Regular “check-up” appointments are an important part of how we administer preventative care. While you are settling in for your appointment and we are catching up, we are also taking a look to see if you are just as healthy as when we saw you last. To prevent oral diseases such as decay, periodontitis and oral cancer, our hygienists are listening for changes in your homecare, dietary habits and lifestyle choices.
The dental hygiene appointment includes a process of assessment, diagnosis, planning, and implementation of treatment. Oral “health care” involves frequent evaluation of the teeth and their supporting structures (the periodontium). Taking regular radiographic images and completing periodontal chartings are the foundations of this process, and this systematic collection of data allows our dental team to appropriately care for the needs of each patient. Essentially, we are striving to find the balance of care. We do not want to over-treat or under treat.
Diagnostic digital imaging (taking x-rays) is essential to the care of the teeth and the surrounding bone. Most people think that x-rays are just to diagnose cavities. Although this is true, x-rays are also fundamental in determining the health of the roots of the teeth and surrounding bone support. Periodontal disease is an infection that creates bone loss around the roots of the teeth and is visible on these images. Our team collects bitewing images (cavity checking x-rays) every 12-18 months and a full series of images that includes the roots and surrounding bone of all of the teeth every 3-5 years. Keeping consistent records provides accurate means for evaluating changes. Digital x-rays are taken using the computer and a sensor. The images are instant, clear, and easy to read, all with just a fraction of the radiation exposure used to take regular x-rays.
In addition to digital images, our team will complete a periodontal probing and charting. By recording specific measurements around each tooth, a more complete picture of the topography of the mouth is formed. Careful evaluation of the supporting tissues and noting areas of inflammation (bleeding) help us classify each person’s health.
New Patient Appointments: What to Expect
What are Digital X-Rays?
Digital radiography capture dental images through a sensor that processes the image onto a computer screen. Digital X-rays provide greater comfort than traditional X-rays and reduce radiation exposure (four digital radiographs equal one “film” X-ray). Additionally, digital radiographs allow dentists to magnify images for greater diagnostic accuracy, ensuring more timely and appropriate treatments. Radiographs are an important part of diagnosing cavities but are also important when evaluating bone support, impacted wisdom teeth, bone abnormalities, and gum disease. Our office has a conservative approach to taking X-rays, known as “As Low As Reasonably Achievable” (ALARA), meaning simply, we take as few as possible with the lowest possible amount of radiation exposure to meet your treatment needs.
What is the difference between a “Prophy” and a “Periodontal Maintenance”?
A “prophy” (prophylactic appointment) is by definition to prevent the onset of dental disease and is administered strictly to healthy individuals. There are the “regular check-ups” that include looking for cavities, evaluating gum and bone health and learning new ways to prevent disease at home on you own. This type of cleaning includes scaling and polishing the teeth to remove plaque, tartar and stains. The typical prophy patient comes in every six months, exhibits excellent homecare, and has healthy gum tissues that do not bleed.
“Periodontal Maintenance” appointments follow active non-surgical periodontal therapy procedures to treat periodontal disease. In this case, the objective is to ward off the bacteria living below the gum line that can initiate more bone loss. Periodontal disease is by nature an episodic disease that occurs in bursts of activity. Destructive episodes can occur without any sign or symptoms triggered by stress, disease, dry mouth, or other systemic problems. It is for this reason we are ever-vigilant in monitoring for signs of active disease long after the disease has been stabilized.
What is Scaling and Root Planing?
Scaling and Root Planing is for patients who are diagnosed with periodontal disease. It is a careful cleaning of the root surfaces to remove plaque and calculus (tarter) from deep periodontal pockets (where bone and tissue has been lost) to remove bacterial toxins. The teeth to be scaled are numbed with local anesthetic for maximum comfort. This allows the hygienist to thoroughly remove tartar from root surfaces. Scaling and root planing is sometimes followed by adjunctive therapy such as local delivery of antimicrobials or systemic antibiotics, as needed on a case-by-case basis. It is considered non-surgical periodontal treatment to stop bone loss caused by periodontal disease. However, the majority of patients will require ongoing periodontal maintenance therapy to sustain health.
Oral Cancer Screenings: Who, what, when, where and why?
We screen all of our patients for oral cancer. Of all cancer types, the incidence of oral cancer has continued to rise. The mortality rate has not changed significantly in three decades. It is higher than the rates for cervical cancer, Hodgkin’s lymphoma, laryngeal cancer, testicular cancer, thyroid cancer and skin cancer. Oral cancer has historically been discovered when it has reached a later stage and is much more difficult to treat. As with all of these cancers, the sooner you treat it the better your odds.
Part of our screening includes the use of fluorescence technology, OralID. This is the use of a blue light that allows us to identify oral cancer, pre-cancer and other abnormal lesions at an earlier stage. This same simple technology is used in medical evaluations for the GI tract, cervix, lung, skin as well as in oral mucosa.
When do we use the CariVu? How does it work?
We use the CariVu as an adjunct to dental X-rays. The CariVu camera is an easy diagnostic device to detect cavities, lesions and cracks. The CariVu camera hugs each tooth one by one and shines a safe near infrared light into it using transillumination and no radiation. This makes the enamel transparent while porous lesions (cavities) trap and absorb the light (essentially creating a shadow where there is decay). This is especially helpful if a suspicious area is noted on an X-ray between the teeth. The CariVu can help determine if immediate treatment is necessary or not. Although this technology is of great value in diagnosing early decay between the teeth, it will not detect cavities under crowns and large metal fillings the way digital imaging can.
What are sealants?
A sealant is a thin plastic coating applied to the chewing surface of a permanent tooth that is able to prevent a cavity. Most decay in young people starts in these grooves. Sealants basically seal out the food particles and bacteria that cause decay. Sealants are placed on permanent first and second molars as soon after eruption as possible, before decay has a chance to start. The first molars erupt at around age 6, and the second set usually appear at around age 12.
Placing sealants is an easy process that does not require drilling or anesthesia. Sealants are replaced on clean, dry grooves and hardened with a curing light. They are smooth and very thin, only filling the grooves. A sealant can last up to 10 years or more, but should be checked regularly and repaired or replaced, if necessary.
Sealants are a part of an overall preventative plan. They are not a replacement for brushing, flossing, fluoride, and careful dietary choices. Decay damages teeth permanently. Sealants protect them. Placing sealants can help save time, money and the discomfort associated with dental fillings.
What are nightguards and what do they do?
Nightguards, or occlusal guards, are dental appliances that are used to provide relief from bruxism (grinding or clenching) and/or TMJ/TMD (Temporomandibular Joint Dysfunction). They are also used as a protective device for the mouth to prevent injury in contact sports. Depending on the intended use, they are most often made of heat-cured acrylic resin, a hard, clear plastic material or a heat-contoured laminate material.