Tag Archives: inflammation

Non-surgical Periodontal Therapy

KatieM

Katie Moynihan, BS RDH

Non-surgical Periodontal Therapy

If your hands bled when you washed them, you would be concerned. However, many people think it is normal if their gums bleed when they brush or floss. False! Inflammation and bleeding are early signs that your gums are infected with bacteria. If not treated quickly and properly, those early signs of gingivitis may lead to a more serious infection called periodontal disease.

Periodontal disease affects the supporting tissues around the teeth including the gums, the periodontal ligament, and the bone. As the plaque in your mouth spreads and accumulates below the gum line, the toxins within that plaque infect and break down the “foundation” that hold your teeth in place. If not treated with periodontal therapy, the disease will only get worse and tooth loss may occur.

In the presence of periodontal disease, a “regular” prophylaxis cleaning can NOT be completed. The definition of prophylaxis is the prevention of disease. Once periodontal disease is diagnosed, your dentist and dental hygienist will recommend non-surgical periodontal therapy. Non-surgical periodontal therapy is also referred to as scaling and root planing, or a deep cleaning. Scaling and root planing involves thoroughly removing the plaque and calculus (tartar) that resides above and below the compromised gums. Smoothing the tooth roots allows a clean surface for tissue re-attachment and pocket reduction. Local anesthetic is recommended to make this procedure comfortable and painless for the patient. The goal for non-surgical periodontal therapy is to treat and eliminate the active infection, reduce periodontal pocketing around teeth, prevent further bone loss. The shallower the pockets are around your teeth, the easier they are to keep clean and healthy! When periodontal health is achieved, your oral health care provider will recommended more frequent periodontal maintenance cleanings every 3-4 months to keep tissues healthy and stabilized. In few circumstances where periodontal health cannot be achieved, a referral to a Periodontist may be recommended for further treatment.

Signs & Symptoms of Gum Disease:

  • Swollen, red, tender or bleeding gums
  • Gums that recede or move away from the tooth
  • Persistent bad breath or bad taste in mouth
  • Pain/sensitivity when chewing
  • Loose teeth
  • Visible pus surrounding the teeth and gums

You can prevent periodontal disease by practicing good oral hygiene and visiting your dentist regularly for professional cleanings. In recent years, gum disease has been linked to overall health problems. You can read more about those on Andra’s recent blog post Oral Health: A Window to your Overall Health! Remember, taking care of your oral health is an investment in your overall health.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

www.perio.org

www.colgate.com

What is Calculus?

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Lora Cook, RDH

What is calculus and what dangers does it cause to the health of your mouth.

Calculus or tartar, same thing is calcified plaque.  Plaque is the soft sticky film that will start to form twenty minutes after you brush your teeth.  Another name for the soft sticky plaque is biofilm.  This is basically a bacteria that grows in your mouth, a “slime layer”.  Plaque is white or pale yellow soft, sticky, slimy stuff.  This is what makes your teeth feel “fuzzy” when you first wake up and at the end of a long day.  So do all these pleasant descriptions make you want to go brush your teeth yet?

So where does calculus come from?  Calculus is calcified plaque.  When plaque is allowed to stay hiding in your mouth for twenty-four hours or more is has the opportunity to harden and turn into tartar. Calculus/Tartar, same thing, this is calcified plaque. Once this soft sticky substance (biofilm) becomes hard it will attach itself to the tooth surface, then you will not be able to remove it yourself with your tooth brush or your floss. Calculus will form above and below your gum tissue.

The calculus will be a physical irritant to your gum tissue, causing inflammation.  The calculus also becomes a source that harbors bacteria that causes harm to the tissue and bone around the teeth.  This aggressive bacteria may lead to periodontal disease. What is periodontal disease?  In short, it is bone loss around the teeth.  This bone loss may range from slight to moderate, to severe.  Some people will build up tartar more quickly than others, and some people are more prone to the bacteria that causes periodontal disease (bone loss).

So this brings the questions; What can I do to prevent calculus build up?

USE AN ELECTRIC TOOTHBRUSH: electric tooth brushes have been proven to be more effective at cleaning than manual brushes. Use the rechargeable electric brushes, not the battery spin brushes.

CHANGE YOUR TOOTHBRUSH EVERY THREE MONTHS: Do not go longer than three months with the same tooth brush or tooth brush head.  Once the bristles start to wear out they cannot do a good job for you.

TIME YOUR BRUSHING ROUTINE: Brush for at least two minutes, preferably two to three minutes.  Sometimes just adding more time to your routine can make a big difference, most people will brush for only forty to sixty seconds. So try timing yourself, you will be surprised.  Two minutes feels like forever when you are brushing.

FLOSS DAILY: You don’t have to floss two times daily, once a day is sufficient. Make flossing part of your nightly routine.  Flossing techniques are important, because some techniques are more effective than others. It is important to floss under the gum tissue where everything likes to hide, not just in between the teeth.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

http://www.colgate.com/en/us/oc/oral-health/conditions/plaque-and-tartar

https://www.quora.com/Does-tartar-cause-gum-disease-purely-through-MECHANICAL-means/

What is a Periodontal Maintenance?

AriannaM

Arianna Ritchey RDH

What is a Periodontal Maintenance?

One of the terms that is commonly used by dental professionals, and also commonly misunderstood by patients, is ‘Periodontal Maintenance.’  A periodontal maintenance procedure is similar to a prophy, or general adult cleaning, but is a more involved procedure meant for patients who have periodontal disease.

Periodontal disease, or gum disease, is characterized by deep periodontal pockets, inflammation, and bone loss.  Periodontal disease is an irreversible condition which, if left untreated, may lead to further bone loss and eventually tooth loss.  In order to treat periodontal disease, a dental hygienist or dentist will likely recommend a procedure called a “deep cleaning,” also known as SRP, or scaling and root planing.  Once a deep cleaning is completed, inflammation will reduce and periodontal pockets may decrease in depth.  When the patient’s periodontal status has stabilized, the next step in the care of the teeth and gums is periodontal maintenance, or more colloquially, “perio maintenance.”

Perio_Health

Periodontal maintenance is a teeth cleaning procedure which is done at either 3, 4, or 6 month intervals, depending on the patient’s needs.  The purpose of the periodontal maintenance procedure is to maintain the level of the periodontal disease present, and to prevent it from getting any worse.  Unfortunately, bone that has been lost as a result of periodontal disease does not grow back, and as such, periodontal pockets may remain at a deeper-than-optimal level despite the initial deep cleaning therapy.  These deep periodontal pockets collect plaque and tartar, and are impossible to clean properly with a toothbrush, floss, and other dental hygiene aids.  In order to keep these periodontal pockets clean and prevent further bone loss, it is necessary to have a dental hygienist regularly perform professional cleanings.

perio probe

Periodontal maintenance involves a dental hygienist scaling and root planing some areas in order to remove irritating tartar buildup.  When a dental hygienist performs root planing, instrumentation is completed below the gumline all the way to the bottom of the periodontal pocket.  This cleaning of the root surface below the gumline is what makes a periodontal maintenance different, more involved, and potentially more costly  than a prophy, or regular cleaning.

scaling-root-planing

In patients who have deep periodontal pockets, a prophy, or general cleaning, is not beneficial, because the irritating plaque and tartar below the gumline that is causing the most irritation and loss of bone is not removed during a prophy or general cleaning.  Performing a general cleaning on a patient with periodontal disease would be similar to sweeping dirt under the rug instead of properly cleaning a floor.  The offending dirt in the case of the floor,  or the bacteria-infused-tartar in the case of the mouth, is still present and causing harm.


Sweep-Dirt-Under-the-Rug-570x566

As dental hygienists, our primary goal and concern is to assist patients in maintaining the healthiest oral cavity possible.  Providing periodontal maintenance treatments for our patients who have periodontal disease at 3, 4, or 6 month intervals, along with the patient’s good oral hygiene care at home, is the best way to work towards a stable periodontal health status and to help our patients from experiencing bone and tooth loss.

perfect-smile

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources

http://jdh.adha.org/content/82/suppl_2/16.refs

http://www.rdhmag.com/articles/print/volume-0/issue-9/columns/staff-rx/prophy-vs-perio-maintenance.html

https://www.deltadental.com/Public/Study/StudyPerio.jsp

Hydrogen Peroxide

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Lora Cook RDH

 Is Using Hydrogen Peroxide as a Mouth Rinse Safe?

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​Many commercial mouth washes and whitening strips have hydrogen peroxide as one of the key active ingredients. However many are using straight hydrogen peroxide as a mouth wash to kill germs. Is this a safe and effect practice?

​Hydrogen peroxide is compose of water and oxygen that works to kills germs and bacteria, and helps to whiten teeth.  It comes in either 1% or 3% concentrations. You can even see it in action!  When it foams in your mouth you know that it is working at killing bacteria.  It also can be used to clean your night guard, retainers, or even soak your tooth brush in.  Best of all it is inexpensive. 

​ However this is not the magic cure all, there are some strong precautions that I would like to share with you.  While there are many benefits it can be harmful on gum tissue if used in too strong a solution or too long.  It is very drying to the tissues. This will also work to kill good bacteria in the mouth.  This will leave opportunity for yeast infections of the mouth to flourish, also called thrush.  Candidiasis is a fungal or yeast infection of the mouth or throat. Candida yeast that normally live in the mucosa membrane will flourish causing a over growth of candida, commonly called yeast infections. 

​This can be a relatively safe practice by following a few guidelines; dilute peroxide with 50% water, and do use every day.  If you are one of the many people who suffer from dry mouth stick with a over the counter rinse formulated for dry mouth sufferers. 

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.using-hydrogen-peroxide.com/hydrogen-peroxide-as-mouthwash.html

http://copublications.greenfacts.org/en/tooth-whiteners/l-3/6-tooth-whitening-side-effects.htm

http://www.healthline.com/health/thrush#Symptoms4

Health and Nutrition

JW9(sm)

 

Julie West BS RDH 

Statistics from the World Health Organization show that up to 93% of diabetes, 81% of heart disease, 50% of strokes, and 36% of all cancers could be prevented by a healthy diet and lifestyle.  We have all heard of fad diets and medications that claim to slim you down in weeks, but have you looked at the asterisk on the bottom of your television screen during their commercials?  You will see that the testimonials you are seeing are from “results not typical” and have occurred in less and 5% of the people who took that particular diet plan or pill.  The best weight loss experts will tell you that there is no shortcut to being healthy.  Diet and exercise are essential in establishing and maintaining health.

Obesity is increasing in prevalence and is a major contributor to worldwide morbidity.  As obesity in this country rises, are we surprised that the prevalence of heart disease, diabetes, cancer, and other diseases rises too?  One of the dangers in obesity is due to a prolonged state of inflammation in the body.  Inflammation is the first response of the body to injury, cell damage, infection, or irritants.  Inflammation that is chronic and unresolved can lead to:

  • Rheumatoid Arthritis
  • Periodontal Disease
  • Diabetes
  • Cardiovascular Disease
  • Asthma
  • Cancer

Fat cells produce hormones and proteins that cause inflammation and insulin resistance, which promote cell growth.  Overweight people have high levels of substances circulating in their blood that stimulate cell division. The more often cells divide, the more opportunity there is for cancer to develop.  To help lower your risk for cancer, it is important to know how much inflammation is present inside your body.

At your next visit to your doctor, ask for a blood workup with a screening of your C-reactive protein, a protein made by the liver when there is inflammation in the body.

Inflammation also often manifests in the mouth.  If you have one or more of the above diseases, inflammation may be the underlying factor.  At your next dental visit, ask your dental hygienist if there is inflammation in your mouth.  Your dental hygienist can provide great information about the inflammation process and its effects on the body.

 

Source:

Brand-Miller J, et al. Cur Opin Lipidol 2012, 23(1): 62-7

Low Dog, MD. (February 2014). Cancer and Nutrition in the 21st Century. Western Regional Dental                    

Convention.  GC America, Phoenix, Arizona.

 

Flossing…Do I have to?

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Wendy Parker RDH
 
Absolutely! In some shape or form, flossing is essential in keeping the mouth and the rest of your body healthy!
As a hygienist, I have heard almost every excuse as to why people don’t floss, and trust me, I understand! From the “I’m too tired at night” to the “I just don’t have time” or the “I just forget to,” my job today is to try and make it a little simpler for you to want to floss and to help you understand why we should floss.
 
As a mother of 4 little ones, I understand that flossing isn’t a priority somedays….getting showered is. But with that, let me just say, flossing really is something that you don’t see the immediate results from, but in 20 years when you have your teeth still and you are smiling at their graduation with all your pearly whites, you will thank me.
 
So, let’s start with answering the basic questions about flossing….WHY should I floss? I brush really well!Brushing is a wonderful thing, and we are encouraged to do it twice a day, for two minutes with a fluoride toothpaste. What most people don’t realize is that brushing only reaches that tops, outside and inside surfaces of the teeth. But how to get inbetween? There really isn’t a substitute for flossing, sorry to be the bearer of bad news. Rinsing with mouthrinse or using an electric toothbrush will definitely help with keeping the mouth cleaner however, it is NOT a substitute for flossing. Plaque and bacteria form on every surface in the mouth, including the tongue and inbetween the teeth, therefore, you have to clean every surface of the teeth, not just the ones you can see. The tongue, saliva, and brushing take care of the plaque on most surfaces of the teeth, but floss truly is the only way to get the sticky plaque off the sides.The idea behind flossing is that as long as you disrupt the bacteria in the mouth once every 24 hours, you prevent it from hardening and becoming tartar. Flossing is MOST effective just before or after brushing at bedtime but really….you can do it any time of the day! Stuck in traffic? Floss. Waiting to pick the kids up? Floss. Going for a walk? Floss. Any time is a great time to floss! When you floss, it prevents Gingivitis (inflammation of the gum tissues), bleeding gums, bad breath, and will make easier dental appointments! The more you floss, the easier it becomes and the less your gums will bleed. It’s kind of like riding a bike. The first time you get one, you’re a little shaky but with practice you’ll be jumping off curbs in no time!
A lot of times people don’t floss because their gums bleed. That is because the gum tissue in that area is unhealthy so the body sends more blood to that area to help it heal. When your gums bleed, and the bacteria from the plaque and tartar are present, that bacteria gets into your bloodstream it is carried throughout the body increasing your chances of heart disease, compromising your immune system, and possibly causing an infection in the lining of your heart, which can be deadly! So, the more you floss, the healthier your gums are and the less they bleed!
 
So now that we know why, let’s focus on HOW to properly floss….

  • Starting with about 18 inches of floss, wind most of the floss around each middle finger, leaving an inch or two of floss to work with
  • Holding the floss tautly between your thumbs and index fingers, slide it gently up-and-down between your teeth
  • Gently curve the floss around the base of each tooth, making sure you go beneath the gumline. Never snap or force the floss, as this may cut or bruise delicate gum tissue
  • Use clean sections of floss as you move from tooth to tooth
  • To remove the floss, use the same back-and-forth motion to bring the floss up and away from the teeth
       floss1 floss2 floss3
 
The type of floss you choose is up to you. My personal favorites are Glide floss and Oral-B Satin floss. You may need to try a few different types to find the one that’s right for you. But don’t give up! It does get easier. Flossing looks simple, right? But what if you don’t have the perfect and easiest mouth to floss? Or you hate how the floss cuts off your circulation in your fingers every time? When you walk down the dental isle in any store there are so many aides to assist you, so which one is right for you? Hopefully you have already asked your hygienist this question but if not, here are a few things for you to check out the next time you are perusing the dental isle.
 
Several of my patients enjoy using floss picks. These are a great way to start your day. They don’t cut off your circulation and are totally disposable. These are great to keep a pack in your car or purse when you’re out and about.
And you can find all kinds of cute designs for your kids! Kids don’t usually become proficient at flossing until 10 or 11 years old. It’s never too young to start them on flossing. They’ll thank you later!
 

For those with braces, bridges, or large gaps between their teeth you may want to try Oral-B’s superfloss. It is a piece of floss that has one stiff end, a thicker, yarn-like middle section, and regular floss at the end. It’s hand to floss your thread through those brackets, bridges, permanent retainers, and then use the floss width that fits the area. This is a favorite of mine.
Also for places that have a little bit of a space, braces or bridges, is the interproximal brush. Some are disposable, some are reusable, just check them out and decide which one you would like. But these are great for teens who get something stuck in their teeth at school and don’t want to carry a toothbrush with them. Or for men just before business meetings.
 
And of course, there are the rubber tips toothpicks. You can go back to old school and use a regular wooden toothpick if that’s your preference but these are great. They are small, disposable, and awesome for on the go. They have a flexible rubber tip you can get inbetween tight spaces, permanent retainers, and brackets. Check them out, you may like them.
 
I know that there are several other gadgets out there but these are just a few of my personal favorites. If you see one you like, ask us about it and we’ll do the research for you to see if it’s the best one for you! But no matter what you do, just be sure that you do your best and remember what Dory from Finding Nemo says, “Just keep flossing, just keep flossing, flossing, flossing…..” Or was is swimming?

Quick Relief for the Constant Canker Sore

It’s no secret that at least everyone has gotten a few canker sores in their lifetime. Have you ever had that period of time where you just cannot seem to get rid of a canker sore? Or you just keep getting them? Well, as I’ve mentioned in my previous blog, I was an orthodontic patient for 3 years. If you’ve ever had braces, you know the drill with the canker sores. Your braces just love to cut you, and canker sores just LOVE to appear everywhere they possibly can. I was so annoyed with my mouth, that I tried every possible way I could to get rid of them. Allow me to walk you through my journey of canker sore relief.

To start, canker sores are small lesions that develop on the soft tissues in your mouth, or at the base of your gums. You can have 2 different types of canker sores; simple, or complex. Simple canker sores may appear three or four times a year and last up to a week. Complex canker sores are less common than simple, and occur more often in people who have previously had them. Unlike cold sores, canker sores are not contagious. A lot of people confuse canker sores with cold sores when in reality, they are very different. The exact cause of a canker sore is unknown, while some say that it could be caused b stress, or injury to your tissue in your mouth. So for example, if you were a cheek biter and lip biter like I was, canker sores will come very easily to your mouth. The constant chewing damages the tissue, leaving room for canker sores to “grow.”

When I was younger, I remember getting the occasional canker sore here and there, nothing big. I would wait for a few days, they would go away. But, when I had my braces put on, it was like I was getting a new canker sore every other day! It was awful. I wasn’t just getting them on my gums, or cheeks, but I was also getting them on my tongue. I tried everything. I went to Walgreens and got every canker sore cream they owned. Nothing would ever help me. I tried everything from orajel, to canker care. It would relieve them, and make them smaller, but I would feel like they would never heel, or new ones would always be sprouting different places in my mouth. I finally made the trip to my dentist after I couldn’t stand them anymore. This was when I had braces, so it’s really hard to clean the gum tissue around my braces. And it was also really hard for me to clean the food out of my teeth really well, which was also part of the problem. When I would eat acidic food, it would stay in my teeth, and because my cheeks would always be damaged due to the braces, it would result in canker sores…everywhere. Well, I started to change my diet, be more thorough with my cleaning, and floss. What do you know? My canker sores started becoming less and less! It was amazing, I was so happy. Doing a really detailed job on cleaning my teeth have now become a habit I never intend to break.

My canker sore journey doesn’t end there, even after my braces were off, I continued to get canker sores. I was furious! I marched right back to Walgreens and started from square 1. All of those creams and gels still did nothing for me. I didn’t want to go to my doctor again, knowing he would just tell me the same thing again. I decided to take matters into my own hands. I started to Google things, and tried all of these ridiculous home remedies….until I found one remedy that was no longer ridiculous. Are you ready for it? Warm salt water. Who knew? It worked miracles. I would swish warm salt water in my mouth twice a day, and within one day, I was feeling the canker sores go down, and I had little pain, and I was able to eat salty things again. After about 3 days of warm salt water, my mouth was canker sore free. I was one happy lady. It just blew my mind that the simplest of things helped me so much. This is what I recommend to everyone out there suffering from canker sores. The salt helps fight the infection and the pain, and inflammation, whereas the warm water helps ease the pain.

Every time I feel a canker sore coming on, I grab that salt water, and gargle and I’m feeling better the next day. It is the only thing I trust when it comes to my canker sores! I recommend it to everyone who has the same problem as I do.sorecanker