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When we do a regular cleaning, which is called a dental clean-up we are taking the tartar and calculus build up off your tooth. We are working on the part of your tooth that you can see, the part that is above the gum line. But, that's just the tip of the iceberg, your tooth extends below your gum line. The foundation and strength of your tooth is what you can't see. Under the gums is the root of your tooth that is embedded in your jawbone. This is where periodontal disease hides.
Periodontal disease is a bacterial gum infection that destroys the supporting fibres attached to the underlying bone, that hold your teeth in your mouth. The main cause of this disease is bacterial plaque, a sticky, colourless film that constantly forms on your teeth. If plaque is not removed, it can turn into a hard substance called calculus in less than two days. Calculus can only be removed during a professional cleaning. If calculus forms below the gum line on the root of the tooth, it makes plaque removal more difficult, leaving you at risk for periodontal disease.
Toxins (poisons) produced by the bacteria in plaque irritate the gums, causing infection. These toxins can also destroy the supporting tissues around the teeth, including the bone. When this happens, gums separate from the teeth, forming pockets that fill with even more plaque and more infection. As the disease progresses, these pockets deepen, more gum tissue and bone are destroyed, and the teeth eventually become loose. If periodontal disease is not treated, these teeth may need to be removed.
Gingivitis : The mildest form of the disease, gingivitis causes the gums to become red, swell and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is reversible with professional treatment by our gum specialist also known as a periodontist and good home care.
Mild Periodontitis : Gingivitis, if left untreated, can advance to periodontitis. In the mild stage, periodontal disease begins to destroy the bone and tissue that support the teeth.
Moderate – Advanced Periodontitis : In the mid-stages, periodontal disease can lead to more bone and tissue destruction. The most advanced form of the periodontitis includes extensive bone and tissue loss. Teeth often become loose and may have to be removed. If gum disease is caught early by our gum specialist and it hasn't damaged the structures below the gum line, a professional cleaning also known as scaling or clean up should do. Dental scaling or Dental Clean-up is the most common non-surgical way to treat gum disease, which is also known as periodontitis. This will remove plaque and tartar from your teeth and help your gums regain health. If the pockets between your gums and teeth are too deep, however, scaling and root planing may be needed.
Root planing : Root planing is a method of treating severe gum disease. When you have gum disease, inflammation of the tissues will lead to separation of gum from the root surface, which creates a tiny space known as a periodontal pocket. It can be very difficult to keep clean and allows bacteria to accumulate. Root planing is a meticulous cleaning of root surfaces to remove dental plaque and calculus.
People with severe gum disease need to receive treatments of scaling and root planing. Before carrying out the treatment, the dentist will use a periodontal probe and take radiographs to confirm the severity of gum disease. The dentist will also let the involved area be numbed by using anaesthesia to reduce discomfort during treatment. Instruments called curettes or ultrasonic cleaners will be used to remove the plaque and calculus on root surface in the periodontal pocket.
Periodontal disease has many causes including poor oral hygiene, pregnancy, puberty, genetics (Thanks Mom and Dad!) medications, stress, poor eating habits, clenching and grinding, diabetes, chewing tobacco and smoking. Symptoms can be; swollen and red gums, receding gum line that makes your tooth look longer than normal, bad breath or a bad taste in your mouth, loose teeth, bleeding gums and tender gums.
Deep cleaning your teeth might sound like something you should do after you've missed a few visits to the dentist or eaten a particularly sticky, messy meal. A deep cleaning is actually a specific procedure performed by us to treat gum and periodontal disease.
Our specialist will take some measurements which are called periodontal charting or pocket measurements.
A totally healthy reading would be in the 0-1 range, 2-3 mm is stage 1 which is called gingivitis. Pocket depths of 4-5mm is stage 2 periodontitis which starts to include gum recession. When we see pocket depths of 4mm or higher we recommend a periodontal deep cleaning called scaling and root planing. When there are reading s of 6-10mm this is advanced periodontal disease and now you have bone loss too!
Your gums will be anaesthetised to ensure that you undergo this procedure absolutely painlessly! We will use a scaling instrument to remove plaque and tartar from the surface of the roots of your teeth. A scaling and root planing procedure will require a minimum of two visits.
A follow-up visit may be necessary to confirm that your gums and teeth are getting healthier and there is no pocket depth. We usually recommend coming back for another procedure if the pockets don't shrink.
In fact, you'll likely be placed on a periodontal maintenance cleaning schedule, returning for regular clean-ups every three to four months versus the standard clean-ups every six months .
The purpose is to remove the dental plaque and calculus on the root surface inside periodontal pocket in order to get rid of the bacteria that cause gum disease. It helps to reduce inflammation and allows the gum diseases to be recovered. If needed, our gum specialist may perform periodontal surgery that flips the gum, exposing the root surface. The gum specialist can then clean the root surface with direct vision.
Teeth scaling and root planing do tend to make the gums swollen and tender. Regular scaling procedure avoids future build-up of bacteria filled plaque under the gum line, which helps in averting dental complications. Side effect can also raise teeth's sensitivity to cold and hot food. Inadequate scaling exposes roots after the gums begin to shrink, resulting in bleeding of the gums.
Our Gum specialist will schedule another visit to see how your gums have healed and measure the depth of your pockets. If they have beccome deeper, more treatment may be needed.
Periodontal disease is not just about your oral health, but your overall health as well. The bacteria in your mouth are passed on through your body constantly all day. There is a direct connection between periodontal disease and your systemic health. Periodontal disease increases risk of heart attack by 25%, strokes by a factor of 10 and makes it harder to control diabetes.