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Cleaning and Prevention

Dentistry is founded on the principle of prevention. All patients are recommended biannual cleanings and examinations. Not only do they help you quash dental problems before they arise, but they also leave your gums healthier, and your teeth cleaner and whiter. A professional cleaning removes hard plaque that cannot be removed by brushing and flossing alone. It also involves a fluoride treatment and polish to help protect and soothe your teeth and gums. Even if you haven’t had a cleaning in over two years, it’s never too late to treat your teeth.


What are some preventative measures I can take?

  • Brush with a fluoride toothpaste

  • Use a soft-bristled toothbrush after each meal

  • Floss daily before bedtime

  • Use an oral rinse after flossing

  • Avoid sugary foods, coffee, and tobacco


Dental Exam

What is involved?

At your initial visit, a complete dental exam will be performed that includes the following:

  1. Diagnostic X-rays - used for the detection of dental cavities and the positions of teeth and roots.  X-rays are also used for identifying oral pathology, including cysts and tumors, and correlating systemic diseases/syndromes.  Early detection is critical.
  2. Diagnosis of Gum Disease - gums and underlying bone levels around teeth will be checked to determine the presence of gingivitis and/or periodontitis.  Early detection is critical.
  3. Screening for Oral Cancer - lips, neck, face, lymph nodes, tongue, throat, floor of mouth, bone and gums will be checked for signs of oral cancer to promote early detection.
  4. Status of Teeth & Existing Restorations - tooth surfaces will be checked for decay as well as the current fillings and crowns.
  5. Treatment Plan - all information obtained during the exams will be used to form a personalized plan for dental treatment with emphasis on the patient's decision making. 

Teeth Cleaning (Prophylaxis)

At this appointment, the teeth will be thoroughly cleaned to prevent the progression of gum disease (periodontitis & gingivitis) and polished to help remove  visible stains.  Periodontal disease, including periodontitis & gingivitis, occur when bacteria and plaque accumulate above and beneath the gums (gingival tissue).  Inflammation and irritation caused by the presence of these bacterial colonies can lead to a chronic inflammatory response that affects other parts of the body (a number of studies have shown a link between periodontitis and coronary heart disease).   Due to the inflammation, the body's immune response begins to destroy the bone that surrounds the teeth and eventually cause teeth to shift, become loose, or even fall out.  Periodontitis is a serious condition whose effects are preventable if addressed early. 

What is involved in a dental cleaning?

The prophylaxis appointment consists of the following steps:

  1. Evaluation of periodontal status to see current status of gum disease or compare previous results to see if prophylaxis appointments have improved the status from gum disease to gingival health
  2. Supra-gingival (Above gum line) removal of plaque and calculus with scaling instruments
  3. Sub-gingival (Beneath gum line) removal of calculus under the gums that contributes to periodontal disease
  4. Root Planing - we will smooth exposed or diseased tooth root surfaces to eliminate harmful bacteria
  5. Flossing - we will floss the teeth following plaque/tartar removal and teach you the proper technique as well 
  6. Polishing to Remove Stains - we will polish tooth surfaces to remove external stains from coffee, tobacco, tea etc.
  7. Education on how to properly Brush & Floss - we will recommend techniques for an effective home care regimen for you and your family

What are the benefits of a prophylaxis?

  • Early identification of Disease - By examining the entire oral cavity, the dentist can observe the initiation of many health problems in the oral cavity and possibly help identify medical issues such as bacterial/viral infections, diabetes, kidney disease and many more oral or systemic diseases!
  • Improve oral hygiene - Tartar and plaque removal is important to prevent serious periodontal disease.  An experienced dentist or hygienist with knowledge of dental anatomy and specialized equipment is able to deliver comprehensive tartar and plaque removal above and below the gums that can become impossible to remove with only brushing and flossing!

  • Improve appearance of teeth - removing stains can restore one's smile and confidence!

  • Fresh Breath  removing plaque/tartar/food debris can significantly improve breath as halitosis (bad breath) is often present in a patient with periodontal disease.  Your provider can also show you ways to clean your tongue to prevent bad breath!

Fluoride

The benefits of fluoride have been known for more than 50 years and it is still the most effective mineral agent against dental cavities.  

How does it work?

  1. Fluoride strengthens the enamel layer, making it more resistant to dissolution in an acidic environment (pH less than 5.5) - ex. after eating a meal.  Fluoride can be found in toothpaste, mouth rinses and gels.  It is recommended for children to have a professional application of fluoride twice per year at their check up appointments.  
  2. Fluoride that enters the body systemically through food and water supplies strengthens enamel of erupted and non-erupted teeth.     

It is important to monitor the amounts of fluoride a child ingests since too much consumption can lead to white spots being formed on the teeth, a condition known as fluorosis.  Though most people receive adequate fluoride from their water supply, it may be recommended by your dentist to receive additional amounts if needed due to the following reasons:

  1. Recent History of dental decay
  2. Impaired salivary flow due to medical conditions or medications
  3. Diet high in sugar and carbohydrates
  4. Improvement needed in oral hygiene and home care
  5. Sensitivity from exposed root surfaces
  6. Deep grooves (pits & fissures) on chewing surfaces prone to decay

Digital X-rays

Digital X-rays are the latest in dental radiography that use a sensor that can electronically transmit an image of your teeth to a computer screen in seconds.  The image can be enlarged to help the dentist diagnose dental problems faster than ever.  Most importantly, digital x-rays use approx. 10% of the radiation exposure needed for traditional methods (which was already a low exposure).  Detection and prevention of dental problems is essential for maintaining oral and general health.  Early detection can save teeth, money, time and stress. 

Dental x-rays are used for identification and prevention of the following dental issues:

  1. Dental infections (Abscess/cyst)
  2. Cavities (decay)
  3. Bone loss (periodontal disease)
  4. Malignant & Benign Tumors of oral tissue
  5.  Developmental abnormalities
  6. Impacted teeth
  7. Congenitally missing teeth
  8. Space for implants/Success of Implants
  9. Oral pathology of bone/connective tissue

Panoramic x-rays are images of the entire mouth and teeth.  The image is taken by wrapping around the outside of the face and can show a number of dental related issues, including wisdom teeth in relation to the mandibular nerve or maxillary sinus and identifying oral pathology.  Panoramic x-rays are only requested when they are needed.

Panoramic x-rays are used for identification and prevention of the following issues:

  1. Full mouth evaluation of teeth
  2. Full mouth evaluation of bone loss
  3. Evaluation of TMJ 
  4. Jawbone fractures
  5. Impacted teeth proximity to vital structures
  6. Oral pathology of bone/connective tissue

Bad Breath (Halitosis)

There are varying degrees of bad breath.   A smaller percentage of bad breath may be related to issues in the stomach; however, most often bad breath is caused by bacteria in the mouth that exists on the surface of the tongue, under the gums and on hard to clean surfaces of teeth.  Volatile sulfur compounds generated by these bacteria have an unpleasant odor.  A first step in combating halitosis is to implement strict oral hygiene measures that includes proper brushing, flossing, rinsing, and tongue brushing along with regular dental visits.    

Sealants can be light-cured.

Sealants

How do dentists prevent the deep grooves (called pits & fissures) on chewing surfaces of teeth from accumulating plaque and food debris to prevent the initiation of cavities?  The answer is a thin, tooth-colored material called a sealant that fills the grooves of the enamel, creating a smooth surface that is easily cleansable and effectively prevents cavities from forming in high-risk areas.  Sealants can be especially useful in children who have their permanent molars and are prone to decay.  Sealants can last for many years but should be checked regularly for wear.  

How are sealants placed?

The tooth is cleaned, isolated and kept dry.  A flowable resin material is painted on the grooves and bonded to the tooth surface.  The process takes a few minutes.  Proper brushing & flossing, a balanced diet and regular checkups will help with the success of sealants.