Periodontal (gum) disease is insidious. It is an infection of the gums that starts out as plaque, an opaque film on the teeth that hardens to form tartar. As tartar accumulates, it harbors bacteria that attack the soft tissue around the gums. This is the early stage of gum disease known as Gingivitis. Left untreated, Gingivitis becomes Periodontitis which ultimately destroys the tissue surrounding your teeth AND the bone that holds your teeth in place. Except for bad breath and gums that bleed, there are very few early warning signals. The disease advances silently, often without pain, and before you know it, you are losing your teeth and you don't know why.
Tooth loss is only the most obvious indicator of gum disease. Scientific research has discovered linkage between gum disease and stroke, heart disease, diabetes - even an increased risk for pregnant women. When your gums become diseased, your entire immune system is weakened.
In the past, fear of painful dental surgery has kept people with gum disease from seeking the care they needed. Well, those days are gone forever.
Regular Cleaning vs Periodontal Maintenance
Patients often ask why they are having “periodontal maintenance” when all they want is to have their teeth cleaned. If your dentist or hygienist has recommended that you be scheduled for periodontal maintenance, or if you have noticed that there is a difference in billing for these procedures, here is a brief explanation:
Prophylaxis, or Regular Cleaning
A regular cleaning is recommended for patients who do not have bone loss, periodontal disease, or infection around the teeth. There should be no bleeding, mobility of the teeth, receded areas, or gaps where the spaces around the roots of the teeth are exposed. In other words, the mouth should be healthy with no bone or gum problems. A regular cleaning, or prophylaxis, removes soft plaque, tartar, and stains from the teeth above the gum line, and only slightly below.
A regular cleaning is usually done 2 to 3 times a year, depending on how quickly stain, plaque, and tartar accumulate. It is considered a preventive procedure by your insurance carrier, since regular cleanings will help prevent periodontal disease.
If you have periodontal disease that has resulted in bone loss, gum “pockets” deeper than 4 millimeters, bleeding gums, exposed root surfaces, or if you have had periodontal surgery or root planning to treat periodontal surgery or root planning to treat periodontal disease, a regular cleaning is not appropriate. Periodontal maintenance scaling is needed to maintain gum and bone health. This procedure includes removal of plaque and tartar from above and below the gum line, all the way down the length of each tooth to where the root, gum, and bone meet. Rough areas of the roots are smoothed if needed, pocket depths are carefully monitored, and inflamed pockets may be irrigated with antibacterial medicines if necessary.
Periodontal maintenance is considered a basic service by your insurance carrier, and may be subject to a yearly deductible. PM is usually performed 3 to 4 times a year, depending on several factors: how quickly the plaque and tartar accumulate, how much bleeding or inflammation is present, how stable the present condition is, how well you are able to maintain your teeth at home on a daily basis, and any health risk factors you may have.
We know that there is a relationship between chronic inflammation in the gums and overall health, especially heart disease and diabetes. Keeping the gums and the bone surrounding your teeth as healthy as possible is an important part of your regular dental visits or hygienist.