About Periodontal Maintenance | Oral Hygiene | Preventing Gum Disease
About Periodontal Maintenance
Maintenance or supportive periodontal therapy is an ongoing program designed to prevent periodontal disease from recurring in patients who have undergone periodontal treatment. Once you've been diagnosed with and treated for periodontal disease, Periodontal Maintenance cleanings increase your chances of keeping your natural teeth. It's your protection.
Are you aware of the basis for cleanings every 6 months? In reality, there was no scientific basis for this interval. A Madison Avenue advertising executive created the 6-month interval for routine patient visits with a toothpaste ad in the 1950's; it had Bucky Beaver advocating that. You should brush three times a day and visit your dentist two times a year! While it's not a bad idea to have semi-annual visits to ensure small problems stay that way, there are indications for more frequent visits for our periodontally involved patients.
Research has shown that the bacteria associated with periodontal breakdown proliferate very rapidly and overcome any healthy bacteria after approximately 90 days. When these virulent microorganisms overgrow, this can cause breakdown of the periodontal tissues that will lead to inflammation and infection. Therefore, waiting over the 3 months interval allows bacteria to damage the foundation for the teeth. Since it's easier and more reasonable to intercept or prevent damage than to repair it, the 3-month interval usually should be the period of time between periodontal maintenance visits.
During our maintenance visits, we start with complete periodontal charting to monitor your periodontal health and make sure infection stays under control. We use intra pocket irrigation, where appropriate, in addition to ultrasonic scalers and hand scaling to assure a thorough cleaning. Our goal is to provide a comfortable experience so we also anesthetize (numb) specific areas where needed. Most frequently, this is done with topical anesthetic that is applied to the gum tissue. In addition, we review oral hygiene instructions to will help to improve home dental care.
With the right teamwork, it is possible to keep your teeth for your lifetime.
Maintaining a good at-home oral hygiene regimen is the main way to keep your smile beautiful and healthy! Careful brushing and flossing, preferably after every meal and snack, is the best way to prevent plaque build-up, tooth decay and gum disease.
Use a toothbrush with soft bristles and a small strip of fluoride toothpaste. When you brush your teeth, move the brush in small circular motions to reach food particles that may be under your gum line. Hold the toothbrush at an angle and brush slowly and carefully, covering all areas between teeth and the surface of each tooth. It will take you several minutes to thoroughly brush your teeth. Brush up on the lower teeth, down on the upper teeth and the outside, inside and chewing surface of all of your front and back teeth. Brush your tongue and the roof of your mouth before you rinse.
Brush your teeth four times daily to avoid the accumulation of food particles and plaque:
- In the morning after breakfast
- After lunch or right after school
- After dinner
- At bedtime
As soon as the bristles start to wear down or fray, replace your toothbrush with a new one. Do not swallow any toothpaste. Rinse your mouth thoroughly with water after you finish brushing. It is important to carefully floss and brush daily for optimal oral hygiene.
For areas between the teeth that a toothbrush can’t reach, dental floss is used to remove food particles and plaque. Dental floss is a thin thread of waxed nylon that is used to reach below the gum line and clean between teeth. It is very important to floss between your teeth every day.
Pull a small length of floss from the dispenser. Wrap the ends of the floss tightly around your middle fingers. Guide the floss between all teeth to the gum line, pulling out any food particles or plaque. Unwrap clean floss from around your fingers as you go so that you have used the floss from beginning to end when you finish. Floss behind all of your back teeth.
Floss at night to make sure your teeth are clean before you go to bed. When you first begin flossing, your gums may bleed a little. If the bleeding does not go away after the first few times, let a staff member know at your next appointment.
After your brush your teeth, we recommend rinsing your mouth with water. If you aren’t able to brush after a meal, rinsing with water is the next best thing. Rinsing helps sweep away the leftover food particles and prevents the development of plaque. You may use over-the-counter mouthwashes, but we ask that you consult with us to make sure it’s the right mouthwash for you!
Preventing Gum Disease
Adults over the age of 35 lose more teeth to gum diseases than from cavities. Three out of four adults are affected at some time in their life. The best way to prevent cavities and Periodontal Diseases is by daily thorough tooth brushing and flossing techniques and regular professional examinations and cleanings. Unfortunately, even with the most diligent home dental care, people still can develop some form of periodontal disease. Once this disease starts, professional intervention is necessary to prevent its progress.
Other important factors affecting the health of your gums include:
- Tobacco usage
- Clenching and grinding teeth
- Poor nutrition
Periodontal Disease & Tobacco
You are probably familiar with the links between tobacco use and lung disease, cancer, and heart disease.
Current studies have now linked periodontal disease with tobacco usage. These cases may be even more severe than those of non-users of tobacco. There is a greater incidence of calculus formation on teeth, deeper pockets between gums and teeth as well as greater loss of the bone and fibers that hold teeth in your mouth. In addition, your chance of developing oral cancer increases with the use of smokeless tobacco.
Chemicals in tobacco such as nicotine and tar slow down healing and the predictability of success following periodontal treatment.
Problems caused by tobacco include: Lung disease, heart disease, cancer, mouth sores, gum recession, loss of bone and teeth, bad breath, tooth staining, less success with periodontal treatment,and with dental implants.
Quitting tobacco will reduce the chance of developing the above problems.
Diabetes & Oral Health
Individuals suffering from diabetes, especially uncontrolled diabetics, have a higher risk of developing bacterial infections of the mouth. These infections may impair your ability to process insulin, resulting in greater difficulty with controlling your diabetes. Periodontal diseases will be more severe than those of a non-diabetic and treatment more difficult. However, well-controlled diabetics have a lower incidence of cavities.
Steps to prevent periodontal disease include daily brushing and flossing to remove plaque from your teeth and gums, regular dental visits for professional cleaning, and regular periodontal evaluation. Your health professional must also be told of your history and the current status of your condition. And finally, you can help resist periodontal infection by maintaining control of your blood sugar levels.
Respiratory & Periodontal Disease
There is now strong evidence to suggest a relationship between respiratory disease and periodontal disease. It has been shown that infections of the mouth are associated with an increased risk of respiratory infection. Periodontal disease may increase a person's risk for Cardio-Pulmonary Disease. Patients with periodontal disease experience twice as many respiratory infections as healthy patients.
Heart & Periodontal Disease
Researchers have discovered that bacteria contributing to periodontal disease activate white blood cells producing a systemic inflammatory response that may contribute to cardio-vascular disease and stroke. One theory is that oral bacteria can affect the heart when they enter the blood stream through the periodontal pocket and attach to fatty plaques in the coronary arteries contributing to clot formation.
Women & Periodontal Health
Throughout a woman’s life, hormonal changes affect tissue throughout the body. Fluctuations in levels occur during puberty, pregnancy and menopause. At these times, the chance of periodontal disease may increase, requiring special care of your oral health.
During puberty, there is increased production of sex hormones. These higher levels increase gum sensitivity and lead to greater irritations from plaque and food particles. The gums can become swollen, turn red, and feel tender.
Similar symptoms occasionally appear several days before menstruation. There can be bleeding of the gums, bright red swelling between the teeth and gum, or sores on the inside of the cheek. The symptoms clear up once the period has started. As the amount of sex hormones decrease, so do these problems.
Your gums and teeth are also affected during pregnancy. Between the second and eighth month, your gums may also swell, bleed, and become red or tender. Large lumps may appear as a reaction to local irritants. However, these growths are generally painless and not cancerous. They may require professional removal, but usually disappear after pregnancy.
Periodontal health should be part of your prenatal care. Any infections during pregnancy, including periodontal infections, can place a baby’s health at risk.
The best way to prevent periodontic infections is to begin with healthy gums and continue to maintain your oral health with proper home care and careful periodontal monitoring.
Swelling, bleeding, and tenderness of the gums may also occur when you are taking oral contraceptives, which are synthetic hormones.
You must mention any prescriptions you are taking, including oral contraceptives, prior to medical or dental treatment. This will help eliminate the risk of drug interactions, such as antibiotics with oral contraceptives – where the effectiveness of the contraceptive can be lessened.
Changes in the look and feel of your mouth may occur if you are menopausal or post-menopausal. They include feeling pain and burning in your gum tissue and salty, peppery, or sour tastes.
Careful oral hygiene at home and professional cleaning may relieve these symptoms. There are also saliva substitutes to treat the effects of “dry mouth”.