Prevention & Cleanings
A successful preventive program depends on a cooperative effort by the patient, dentist, and dental staff to preserve the natural dentition and supporting structures of your mouth. This helps prevent the onset, progress, and recurrence of dental diseases and conditions.
Preventing dental disease starts at home with good oral hygiene and a balanced diet. It is continued in the dental office by the efforts of your dentist and dental hygienist to promote, restore, and maintain your oral health.
Prevention also includes regular dental cleanings, x-rays, and exams. Sealants and fluoride are also great preventive treatments that help protect the teeth.
Prevention helps avoid serious and costly dental problems and is the key to having a healthy, confident, beautiful smile.
Dental Exams & Cleaning
A comprehensive dental exam will be performed by your dentist at your initial dental visit. At regular check-up exams, your dentist and hygienist will include the following:
– Examination of diagnostic x-rays (radiographs): These are essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
– Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
– Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
– Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
– Examination of existing restorations: Check current fillings, crowns, etc.
Professional Dental Cleaning
Professional dental cleanings (dental prophylaxis) are usually performed by Registered Dental Hygienists. Your cleaning appointment will include a dental exam and the following:
– Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line and can only be removed with special dental instruments.
– Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease!
– Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.
Prophylaxis (Teeth Cleaning)
A dental prophylaxis is a cleaning procedure performed to thoroughly clean the teeth. Prophylaxis is an important dental treatment for halting the progression of periodontal disease and gingivitis.
Periodontal disease and gingivitis occur when bacteria from plaque colonize on the gingival (gum) tissue – either above or below the gum line. These bacteria colonies cause serious inflammation and irritation which in turn produce a chronic inflammatory response in the body. As a result, the body begins to systematically destroy gum and bone tissue, making the teeth shift, become unstable, or completely fall out. The pockets between the gums and teeth become deeper and house more bacteria which may travel via the bloodstream and infect other parts of the body.
Reasons for Prophylaxis/Teeth Cleaning
Prophylaxis is an excellent procedure to help keep the oral cavity in good health and also halt the progression of gum disease.
Here are some of the benefits of prophylaxis:
Tartar removal – Tartar (calculus) and plaque buildup, both above and below the gum line, can cause serious periodontal problems if left untreated. Even using the best brushing and flossing homecare techniques, it can be impossible to remove debris, bacteria, and deposits from gum pockets. The experienced eye of a dentist using specialized dental equipment is needed in order to spot and treat problems such as tartar and plaque buildup.
Aesthetics – It’s hard to feel confident about a smile marred by yellowing, stained teeth. Prophylaxis can rid the teeth of unsightly stains and return the smile to its former glory.
Fresher breath – Periodontal disease is often signified by persistent bad breath (halitosis). Bad breath is generally caused by a combination of rotting food particles below the gum line, possible gangrene stemming from gum infection, and periodontal problems. The removal of plaque, calculus, and bacteria noticeably improves breath and alleviates irritation.
Identification of health issues – Many health problems first present themselves to the dentist. Since prophylaxis involves a thorough examination of the entire oral cavity, the dentist is able to screen for oral cancer, evaluate the risk of periodontitis, and often spot signs of medical problems like diabetes and kidney problems. Recommendations can also be provided for altering the home care regimen.
What Does Prophylaxis Treatment Involve?
Prophylaxis can either be performed in the course of a regular dental visit or, if necessary, using local anesthetic. The latter is particularly common where severe periodontal disease is suspected or has been diagnosed by the dentist.
Stages of Prophylaxis (Cleaning):
Supragingival cleaning – The dentist will thoroughly clean the area above the gum line with scaling tools to rid them of plaque and calculus.
Subgingival cleaning – This is the most important step for patients with periodontal disease because the dentist is able to remove calculus from the gum pockets and beneath the gum line.
Root planing – This is the smoothing of the tooth root by the dentist to eliminate any remaining bacteria. These bacteria are extremely dangerous to periodontitis sufferers, so eliminating them is one of the top priorities of the dentist.
Medication – Following scaling and root planing, an antibiotic or antimicrobial cream is often placed in the gum pockets. These creams promote fast and healthy healing in the pockets and help ease discomfort.
X-ray and examination – Routine X-rays can be extremely revealing when it comes to periodontal disease. X-rays show the extent of bone and gum recession and also aid the dentist in identifying areas which may need future attention.
Prophylaxis is recommended twice annually as a preventative measure. Periodontal maintenance cleanings should be more often and are usually performed every 3-4 months on periodontitis sufferers. Though gum disease cannot be completely reversed, prophylaxis is one of the tools the dentist can use to effectively halt its destructive progress.
Periodontal Scaling & Root Planing
The objective of scaling and root planing is to remove etiologic agents which cause inflammation to the gingival (gum) tissue and surrounding bone. Common etiologic agents removed by this conventional periodontal therapy include dental plaque and tartar (calculus).
These non-surgical procedures work very effectively for individuals suffering from gingivitis (mild gum inflammation) and moderate/severe periodontal disease.
Reasons for Scaling and Root Planing
Scaling and root planing can be used both as a preventative measure and as a stand-alone treatment. These procedures are performed as a preventative measure for a periodontitis sufferer.
Here are some reasons why these dental procedures may be necessary:
Disease prevention – The oral bacteria which cause periodontal infections can travel via the bloodstream to other parts of the body. Research has shown that lung infections and heart disease have been linked to periodontal bacteria. Scaling and root planing remove bacteria and halts periodontal disease from progressing, thus preventing the bacteria from traveling to other parts of the body.
Tooth protection – When gum pockets exceed 3mm in depth, there is a greater risk of periodontal disease. As pockets deepen, they tend to house more colonies of dangerous bacteria. Eventually, a chronic inflammatory response by the body begins to destroy gingival and bone tissue which may lead to tooth loss. Periodontal disease is the number one cause of tooth loss in the developed world.
Aesthetic effects – Scaling and root planing help remove tartar and plaque from the teeth and below the gumline. As an added bonus, if superficial stains are present on the teeth, they will be removed in the process of the scaling and root planing procedure.
Better breath – One of the most common signs of periodontal disease is halitosis (bad breath). Food particles and bacteria can cause a persistent bad odor in the oral cavity which is alleviated with cleaning procedures such as scaling and root planing.
What do Scaling and Root Planing Treatments Involve?
Scaling and root planing treatments are only performed after a thorough examination of the mouth. The dentist will take X-rays, conduct visual examinations, and make a diagnosis before recommending or beginning these procedures.
Depending on the current condition of the gums, the amount of calculus (tartar) present, the depth of the pockets, and the progression of the periodontitis, local anesthetic may be used.
Scaling – This procedure is usually performed with special dental instruments and may include an ultrasonic scaling tool. The scaling tool removes calculus and plaque from the surface of the crown and root surfaces. In many cases, the scaling tool includes an irrigation process that can also be used to deliver an antimicrobial agent below the gums that can help reduce oral bacteria.
Root Planing – This procedure is a specific treatment which serves to remove cementum and surface dentin that is embedded with unwanted microorganisms, toxins, and tartar. The root of the tooth is literally smoothed in order to promote good healing. Having clean, smooth root surfaces helps bacteria from easily colonizing in future.
Following these deep cleaning procedures, the gum pockets may be treated with antibiotics. This will soothe irritation and help the gum tissues to heal quickly.
During the next appointment, the dentist or hygienist will thoroughly examine the gums again to see how well the pockets have healed. If the gum pockets still measure more than 3mm in depth, additional and more intensive treatments may be recommended.
Oral Cancer Exam
According to research conducted by the American Cancer Society, more than 30,000 cases of oral cancer are diagnosed each year. More than 7,000 of these cases result in the death of the patient. The good news is that oral cancer can easily be diagnosed with an annual oral cancer exam, and effectively treated when caught in its earliest stages.
Oral cancer is a pathologic process which begins with an asymptomatic stage during which the usual cancer signs may not be readily noticeable. This makes the oral cancer examinations performed by the dentist critically important. The most common type of oral cancer is the malignant squamous cell carcinoma. This oral cancer type usually originates in lip and mouth tissues.
There are many different places in the oral cavity and maxillofacial region in which oral cancers commonly occur, including:
Oropharyngeal Region (throat)
Reasons for Oral Cancer Examinations
It is important to note that around 75 percent of oral cancers are linked with modifiable behaviors such as smoking, tobacco use, and excessive alcohol consumption. Your dentist can provide literature and education on making lifestyle changes and smoking cessation.
When oral cancer is diagnosed in its earliest stages, treatment is generally very effective. Any noticeable abnormalities in the tongue, gums, mouth, or surrounding area should be evaluated by a health professional as quickly as possible. During the oral cancer exam, the dentist and dental hygienist will be scrutinizing the maxillofacial and oral regions carefully for signs of pathologic changes.
A routine oral cancer exam will investigate the following signs:
Red patches and sores – Red patches on the floor of the mouth, the front and sides of the tongue, white or pink patches which fail to heal and slow healing sores that bleed easily can be indicative of pathologic (cancerous) changes.
Leukoplakia – This is a hardened white or gray, slightly raised lesion that can appear anywhere inside the mouth. Leukoplakia can be cancerous or may become cancerous if treatment is not sought.
Lumps – Soreness, lumps, or the general thickening of tissue anywhere in the throat or mouth can signal pathological problems.
Oral Cancer Exams, Diagnosis, And Treatment
The oral cancer examination is a completely painless process. During the visual part of the examination, the dentist will look for abnormality and feel the face, glands, and neck for unusual bumps.
If abnormalities, lesions, leukoplakia, or lumps are apparent, the dentist will implement an appropriate course of action and treatment plan, which may include a referral to a specialist. In some cases, a biopsy may be done. This includes a clinical evaluation which will identify the precise stage and grade of the oral lesion.
Oral cancer is deemed to be present when the basement membrane of the epithelium has been broken. Malignant types of cancer can readily spread to other places in the oral and maxillofacial regions, posing additional secondary threats. Treatment methods vary according to the precise diagnosis but may include excision, radiation therapy, and chemotherapy.
During bi-annual check-ups, the dentist and hygienist will thoroughly look for changes and lesions in the mouth, but a dedicated comprehensive oral cancer screening should be performed at least once each year.
If you have any questions or concerns about oral cancer, please ask your dentist or dental hygienist.
Home Dental Care
A beautiful, healthy smile that lasts a lifetime is our ultimate goal when treating patients. Your personal home care plays an important role in achieving that goal. You can start by eating balanced meals, reducing the number of snacks you eat and correctly using the various dental aids that help control the plaque and bacteria that cause dental disease.
Tooth brushing – Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and toothpaste.
– Place the brush at a 45-degree angle to the gums and gently brush using a small, circular motion, ensuring that you always feel the bristles on the gums.
– Brush the outer, inner, and biting surfaces of each tooth.
– Use the tip of the brush to clean the inside of the front teeth.
– Brush your tongue to remove bacteria and freshen your breath.
– Electric toothbrushes are also recommended. They are easy to use and can remove plaque efficiently. Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.
Flossing – Daily flossing is the best way to clean between the teeth and under the gumline. Flossing not only helps clean these spaces, but it also disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.
– Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
– Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
– Curve the floss into a “C” shape around each tooth and under the gumline. Gently move the floss up and down, cleaning the side of each tooth.
– Floss holders are recommended if you have difficulty using conventional floss.
Water Flossers- Use to remove plaque along the gumline and between teeth
–This home dental care device combines water pressure with pulsation to clean deep between teeth and below the gumline. It’s aids to remove harmful bacteria and debris that is hard to reach with traditional brushing and flossing.
–Very effective cleaning around crowns, bridges, and other dental restorations.
–Cordless versions are very convenient to use.
Rinsing – It is important to rinse your mouth with water after brushing, and also after meals if you are unable to brush. If you are using an over-the-counter product for rinsing, it’s a good idea to consult with your dentist or dental hygienist on its appropriateness for you.
Use other dental aids as recommended by your dentist or dental hygienist: Interdental brushes, rubber tip stimulators, tongue cleaners, irrigation devices, fluoride, medicated rinses, etc., can all play a role in good dental home care.
Digital radiography (digital x-ray) is the latest technology used to take dental x-rays. This technique uses an electronic sensor (instead of x-ray film) that captures and stores the digital image on a computer. This image can be instantly viewed and enlarged, helping the dentist and dental hygienist detect problems easier. Digital x-rays reduce radiation 80-90% compared to the already low exposure of traditional dental x-rays.
Dental x-rays are essential tools that provide valuable information not visible during a regular dental exam. Dentists and dental hygienists use this information to safely and accurately detect hidden dental abnormalities and complete an accurate treatment plan. Without x-rays, problem areas may go undetected.
Dental x-rays may reveal:
– Abscesses or cysts.
– Bone loss.
– Cancerous and non-cancerous tumors.
– Decay between the teeth.
– Developmental abnormalities.
– Poor tooth and root positions.
– Problems inside a tooth or below the gum line.
Detecting and treating dental problems at an early stage may save you time, money, unnecessary discomfort, and your teeth!
Are Dental X-Rays Safe?
We are all exposed to natural radiation in our environment. Digital x-rays produce a significantly lower level of radiation compared to traditional dental x-rays. Not only are digital x-rays better for the health and safety of the patient, but they are also faster and more comfortable to take, which reduces your time in the dental office. Also, since the digital image is captured electronically, there is no need to develop the x-rays, which eliminates the disposal of harmful waste and chemicals into the environment.
Even though digital x-rays produce a low level of radiation and are considered very safe, dentists still take necessary precautions to limit the patient’s exposure to radiation. These precautions include only taking those x-rays that are necessary, and using lead apron shields to protect the body.
How Often Should Dental X-Rays Be Taken?
The need for dental x-rays depends on each patient’s individual dental health needs. Your dentist and dental hygienist will recommend necessary x-rays based upon the review of your medical and dental history, a dental exam, signs and symptoms, your age, and risk of disease.
A full mouth series of dental x-rays is recommended for new patients. A full series is usually good for three to five years. Bite-wing x-rays (x-rays of top and bottom teeth biting together) are taken at recall (check-up) visits and are recommended once or twice a year to detect new dental problems.
Panoramic X-Rays & CBCT
Panoramic X-rays are wraparound photographs of the face and teeth. They offer a view that would otherwise be invisible to the naked eye. X-rays, in general, expose hidden structures (such as wisdom teeth), reveal preliminary signs of cavities, and also show fractures and bone loss.
Panoramic X-rays are extraoral and simple to perform. Usually, dental X-rays involve the film being placed inside the mouth, but panoramic film is hidden inside a mechanism that rotates around the outside of the head.
Unlike bitewing X-rays that need to be taken every few years, panoramic X-rays are generally only taken on an as-needed basis. A panoramic x-ray is not conducted to give a detailed view of each tooth, but rather to provide a better view of the sinus areas, nasal areas, and mandibular nerve. Panoramic X-rays are preferable to bitewing X-rays when a patient is in extreme pain, and when a sinus problem is suspected to have caused dental problems.
Panoramic X-rays are extremely versatile in dentistry, and are used to:
– Assess patients with an extreme gag reflex.
– Evaluate the progression of TMJ.
– Expose cysts and abnormalities.
– Expose impacted teeth.
– Expose jawbone fractures.
– Plan treatment (full and partial dentures, braces, and implants).
– Reveal gum disease and cavities.
How are Panoramic X-rays Taken?
The panoramic X-ray provides the dentist with an ear-to-ear two-dimensional view of both the upper and lower jaw. The most common uses for panoramic X-rays are to reveal the positioning of wisdom teeth and to check whether dental implants will affect the mandibular nerve (the nerve extending toward the lower lip).
The Panorex equipment consists of a rotating arm that holds the X-ray generator, and a moving film attachment that holds the pictures. The head is positioned between these two devices. The X-ray generator moves around the head, taking pictures. The positioning of the head and body is what determines how sharp, clear, and useful the X-rays will be to the dentist. The pictures are magnified by as much as 30% to ensure that even the smallest detail will be noted.
Panoramic X-rays are an important diagnostic tool and are also valuable for planning future treatment. They are safer than other types of X-ray because less radiation enters the body.
3D Cone Beam Imaging
Cone beam CT (CBCT) provides detailed 3D images of the bone and is performed to evaluate diseases of the jaw, dentition, bony structures of the face, nasal cavity and sinuses.
At Laramie Dental Arts, we use 3D ConeBeam technology for more informed dentistry. This new digital technology produces 3D digital X-rays that fully show the relationship between your teeth, bones, and nerves. The scans help your dentist more precisely place your dental implants using computer-generated guides for incision-free implants and practically painless implant placement.
Dental cone beam CT is commonly used for treatment planning of orthodontic issues. It is also useful for more complex cases that involve:
- surgical planning for impacted teeth.
- diagnosing temporomandibular joint disorder (TMJ).
- accurate placement of dental implants.
- evaluation of the jaw, sinuses, nerve canals and nasal cavity.
- detecting, measuring and treating jaw tumors.
- determining bone structure and tooth orientation.
- locating the origin of pain or pathology.
- cephalometric analysis.
- reconstructive surgery.
Not only are these scans helpful to your dentist, but they also have the advantage of lower radiation exposure compared to conventional CT.
If you have questions or concerns about panoramic X-rays or a CBCT, please ask your dentist.
Intraoral cameras are changing the face of routine dental appointments! The intraoral camera gives the patient a unique view of each tooth – enabling them to understand diagnoses and make informed treatment decisions.
The intraoral camera is connected to a computing unit at the side of the dental chair. A pen-sized wand is inserted into the mouth, and a movie of the inner mouth is created. This movie can be magnified more than 30x to allow every aspect of the teeth to be viewed in full color. The intraoral camera is an incredibly valuable tool that brings dentistry to life.
How Can the Intraoral Camera Help You?
Using intraoral cameras is a completely comfortable process for patients, and provides an honest assessment of the teeth. Here are some of an intraoral camera’s main uses:
Dental education – Education and preventive care are highly important in dentistry. The intraoral camera can expose areas where home hygiene may be lacking. Any problems can then be resolved before complicated treatments are required.
Exposing hidden problems – Conditions like gum disease and oral cancer may display easy-to-miss symptoms in their earliest stages. The intraoral camera can more clearly highlight these issues to the dentist and the patient.
Treatment planning – No matter how well a dentist might describe a condition, it is easier to understand the issue if it can be seen. Seeing tooth decay and problem teeth
Assessing progress – Some treatments impact the teeth slowly. The intraoral camera allows treatment to be modified along the way, if necessary, to ensure the desired results are achieved.
Eliminating uncertainty – One of the most common patient fears is that a dentist is performing unnecessary treatments. The intraoral camera highlights problem areas, so that individuals are less likely to refuse necessary treatment.
Referrals to specialists – On occasion, a patient may need to be referred to a specialist for complex treatment. If this specialist is able to view clear images of the teeth in advance, consultation times and costs can be reduced.
How Will the Intraoral Camera
The intraoral camera is the size and shape of a pen. It is covered with a disposable sheath to ensure that no germs are transmitted from patient to patient. The slim wand is inserted into the mouth and rotated until clear pictures of every tooth can be recorded. The images are transmitted onto a television screen in movie format. The movie can be paused and images of individual teeth can be magnified to allow the dentist to explain and explore any noticeable problems. One of the biggest advantages of the intraoral camera is that it does not expose patients to radiation. The intraoral camera is one of the most useful and versatile diagnostic tools available.
If you have any questions or concerns about the intraoral camera, please contact your dentist.
A sealant is a thin, plastic coating applied to the chewing surface of molars, premolars, and any deep grooves (called pits and fissures) of teeth. More than 75% of dental decay begins in these deep grooves. Teeth with these conditions are hard to clean and are very susceptible to decay. A sealant protects the tooth by sealing deep grooves, creating a smooth, easy to clean surface.
Sealants can protect teeth from decay for many years, but need to be checked for wear and chipping at regular dental visits.
Reasons for sealants:
Children and teenagers – As soon as the six-year molars (the first permanent back teeth) appear or any time throughout the cavity-prone years of 6-16.
Adults – Tooth surfaces without decay that have deep grooves or depressions.
Baby teeth – Occasionally done if teeth have deep grooves or depressions and the child is cavity prone.
What do sealants involve?
Sealants are easily applied by your dentist or dental hygienist and the process takes only a couple of minutes per tooth.
The teeth to be sealed are thoroughly cleaned and then surrounded with cotton to keep the area dry. A special solution is applied to the enamel surface to help the sealant bond to the teeth. The teeth are then rinsed and dried. Sealant material is carefully painted onto the enamel surface to cover the deep grooves or depressions. Depending on the type of sealant used, the material will either harden automatically or with a special curing light.
Proper home care, a balanced diet, and regular dental visits will aid in the life of your new sealants.