|Prophy (Regular Cleanings)
A prophy includes a series of procedures where plaque, calculus, and stain are removed from all surfaces of the teeth above the gumline. This is done with hand instruments, ultrasonic scalers, and coronal polishing. Only a licensed dental professional is qualified to determine the need for oral prophylaxis. Only a dentist, dental hygienist, and trained dental assistant can perform the procedure.
A periodontal maintenance procedure (PMP) is defined as a procedure that is recommended following periodontal treatment (such as scaling and root planing) and continues at varying intervals, determined by the clinical evaluation of the dentist.
These intervals can be as frequent as every two months and they can be extended as long as six months, depending on the patient. Keeping up you're your PMP interval is important because periodontal disease can recur without adequate follow up.
PMP includes removal of plaque and tartar above and below the gums, scaling and root planing of specific areas, and polishing. PMP is always completed following active periodontal treatment such as scaling and root planing or more extensive gum surgery.
Scaling and Root Planing
Scaling and Root Planing is a special type of treatment that goes deeper BELOW the gum line to remove contaminated debris and bacteria, most often performed on patients with active periodontitis.
This seems to be a procedure that causes so much confusion for patients in trying to understand the difference between "just a cleaning" and Scaling and Root Planing, and the need/reason for this procedure.
Scaling and Root Planing is done to remove soft sticky plaque and hard crusty calculus that is loaded with bacteria, around and BELOW the gum line on root surfaces. A professional polishing or prophy removes only the soft sticky plaque and hard crusty calculus that is ABOVE the gum line on the crown of the tooth. It is a method of treating gum disease when pockets formed around the teeth have a measurement of greater than 3mm and there is evidence of bleeding and tissue attachment loss.
Scaling is a procedure that meticulously removes contaminated biofilm, plaque, calculus, micro-organisms, and toxins from around the gum line down to the bottom of each periodontal pocket in order to obtain a healing response.
2. Root Planing
Root planing involves smoothing the root surfaces of your teeth with thin instruments so gum tissue can more firmly reattach to roots that are clean and smooth to prevent tooth loss and sensitivity problems. This procedure makes it more difficult for plaque, calculus, and bacteria to accumulate along these root surfaces.
Because this procedure goes deeper than a regular cleaning, your mouth may be numbed. The cleaning may take one to six visits to complete. Depending on the extent of the disease, you may need one or more quadrants of the mouth to be treated with scaling and root planing.
Some Reasons Why Root Planning May Be Necessary
• To control the growth of harmful bacteria. (bacteria ABOVE the gum line are less aggressive bacteria whereas the bacteria BELOW the gum are more DESTRUCTIVE and DANGEROUS!
• Helps pocket wall reattach firmly to the clean root surface to create a pocket depth that can be better maintained by patient
• Prevent further bleeding of the gums from disease
• Reduces inflammation
• Reduces discomfort
• Prevent bone loss
• Prevent gum disease related tooth loss
• Reduce systemic disease
Home Care after Root Planing and Scaling
1. Rinse with warm salt water every few hours (1/2 tsp. salt in 8oz water) for the remainder of the day to encourage healing and sooth discomfort.
2. Be careful not to bite or chew your lip, cheek or tongue while they are numb. Avoid chewing for 2 hours after this procedure or until numbness has worn off.
3. Keep your fingers and tongue away from the areas that have been treated.
4. Take Tylenol or ibuprofen according to directions on the manufacturer label for a couple of days to help with the discomfort; do NOT take Aspirin because it may prolong bleeding.
5. Rinse your mouth with Closys or Chlorohexidine, if prescribed by dentist, to reduce oral bacteria.
6. Do not smoke or chew tobacco for 72 hours after the procedure to allow for healing.
7. Gently brush and floss your teeth after each meal.
How you care for your teeth and gums at home after treatment is critical to reduce the risk of recurring periodontal disease.
|Dentistry Then and Now
|It's amazing to see how far dentistry has come through the centuries! Consider the following:
Around 4000 BC, a Sumerian text described "tooth worms" as the cause of dental decay.
Around 200 AD, the Etruscans developed dental prosthetics including gold crowns and bridgework.
In the Middle Ages, dentistry was practiced by monks until a series of Papal edicts prohibited them from doing so. Barbers, with useful tools such as knives and razors at their disposal, took over.
In 1770, Paul Revere advertised his services as a dentist.
In 1790, John Greenwood adapted his mother's foot treadle spinning wheel to rotate as a drill.
In the 1880s, the development of the collapsible metal tube revolutionized toothpaste manufacturing.
In 1911, the U.S. Army Dental Corps was established.
In 1997, the Food and Drug Administration approved the erbium YAG laser for treating tooth decay.
I don't know about you, but thank goodness barbers aren't still in charge of dentistry! I wonder how this list will look in the next 100 years..... Dental robots? (hopefully not!)