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.

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.

Six weeks after Active Periodontal Therapy (APT), we have our patients back for re-evaluation. We reprobe every tooth in the mouth, evaluate the tissue tone and texture and take intra-oral photos to show you the results. This is our report card. How well did we do with our clinical treatment, with our homecare instructions to you, and with our emotional appeal and motivation to you to save your teeth? (For more information go to www.lajolladental.com)
We may have been totally successful, or only partially successful. If we are totally successful and all the pockets have shrunk to 3mm or less, the tissue tone pink and firm, and you are religiously cleaning your mouth, then we celebrate! If we were only partially successful, we need to identify what is going on – or in some cases, what is not happening (i.e. daily) through homecare. We may be able to make some corrections and reconvene in another 6 weeks for re-evaluation, or we may need a referral to a gum specialist for evaluation of one or more sites. Often, the treatment of gum disease is not all or nothing. We may be successful in 60, 70, 80 or even 90% of the areas, and unsuccessful in just a few spots. Those few spots may need treatment by a gum specialist, and often involve surgery.
http://www.nidcr.nih.gov/oralhealth/topics/gumdiseases/periodontalgumdisease.htm

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.

Gingivitis is inflammation of the gums caused by the prolonged presence of plaque and tartar on the teeth. The gums become red, puffy and swollen. Gingivitis is a mild form of gum disease that can be reversed with professional dental cleanings by our hygienist and daily brushing and flossing. The gums may bleed during the cleaning and initially when flossing. Gingivitis can be reversed (the inflammation eliminated) because it does not involve bone loss or gum recession.
When the gums are not treated (the person may be brushing but not flossing) the inflammation increases to a point in becomes periodontitis. Here, the plaque builds up below the gums forming pockets. The body’s natural immune system creates enzymes that fight the bacterial toxins within the pockets, but mechanical removal of the plaque and tartar are essential. Left untreated, with time the pockets become deeper, bone loss around the teeth occurs, and the gums recede. Sooner or later the teeth become loose.

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Following up on my previous blog, gum disease also has a link to cancer in men. From the June issue of The Lancet Oncology, men with a history of gum disease are 14% more likely to develop cancer than men with healthy gums. The report states that men with periodontal disease may be 30% more likely to develop blood cancers, 49% more likely to develop kidney cancer, and 54% more likely to develop pancreatic cancer. Gum disease cannot be cured, but certainly can be controlled by daily brushing and flossing, and routine visits for professional cleaning as a minimum.

Cardiovascular disease kills more Americans each year than cancer. Most people are aware that lifestyle choices such as quitting smoking, eating right, and getting enough exercise can lessen one’s risk of cardiovascular disease. But, what most may not know, is that by just brushing and flossing their teeth each day, they can also prevent this potentially lethal condition.
Periodontal patients whose bodies show evidence of a reaction to the bacteria associated with periodontitis (gum disease) may have an increased risk of developing cardiovascular disease, according to the Journal of Periodontology (December 2007). Thus, it is important to understand that simple activities like brushing and flossing your teeth everyday, and periodic professional cleanings at the dental office can help lower your risk to cardiovascular disease and other conditions.

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We recently welcomed a new patient who came to see us about upgrading his smile. He had a mouth-full of porcelain crowns and veneers done in the past that he was no longer happy with. My concern, when we saw him, was the bright redness of his gums right around each of his restorations. The margins of the restorations are breaking down, retaining plaque, and causing this gum inflammation. I told him his tissue is the first issue, then we can improve the appearance of his smile. He agreed with my concern, and we scheduled his first hygiene visit this week. I sent him home with the abstracts of several articles relating to periodontal disease in his mouth (the redness, puffiness, and recession of his gums) to his general health. Periodontal disease has been linked to tooth loss, subclinical atherosclerosis, and future stroke. Gum disease, also, may affect the development and course of systemic diseases such as cardiovascular disease, bacterial pneumonia, diabetes mellitus, and low birth weight. Now, he can’t get started quick enough!