dental-patientThe most important moment in a dental relationship is when the patient meets the doctor for the first time.  The new patient shares with Dr. Graber the reason why they made their appointment and if they have a chief complaint such as “I am in pain,” When a patient presents in pain our office will focus on eliminating the pain before Dr. Graber proceeds any further.  After thoroughly reviewing a new patient medical history, an initial clinical exam and a full mouth series of radiographs are completed.  both the exam and radiographs reveal either oral health or oral disease.

Some new patients haven’t seen a dentist for many years.  Today, we are treating a patient who hadn’t had a scaling in over three years.  Huge deposits of calculus are seen on the radiographs and the tartar exists above and below the gums.  Plaque buildup is the primary cause of gum disease and caries.  If plaque isn’t  removed by brushing and flossing it hardens.  The hard plaque, known as tartar, contains bacteria that can irritate the gums and break down the fibers that hold the gums tightly to the teeth.  This space between the tooth and the gums fill with bacteria creating a  periodontal pocket.

This can lead to severe infection, pain, swelling, and inflammation which causes spontaneous and abundant bleeding on scaling.  the patients full mouth series of radiographs indicate some bone loss that can help loosen multiple teeth which might require extraction.

At this point, an experienced dentist realizes that this patient has a periodontal problem and there has to be an honest discussion about the patients gums and supporting tissue.  Periodontal disease often causes no symptoms during its early stages such as gingivitis.  Gingivitis is the only stage of gum disease that is reversible because there is no bone loss.  Dental studies show that 90% percent of people with halitosis (persistent bad breath), have a dental problem to blame.

Dr. Graber believes that having your teeth cleaned regularly is the most important investment that a dental patient can make.  Dental scalings can be rendered every three months, four months, or six months depending on each patient’s needs.  Poor oral hygiene can lead to a variety of dental and medical problems such as periodontal disease, infection, bone loss, heart disease and strokes.  Other factors linked to gum disease include smoking and tobacco use, pregnancy, grinding teeth (bruxism), an unhealthy diet, and diabetes.

Most Americans feel that if they don’t have “mouth pain” everything must be healthy.  Even though, many patients haven’t  seen a dentist in years they assume that their oral health is fine.  Periodontal disease is called the “silent disease”, because it doesn’t  cause pain until it is more advanced.

In many cases, the shock of being told that you are going to lose multiple teeth due to periodontal disease is overwhelming.  sometimes the patient post pones or discontinues dental treatment but  they just lose more bone and teeth.

 

Conclusion:

It is very important to visit your dentist routinely to avoid plaque buildup.  Plaque causes dental decay and gum disease.  Great oral hygiene removes most of the plaque on your teeth.  Plaque is removed  by  1. Brushing with a sonicare tooth brush, 2. flossing underneath the gum line (cleans the tooth structure in between your teeth where a toothbrush can’t), 3. rinsing out with an antimicrobial mouth wash that kills plaque.  Therefore, excellent oral health can be accomplished through good oral hygiene and having routine dental checkups and scalings with your dentist.

Review:

Periodontal disease is called the silent disease because it doesn’t cause pain until it is more advanced.  Ginvitis is associated with swollen gums that bleed spontaneously upon brushing, flossing, and scaling.

How Periodontal disease is diagnosed and treated:

Regular dental exams can detect dental problems early.  Early detection of cavities, broken fillings and gum disease are easily treatable.  If these problems go untreated root canals, gum surgery and the removal of teeth could become the only treatment options available.

Gingivitis (Stage I Periodontal Disease), can be treated non-surgically after a gross debridement, and a second scaling the patient is given an oral regimen of 1. brushing with sonicare, 2. flossing 2mm under the gumline, 3. rinsing out with an antimicrobial such as listerine or chlorohexedine.  The patient with gingivitis might be put on a four month scaling rather than a six month scaling, and have frequent periodontal  evaluations.  the primary way to check for gum damage and bone loss is to measure how deep the pockets are.  To do this a tiny ruler is gently inserted between the tooth and gums.  Deeper pockets indicate a more severe stage of gum disease.  Once a full mouth series of radiographs is developed a clinical exam is given.  Your initial exam always includes a full mouth periodontal charting.  Dr. Graber includes a full mouth periodontal charting once a year for all his adult patients.  There are six measurements around each tooth both fascially and lingually.  the periodontal probe measures from the bone to crest of the gums.  Therefore the probe follows the topography of the bone in relationship to the crest of the gums.  Normal or healthy measurements are two or three mm pockets they have an environment that they could predictably clean by brushing, flossing, and rinsing out with a antimicrobial rinse.