Common Preventive/Diagnostic Procedures
Routine dental visits are recommended for ALL individuals, as soon as teeth begin to erupt for babies until our final breath. The doctor will evaluate the health of the entire oral cavity: teeth, gums, tongue, cheek, soft tissues. Dental checkups are important not only for dental health but also for overall general health.
Prophylaxis by definition is an action taken to prevent a disease. In the dental world, this means a teeth cleaning. While excellent home care is very important to maintain good oral health, residual plaque will harden into tartar/calculus that is too tenacious for a toothbrush to remove. A professional teeth cleaning utilizes specialized dental hygiene instruments that will remove plaque and tartar buildup, as well as the harmful bacteria harbored on the teeth and gums. The frequency of teeth cleanings varies from individual to individual, depending upon personal oral health, home care, and level of buildup. Most patients do well with the typical 6-month recall. Some are recommended to come in more frequently due to their specific case, perhaps a 3- or 4-month recall. And some maintain with yearly recalls.
Routine cleanings are recommended for ALL individuals (Except, of course, full denture patients. In that case, routine exams are recommended.). Once a child has been exposed to the dental office and comfortable behavior is observed, routine cleanings will be recommended. Cleanings can begin any time once a child exhibits calm, cooperative behavior. For some, this can be as young as 3 years old! Cleanings are also very important for the elderly. Advanced age can make proper oral care more difficult and many medications have dry mouth as a side effect. These combined circumstances make it vital for elderly patients to continue with regular cleanings and checkups, as their health allows.
Fluoride is a natural mineral that is one of the strongest fighters agains cavities. When fluoride connects with the teeth, it is absorbed in the enamel of the tooth, hardening the tooth against demineralization. Fluoride helps remineralize the enamel by replenishing lost calcium and phosphorous. This strengthens the teeth, preventing softening (and subsequent cavities) during the next demineralization phase that occurs (demineralization can be as common as the increased level of acid in saliva after eating or demineralization can be exacerbated by excessive acid intake from certain foods and soda pop).
An x-ray, or radiograph, is a focused beam of x-ray particles sent through bone, producing an image of the structure through which the x-ray particles passed. This gives the familiar black and white image seen with x-rays. X-rays are a necessary and vital part of the diagnostic process. It allows the doctors to see what the visual, clinical observation cannot. Not utilizing x-rays could lead to undiagnosed problems. Without using an x-ray of the whole tooth including the root structure, supporting bone, and gum tissues, the doctor is severely limited in his selection of effective diagnostic tools to detect the source of an infection or a toothache caused by a hairline fracture. State-of-the-art digital technology allows the Drs. Fisher to utilize digital x-rays as a safe, thorough, and reliable tool to detect and diagnose dental diseases. Digital radiography scatters 50-70% less radiation than traditional x-rays. Coupled with computer monitoring, digital x-ray technology allows us to enhance each image for ideal clarity and superior images for better diagnosis of any dental concerns.
Common Operative Procedures
Fillings are done to repair a fractured tooth surface or to remove decay and replace the affected tooth structure. It is called a filling because a new material fills the hole that remains after the decay has been cleaned out. Treated early enough, cavities can simply and easily be restored at a small, early stage. If not treated, decay can lead to tooth pain, infection, and possible irreversible damage necessitating root canal treatment or extraction.
Sealants (pit and fissure sealants) are used to fill in very narrow grooves in a tooth that cannot be adequately cleaned by brushing. The groovy tooth structure has fine grooves and/or pits that accumulate plaque, not because the patient doesn’t brush, but because the grooves are too narrow to allow even one toothbrush bristle into them. The accumulated, unaccessible plaque will develop cavities over time. Sealants are a preventive measure to keep teeth healthy and solid. The dentist or hygienist will apply a tooth-colored coating that seals all the mini grooves and pits in the tooth, making it possible to brush off all plaque on all tooth surfaces with a toothbrush, keeping your teeth strong and healthy.
Bonding involves adhering composite tooth-colored resin material to the front and/or sides of the tooth. This is done to close gaps between teeth, to achieve desired cosmetic aesthetics desired by the patient, to alter the alignment of a tooth, or to repair tooth structure damaged by decay. First, the surface of the tooth is roughened in order to accept the bonding and hold the bonding material. A gel is applied to micro-etch the tooth surface and a primer/bond agent is applied so the material adheres to the tooth surface. Then the bonding material itself is place on the tooth and hardened with an intense ultraviolet light. The composite resin material is then shaped and polished to achieve a lustrous finished tooth.
PERIODONTAL ROOT PLANING AND SCALING - PERIODONTAL MAINTENANCE TEETH CLEANINGS
The gums, ligaments, and bone around the teeth form the solid foundation for every tooth in the mouth. These structures are called the periodontium. When these structures are not healthy, it jeopardizes the stability of the teeth just as a broken foundation would threaten the stability of a house. Signs of unhealthy periodontium (gum disease) include the following: gums that are red, swollen, and bleed easily; persistent bad breath; gums that are pulled away (receded) from the tooth exposing the soft, sensitive root of the tooth, mobile (loose) teeth, and changes in the position or bite of the teeth due to mobility. Any of these signs may mean something is wrong. However, with the proper treatment and care, it can be possible to return the periodontium to a healthy state. If you are having any of these signs or symptoms of gum disease, please make an appointment for an examination and consultation for appropriate gum treatment. Once the signs of gums disease appear, the first step is usually completing deep cleaning and root planing and scaling of the teeth and tooth roots to remove the hardened buildup of calculus and tartar perpetuating and worsening the gum disease. If gum disease is left untreated, infection, bone loss, and loss of teeth will occur. But if gum disease is properly treated and maintained through regular dental visits and excellent home care, the patient can see improved oral health and retain solid, stable teeth for years to come.
In the dental world, there are two different classifications of cleanings:1) a typical, routine prophylaxis cleaning or 2) a periodontal maintenance cleaning (after root planing and scaling is completed). A typical, routine prophylaxis cleaning is a cleaning where the patient has strong oral health, faithfully commits to dental appointments, biologically builds up minimal calculus/tartar, and has minimal gum recession. A periodontal maintenance cleaning is a cleaning where the patient’s history of dental care has resulted in the need for deep-cleaning root planing and scaling, then followed by more frequent recall visits to maintain (with the goal of improving) periodontal levels.
Why is there a difference in defining a cleaning? Simply put, a prophylaxis is an easy clean for the hygienist and periodontal maintenance is harder. Clinically, a patient who requires a periodontal maintenance cleaning builds up tooth calculus/tartar at a higher rate than the average patient. Gum health has been negatively impacted for enough time that the condition of the teeth and gums deteriorates due to the level of tartar buildup, gum pocketing and recession (the pulling away of the gums from the tooth root), and bone loss. These cleanings are no longer considered a routine prophylaxis. They are classified as periodontal maintenance (after the initial deep clean of root planing and scaling). Hygienists use specialized tools to complete a periodontal maintenance cleaning to thoroughly clean the tooth surface and gum pockets, removing the build-up and bacteria. The cleaning is more involved with a higher level of difficulty. Thus, periodontal maintenance is classified in a different category than routine prophylaxis cleanings and does have a higher fee associated with it.
A periodontal patient is recommended to maintain a 3- to 4-month recall to monitor and maintain periodontal health. A periodontal patient who commits to routine recalls and good home care can see great improvement in new bone growth and reducing gum pocketing, leading to good prognosis for keeping teeth for many more years into the future.
If, after several visits the patient is consistently maintaining excellently and would like to try a 6-month recall (2 visits per year), we can try the longer recall and see if the levels of build-up and gum recession hold. If the levels hold to the doctor’s satisfaction, we can maintain 6-month recalls. But if after trying 6-month recall the levels do not maintain, a 3-month or 4-month recall will again be recommended for a periodontal patient.