient’s final crowns. It is also important that dentists honor their patients’ established care with other dentists.
When doctors, hygienists and patients work together to utilize the appropriate techniques as described above, together we can arrest the aggressive nature of gum disease and eliminate the risks of tooth loss. If you’re curious to know more or are wondering which type of cleaning is right for you, send us a message through our website or give us a call to schedule a consultation with Bell Harbour Dental – PerioInnovations periodontist Dr. Adrian Pawlowski.
Bell Harbour Dental is a family owned, patient-first dental practice in the heart of Downtown, Seattle. Check us on out Facebook, Twitter, and Instagram, or contact us today to assist you in taking initiative towards vibrant dental health!