Q: What is Periodontal Disease?
A: Periodontal (gum) disease is the major cause of tooth loss in adults. It affects 75% of the adult population over the age of 35. More than 50% of the adults over age 18 already have periodontal disease in its early stages. This inflammatory disease causes swelling and redness, and attacks the gums, bone, and other supporting structures of the teeth. Periodontal disease is chronic, meaning that left untreated it can persist and worsen over time.
Recent studies are showing a relationship between gum and bone health and certain heart conditions and other systemic diseases.
Q: What is the difference between Gingivitis and Periodontitis?
A: Gingivitis is the earliest form of periodontal disease. It occurs when plaque (a sticky film of bacteria and other substances) accumulates on the teeth near the gums. The gums become inflamed, causing redness and swelling around the teeth. As the disease progresses, the gums tend to bleed easily. If detected and treated at this stage, the gingival tissues will return to normal.
If left untreated, gingivitis becomes peiodontitis. As the plaque hardens into calculus, it extends from the gumline down onto the root. The gums gradually detach from the tooth and forms a pocket. These pockets create room for more bacterial activity and accumulation. As the disease worsens, the bone supporting the tooth is destroyed, resulting in bone loss.
Q: What is a regular cleaning or prophylaxis?
A: The American Dental Association labels a prophylaxis as a scaling and polishing procedures to remove coronal plaque, calculus, and stains. This type of cleaning is recommended for persons who do not have any periodontal disease, bone loss, or infection around their teeth. There also should not be bleeding, mobile teeth, or recession of the gums where it has pulled away from the teeth and exposed the root surface.
Q: What is a deep cleaning or a scaling-root planing procedure?
A: A deep cleaning removes bacteria, tarter, and diseased deposits from under the gums. This type of meticulous and therapeutic cleaning is one of the first steps to treating gum and bone disease (periodontal disease). Scaling is required the full length of the root surface, down to where the root, gum and bone meet. Periodontal treatment promotes healing of the gum tissue and its reattachment to the teeth.
Q: What is a Periodontal Maintenance?
A: If you have periodontal disease, you may require root planing to removed diseased deposits from the roots of your teeth. Other treatment, including surgery, may be required. After the disease process is under control, a regular cleaning is no longer appropriate. Instead, you will require special on-going gum and bone care procedures known as periodontal maintenance to keep your mouth healthy. Typically, an interval of 3-4 months between appointments is effective for maintaining periodontal health. Intervals longer than this between each maintenance appointment would allow for toxins to accumulate and irreversible bone loss and damage to occur.
Q: My insurance plan only pays for Periodontal Maintenance twice a year, why should I have it done more often?
A: Most benefit plans are only designed to cover a portion of the total cost of a person’s necessary dental treatment. Insurance typically pays a minimum regardless of what you might need as an individual. It is a mistake to let benefits be your sole consideration when you make decisions regarding your health. People who have lost their teeth often say they would pay any amount of money to get them back. Your teeth, smile, attractiveness, ability to chew and enjoy food, and general sense of well being are dependent on your dental health. It is worth the extra time and expense to keep your teeth for a lifetime.
Q: Which type of toothbrush should I use?
A: The brand of the toothbrush is not as critical as the type of bristle and the size of the head. A soft toothbrush with a small head is recommended because medium and hard brushes tend to cause irritation and contribute to recession of the gums, and a small head allows you to get around each tooth more completely and is less likely to injure your gums.
Q: Is one toothpaste better than others?
A: Generally, no. However, it’s advisable to use a fluoride containing toothpaste to decrease the incidence of dental decay. For patients with sensitive teeth, we recommend patients use a toothpaste that contains the soothing effects of potassium nitrate.
Q: How often should I floss?
A: Flossing of the teeth once per day helps to prevent cavities from forming between the teeth where your toothbrush can’t reach. Flossing also helps to keep your gums healthy.
Q: What’s the difference between a “crown” and a “cap”?
A: These are restorations to repair a severely broken tooth by covering all or most of the tooth after removing old fillings, fractured tooth structure, and all decay. The restoration material is made of gold, porcelain, composites, or even stainless steel. Dentists refer to all of these restorations as “crowns”. However, patients often refer to the tooth-colored ones as “caps” and the gold or stainless steel ones as “crowns”.
Q: What’s the difference between a “bridge” and a “partial denture”?
A: Both bridges and partial dentures replace missing teeth. A bridge is permanently attached to abutment teeth or, in some cases, implants. A partial denture is attached by clasps to the teeth and is easily removed by the patient. Patients are usually more satisfied with bridges than with partial dentures.
Q: What about “silver” fillings versus “white” fillings?
A: Although the U.S. Public Health Service issued a report in 1993 stating there is no health reason not to use amalgam (silver fillings), more patients today are requesting “white” or tooth-colored composite fillings. We also prefer tooth-colored fillings because they “bond” to the tooth structure and therefore help strengthen a tooth weakened by decay. While fillings are also usually less sensitive to temperature, and they also look better. However, “white” fillings cannot be used in every situation, and if a tooth is very badly broken-down, a crown will usually be necessary and provide better overall satisfaction for the patient.
Q: Do I need to have a root canal just because I have to have a crown?
A: No. While most teeth which have had root canal treatments do need crowns to strengthen the teeth and to return the teeth to normal form and function, not every tooth needing a crown also needs to have a root canal.