Flossing: More Than Just a Guilt Trip

AriannaM

Arianna Ritchey, RDH

Flossing: More Than Just a Guilt Trip

As a part of a regular preventive or periodontal maintenance visit with your dental hygienist, the topic of flossing usually comes up.  Most people have at least heard of flossing, and while some people floss regularly, most patients I see report flossing less than the ADA recommended once per day.  More often, people fall into the categories of flossing “once in a while” or “once in a blue moon.”  While some people are embarrassed to admit this to their dental hygienist, the condition and health of your gums reveal a lot about your oral hygiene practices at home without you saying a word.  (We can also read minds…just kidding.)

So, if most people have heard about flossing, and are reminded of it semi-annually by their dental hygienist, what is preventing them from actually cleaning between their teeth on a regular basis?

Maybe they don’t realize the impact that flossing has on the health of their gums and prevention of early tooth loss.  Maybe it’s difficult for them to manipulate string floss (it’s harder than it looks).  Maybe they are super busy (who isn’t?) and can’t find time to track down some floss and use it between their teeth.  Maybe they ran out of the sample-size floss their hygienist gave them a their last visit.  Maybe it hurts when they floss because their gums are inflamed, so they avoid the pain.  Maybe they are really committed and diligent for the first while, and then life gets in the way and they fall out of the habit.  All of these are totally understandable reasons, and I’ve been there.  (Hygienists are human, too!)

The good news is, your dental hygienist is interested in helping you to keep your mouth and gums healthy, and offers a judgment-free-zone to learn how to properly perform oral hygiene techniques, like flossing, and to help you come up with some ways to integrate flossing into your daily routine.  (Floss in the shower, floss while watching the intro to your show on Netflix, floss while on Facebook or scrolling through Pinterest, floss while at a red light on your commute, etc.)

The other awesome thing your dental hygienist does for you, is giving you a clean slate to work with!  When your dental hygienist cleans your teeth by removing the plaque and calculus (calcified plaque) from your teeth, they are removing the bacteria that are causing the inflammation, pain, and bleeding in your gums.  (Hooray!)  Once these irritations are removed, the gums have a chance to heal, and by properly cleaning your teeth at home (brushing and flossing), you can keep them healthy.  When the gums are healthy, they don’t hurt, they don’t bleed, they are easier to floss, and you have a faster, easier dental hygiene appointments. (Even when your hygienist is gentle, nobody enjoys being in that chair.)

If you’re still reading, check out this video my former classmates and I produced that demonstrates proper flossing technique and briefly explains why flossing is important.  It’s a little cheesy, but definitely educational.  Make sure your sound is on, there’s some great instruction and music.  

After watching this video and practicing at home, if you’re still having difficulty with string floss, try some other interdental cleaners!  Here’s a great article that talks about lots of interdental cleaners and how to use them (scroll about halfway down).  

Remember, the best interdental cleaning tool is the one that you actually use consistently; if string floss just isn’t your thing, talk to your hygienist at your next visit, and we’ll be happy to give you some samples to try.  Happy flossing!

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

https://dentistrydonedifferently.com/2015/03/22/what-is-a-periodontal-maintenance/

http://www.ada.org/en/science-research/ada-seal-of-acceptance/product-category-information/floss-and-other-interdental-cleaners

https://dentistrydonedifferently.com/2013/10/14/tooth-brushes/

youtube.com/watch

https://dentistrydonedifferently.com/2014/05/19/flossing-do-i-have-to/

 Periodontal Disease and Diabetes 

PeggyS

Peggy Stoor, RDH

 Periodontal Disease and Diabetes

Recently much has come to light regarding oral health and its impact on systemic health and disease. While I’ve always been borderline fanatic about oral health and have been aware of some of these relationships, the recent research connecting oral health to systemic health has helped to make my daily work much more relevant and interesting.

Presently there are 18 million diabetic patients in the U.S. and 171 million diabetic patients worldwide. Diabetes is characterized by increased susceptibility to infection, poor wound healing, and a number of complications that can affect quality of life and length of life.  Diabetes is also a risk factor for severe periodontal disease (the destruction of tissues and bone that support the teeth). It’s critically important to realize that diabetics who have periodontal or gum disease have two chronic conditions, each of which affect the other.

periodontitis-300x195

While we have long known that diabetes can predispose one to periodontal disease, research now suggests that treatment of periodontal disease can have a positive impact on the diabetic condition.  Patients with periodontal disease have more difficulty controlling their blood sugar. Patients who have treatment and gain control of their gum disease have been shown to require less insulin and have a decreased hemoglobin A1c level. (A1c denotes a patients average blood sugar level over the past 3 months). In other words, periodontal disease and diabetes is a two-way street with each disease having a potential impact on the other, either positively or negatively.

Management of gum disease in patients with diabetes involves removal of plaque and calculus both at home and professionally, and maintenance of glycemic control. Nearly all diabetics respond to treatment and maintenance, therefore treatment of periodontal disease should be done as soon as possible. Both conditions require frequent professional evaluations, patient-self monitoring, daily brushing and flossing, approved antibacterial mouth rinses, and good blood glucose control.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

Southerland, J.H. (2005.) Diabetes and periodontal infection: Making the connection. Retrieved from http://clincial.diabetesjournals.org/content/23/4/171

Diabetes and Periodontal Disease: Retrieved from http://www.perio.org,  American Academy of Periodontology, Diabetes and periodontal Disease

Diabetes and Oral Health: Retrieved from http://www.nidcr.nih.gov/OralHealth/Topics/Diabetes.National Institute of Dental and Craniofacial Research by National Institutes of Health-(2007)

Mealey, B.L. ,(2006).Periodontal disease and diabetes: A two-way street. Journal of American Dental Association. Oct.137 suppl:26S-31S. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed

Mirza,B.A., Syed A., Izhar F., Ali Khan. (2001). Bidirectional relationship between diabetes and periodontal disease: Review of evidence. J  Pak Med Assoc. Retrieved from http: http://www.ncbi.nlm.nih.gov/pubmed/21381588

Dental Care and Diabetes. http://www.webmed.com/diabetes/dental-health-dental-care-diabetes

Image Credit: http://www.intelligentdental.com/2012/03/31/effect-of-systemic-factors-on-the-periodontium-part1

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