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Frequently Asked Questions

Periodontal Disease/Treatment

Periodontal Disease is an infection and inflammation that affects the tissues and bone that support your teeth. It’s also called gum disease.

Warning Signs of Gum Disease

• gums that bleed when you brush or floss
• gums that are red, swollen, puffy or tender
• gums that no longer tightly hug your teeth
• bad breath that doesn’t go away
• pus between your teeth and gums
• feeling that your teeth are loose

Plaque is a sticky film that is always on your teeth. Plaque that is not removed between the teeth and on the gum line can cause the gums to become red, puffy and swollen, which causes them to pull away from your teeth. Spaces called pockets start to form between your gums and teeth. These pockets give bacteria a place to collect and grow. As the bacteria stays in the pockets, your gum disease will get worse, eventually causing the gum tissues and bone around your teeth to break down. A professional cleaning will not be enough if your gum disease is severe. Usually a deep cleaning called scaling and root planning is needed.

Scaling: Your hygienist removes plaque and tartar down to the bottom of each periodontal pocket.

Root Planing: Then, the root surfaces of your teeth are smoothed, or “planed”, to allow the gum tissue to heal and reattach to the teeth.

Dr. Patel or your hygienist may recommend certain medicines to help control infection and discomfort or to aid healing. You may be given a mouth rise or they may place medication directly into the pockets after the treatment.

Once your treatment is completed, you will need more frequent dental visits than people without gum disease. The periodic cleanings are called Periodontal Maintenance Care. The purpose of these cleanings is to help you keep your gums healthy and make sure that gum disease does not get worse. With periodic maintenance, the amount of plaque bacteria is lowered. Then, the inflammation can get better, pockets can shrink and your gums can become healthier.

With the help of your dental team, you don’t have to lose your teeth to gum disease! Periodontal maintenance is most effective if you and your dental team work together. Remember, you must do your part and take good care of your teeth and gums at home every day.

Periodontal vs Prophylaxis

Regular Cleaning vs Periodontal Maintenance

Patients often ask why they are having “periodontal maintenance” when all they want is to have their teeth cleaned. If your dentist or hygienist has recommended that you be scheduled for periodontal maintenance, or if you have noticed that there is a difference in billing for these procedures, here is a brief explanation:

Prophylaxis, or Regular Cleaning

A regular cleaning is recommended for patients who do not have bone loss, periodontal disease, or infection around the teeth. There should be no bleeding, mobility of the teeth, receded areas, or gaps where the spaces around the roots of the teeth are exposed. In other words, the mouth should be healthy with no bone or gum problems. A regular cleaning, or prophylaxis, removes soft plaque, tartar, and stains from the teeth above the gum line, and only slightly below. A regular cleaning is usually done 2 times a year, depending on how quickly stain, plaque, and tartar accumulate. It is considered a preventive procedure by your insurance carrier, since regular cleanings will help prevent periodontal disease.

Periodontal Maintenance

If you have periodontal disease that has resulted in bone loss, gum “pockets” deeper than 4 millimeters, bleeding gums, exposed root surfaces, or if you have had periodontal surgery or root planning to treat periodontal disease, a regular cleaning is not appropriate. Periodontal maintenance scaling is needed to maintain gum and bone health. This procedure includes removal of plaque and tartar from above and below the gum line, all the way down the length of each tooth to where the root, gum, and bone meet. Rough areas of the roots are smoothed if needed, pocket depths are carefully monitored, and inflamed pockets may be irrigated with antibacterial medicines if necessary.

Periodontal maintenance is considered a basic service by your insurance carrier, and may be subject to a yearly deductible. PM is usually performed 3 to 4 times a year, depending on several factors: how quickly the plaque and tartar accumulate, how much bleeding or inflammation is present, how stable the present condition is, how well you are able to maintain your teeth at home on a daily basis, and any health risk factors you may have.

We know that there is a relationship between chronic inflammation in the gums and overall health, especially heart disease and diabetes. Keeping the gums and the bone surrounding your teeth as healthy as possible is an important part of your regular dental visits and hygiene. If you would like to learn more about regular and periodontal cleanings or want to schedule an appointment with our practice please contact our office.