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Prevention should serve as a lifestyle pattern for total health, not the least of which is dental health. Prevention in dentistry leads to improved long-term oral health and reduced dental costs. It encourages a bright smile, fresh breath, and an overall good feeling of personal security. Prevention is your insurance policy toward a healthier, pain-free, debt free lifestyle.

Our dental hygienists can provide an excellent service to assist you in the maintenance of your overall dental health. Your cooperation with her can serve to increase your knowledge of your present oral condition. When you keep your appointment with your hygienist, the following benefits will result:

* Your hygienist will customize a personal home care and preventive maintenance program for you and inform you of those dental products that are appropriate for your particular needs. You will be instructed in the proper methods of tooth brushing, flossing and adjunctive dental health devices.

* Your entire mouth will be thoroughly and carefully examined for gum disease, growths, lesions, and any abnormalities that would affect your general health.

* Your teeth will be cleaned and polished to remove plaque and tartar both above and below the gum line, eliminating bacteria that lead to cavities, bad breath, and gum disease.

* Fluoride will be applied to teeth to prevent decay (for children), and root sensitivity / root cavities for adults.

* Sealants can be easily applied to the chewing surfaces of children’s teeth as a protection against future decay.

For our periodontal maintenance patients, your hygienist will use her specialized cleaning instrument, the Cavitron, to not only remove tartar, but also flush bacteria and debris from the periodontal pockets. She will also irrigate and medicate those same pockets with Chlorohexidine Gluconate.

Dental disease is a silent invader, presenting itself in various forms (puffy, bleeding gums, cavities, oral cancer, and abscesses). Although your mouth may appear to be in good health at this time, stresses, body changes, life changes, medications, illness, and age can tax your immune system. Maintaining regular re-care appointments with your hygienist and follow-ups with Dr. Briscoe offer you the assurance that any problems in regard to your oral care will be addressed immediately.

Taking care of tomorrow’s problems today will give you tremendous peace of mind. If you have postponed or missed your last hygiene maintenance appointment, remember: it’s not just a cleaning, it’s an INVESTMENT in your overall health.


For more information see my website at www.lajolladental.com

1. Always brush your tongue or use a tongue scraper daily. Your tongue retains approximately 80% of the bacteria in your mouth.
2. Replace your toothbrush or other home care products if they appear worn out. Toothbrushes should not look flattened or spread out. They should be replaced every six to eight weeks.
3. Toothpastes for sensitive teeth or fluorides are very useful for sensitive root surfaces. Use as directed.
4. Prescription fluoride gels are used to prevent decay, reduce sensitivity and decrease microbial (bacteria) count. After brushing, place gel on a dry toothbrush, proxabrush, or rubber tip and use for one minute, followed by swishing remaining gel for one minute. Do not swallow the fluoride as it may upset your stomach. Fluoride rinses (non-alcohol) you can purchase over the counter such as Act, can also help decrease sensitivity and strengthen teeth. Use one to two times a day. Do not eat or drink for thirty minutes after using.

Periodontal Disease Facts and Reminders
1. Plaque forms 20 seconds after eating and 20 minutes after brushing. It hardens into tartar in 24 hours and stays on your teeth.
2. Healthy gums DO NOT BLEED. If you have bleeding gums, pay more attention to your home care instructions. Salt water rinses can help sensitive and swollen gums (1 tsp. salt dissolved into one cup water). If your gums continue to bleed after a thorough home care routine, please contact our office. Go to www.lajolladental.com
3. Experiencing a bad taste or odor is a sign of gum disease/infection.
4. Mouthwashes have no effect on periodontitis. Some mouthwashes can reduce gingivitis.
5. When subgingival plaque reaches a certain threshold level, it produces periodontal disease. Periodontal Disease, therefore, occurs in episodes of activity and quiescenece. That is why daily removal of the bacteria in your mouth is important in reducing your risk of periodontal disease.

Active Periodontal Therapy (Treatment for Periodontal Disease)

How do we treat gum disease (periodontal disease)? See my website at http://www.lajolladental.com/Procedures_Treatment_42712.aspx It depends where you are at with the progression of the disease. A major component of dental health is what we do for ourselves everyday – homecare. Brushing three times a day (after breakfast, midday, and after dinner) and flossing after dinner are the minimum you should be doing to get back to dental health. The other major component is regular dental visits. Cleaning and check-up at least every six months. With early gum disease (gingivitis) this may be enough. Let the dental team clean your mouth up twice a year and you maintain it daily.
Once we slip to a more advanced stage of gum disease, periodontitis, we have receding gums and/or bone loss. Here, the dental team will need to be more aggressive in their treatment of you. They will take a complete medical-dental history to identify any underlying or predisposing conditions, and do a complete clinical exam. The dental team will take X-rays, a full set is usually indicated. They will also evaluate the depth of the pockets around each tooth using a calibrated probe.
Most patients at this point will require Active Periodontal Therapy and/or a referral to a gum specialist. We treat most patients here and refer out only the surgical needs. the Active Periodontal Therapy consists of scaling and root planing, debridement, irrigation of the pockets with a medicated rinse, and perhaps placement of antibiotics in specific isolated pockets.

Active Periodontal Therapy is similar to the scaling normally done during a routine oral hygiene visit, however, it differs in several significant ways. Infection and the resulting deep pockets exist around your teeth requiring deeper than normal scaling. Since vision is blocked into the tooth structure, small scaling devices (either manual or ultrasonic) will be placed carefully into the pockets and a systematic smoothing of the tooth root surfaces will be performed. Debris that has collected on the tooth surfaces will be removed along with the diseased soft tissue. This procedure (called curettage) requires significant time and expertise. Usually, only one area of your mouth will be done per appointment. The number of the one-hour appointments needed will depend on the severity of your infection. You will be anesthetized for your comfort during these procedures.

Your gum tissue may shrink somewhat as it heals. This is desirable because it reduces the depth of the pockets allowing you to better remove bacteria and debris during your home care. Active Periodontal Therapy is the most conservative way to treat gum disease.

Knowing all that we know about Periodontal Disease (PD), how is it that 75-80% of us are affected by it?
Periodontal Disease is a silent disease in that it does not hurt (until advanced stages) and can go undetected in its earliest stage. Too often, people don’t go to the dentist regularly and start to build up plaque between their teeth. If the person is not a flosser, the plaque starts to accumulate more and more between their teeth. The once healthy gums, pink and firm around each tooth, now start to become inflamed between the back teeth where the plaque is building up. With gingivitis now established, the bacteria residing in the plaque produce toxins that start to break down the attachment of the gums to the teeth. The body’s inflammatory response is to bring increased amounts of blood to those areas to fight off the toxins. The gums become puffy, tender and swollen, and can bleed easily with brushing and flossing (not likely any flossing is occurring in this person).
A cleaning at the dental office at this point could start to turn things around. Flossing and brushing would go a long way toward health. Of course, this person doesn’t have any pain, and is unaware of this situation.
Periodontitis sets in as the plaque by-products, the toxins, destroy the tissues that hold the teeth in the bone. The attachment of the gum to the root surfaces start to be destroyed and pockets develop between the gum and the teeth. The gums pull away from the teeth and recede. More plaque is now accumulating below the gum line in these pockets. Some of the plaque on the root surfaces is hardening into tartar. Like the barnacles forming on the piers at the ocean, the tartar is rough and more plaque sticks to the rough surfaces and become hardened. As the disease progresses, bone under the gums that anchors the teeth begins to dissolve away. The person may notice an unpleasant odor coming from their mouth – bad breath. The gums may bleed when brushing. At this point, with less bone anchoring the teeth and less gum tissue covering the roots, the teeth appear longer and are sensitive to cold and are more susceptible to decay.
In advanced periodontitis, the toxins deep in the pockets continue to destroy the periodontal ligaments and bone, causing the teeth to lose more support. Unless treated, the affected teeth become more mobile and may fall out.
The key, is to not let this all get started. Should you find yourself progressing down the path described above, work hard on brushing and flossing and get into the dental office for evaluation and necessary treatment. You do not have to lose teeth to periodontal disease!

For more information, visit my website.

We talked previously about periodontal disease and its effect on our overall health. Let’s take some time to explain what is periodontal disease (PD). Periodontal Disease ranges from simple gum inflammation (gingivitis), to serious disease that results in major damage to the soft tissue and bone that support the teeth (periodontitis). An estimated 75-80% of adults in America have some level of PD (epidemic proportions). Because there is no pain until the condition is at a very advanced stage, most people are not aware they are infected with PD. Our mouths are full of bacteria, which along with mucus and other particles (tissue particles, food particles), constantly form a sticky, colorless “plaque” on our teeth. Brushing and flossing help get rid of plaque which, if not removed, can harden into bacteria-harboring “tartar”. The tartar cannot be brushed away. It must be removed by a professional dental cleaning (Thank goodness for dental hygienists!)

See my website for more information on Periodontal Disease