New efforts are being made to ensure all patients, including those who have regularly seen a dentist, are aware of the condition of their teeth and gums, and that they realize the connection between their mouth and their body.  

Modern research has shown that Periodontal (Gum) Disease affects more than just your mouth.  It puts you at risks for other conditions such as artherosclerosis, diabetes, etc.  Modern research lets us understand and treat gum disease better than we used to.  Patients that have never had gum disease, patients that have gum disease presently, and patients that have had gum disease in the past can all benefit from educating themselves as to what gum disease is and how to treat it.

What measures can I take to make my mouth healthy?

• All mouths need good home care (brushing, flossing, rinsing) and regular checkups.
• The most determining factor in achieving good oral health is YOU.

How do I know if I have Periodontal Disease?

Multiple signs and symptoms can alert you that you have some form of periodontal disease. 

A professional exam using a periodontal probe checks for pockets in the gums and measures the amount of tissue damage if present.  These measurements are used to classify the severity of disease and to measure stability over time.

What is the overall goal of treatment for periodontal disease?

• No matter the severity of disease, the treatment principals are the same:  rid the infected and inflamed areas of your mouth of harmful bacterial biofilms and the deposits that are associated with them in order to halt the progression of disease.
• Therapeutic cleanings describe the initial non-surgical treatments designed to accomplish this goal of treating the deeper pockets of gum disease.
• The overall goal:  Maintain a healthy mouth that is free of pockets for bacteria to reside in, that is absent of bacterial biofilms, and tissues that are not inflamed.

Are there any differences in this treatment for someone with early disease vs. someone with advanced disease?                        

• There are differences- the scope and depth of the cleaning is different and the time needed to do treatment is different.  A person with moderate gingivitis may be able to reverse their condition with less overall treatments than a person with advanced periodontitis.
• The goals of therapy are the same no matter the severity of the condition.  The amount of therapy needed to achieve those goals is what differs.

I’d rather have the cleaning my insurance pays for fully rather than a cleaning I have to pay some out of pocket for.  Why can’t I just have checkups/twice a year cleanings for my condition? 

Much like just doing checkups for cavities won’t actually fix a cavity, just doing checkup cleanings won’t actually fix or treat advanced gum disease.

A comparison:

• Brushing, flossing, fluoride, and sealants are done to prevent cavities from starting.  But, if a cavity has started and is already there to be diagnosed at a checkup, brushing won’t make it disappear, nor will a sealant fix it.  A filling is the typical initial treatment for a cavity. 
• The number of teeth that have cavities and the size of those cavities determines the amount of treatment you need, the number of appointments you need, and the overall costs.  

In a similar way, a therapeutic cleaning is the treatment for gum disease just like a filling is the treatment for tooth decay (cavities).  Insurance typically pays fully for less costly preventive treatments but only partially if disease is present and therapeutic treatment is necessary.

• Brushing, flossing, and preventive cleanings at checkups are done to prevent gum disease from starting.  But, if advanced gum disease has started to occur and is there to be diagnosed at a checkup, brushing won’t make it disappear, nor will a twice a year preventive cleaning fix it.  A therapeutic cleaning, not a preventive one, is the typical treatment for advanced gum disease.
• The number of teeth that have gum disease pockets and the size of those pockets determines the amount of treatment you need, the number of appointments you need, and the overall costs.  Insurance typically pays for any preventive treatments for gum disease, but if disease is present, insurance only pays for a percentage of the therapeutic treatment necessary to fix the problem.

Will a therapeutic cleaning/scaling therapy fix all my gum problems?

• No.  The most important factor in maintaining a healthy mouth is you.
• Scaling therapy will remove the irritants that contribute to gum disease.  This can allow your gums to heal and become healthier, but your gum problems may not get better if home care and regular dental care are not maintained after treatment.  It does not take long for the bacterial plaques to rebuild, especially if habits go unchanged.  If bacteria repopulate your gum tissues, then they will not stay healthy.
• There are multiple factors that are involved in the healing response after initial scaling therapy.  Good home care and regular dental visits are a must.  Other factors that can contribute are tobacco use, systemic disease (such as diabetes), immune response, genetics, etc.
• The important thing to remember is that your mouth cannot become healthier without first removing the bacterial source of the problem. 
• Adjunctive therapy may be needed if initial therapy is not completely successful.  These include antibiotic therapies, surgical therapies, and possible referral to a periodontal specialist if your gum disease does not respond to initial treatment.

Why can’t I just do regular cleanings (prophy) to treat gum problems?

• Regular cleanings are intended to keep a person without active periodontal disease from getting periodontal disease.  The scope of these cleanings will not get into the pockets of someone that does have gum disease.  If a person with gum disease chooses to maintain regular cleanings without doing necessary deep scaling, their disease can continue to worsen over time.
• A person that has not had a cleaning in a length of time is likely going to need more than one visit to “catch up” to a person that has maintained regular cleaning visits.   Gingivitis is likely present and some scaling may need to be done.
• If a person has undergone successful scaling therapy that has reduced all gum pockets, then regular cleanings may be all that is needed after that.

Why might I need Periodontal Maintenance instead of a prophy?

• Periodontal Maintenance is a regular cleaning designed for patients that have had scaling treatments but that are still not completely resolved.  It includes some deep scaling that may be necessary on deeper pockets to try and keep them at an acceptable level.
• Relapse can happen-additional therapy over your lifetime is a possibility.  Maintaining regular cleaning visits and practicing good habits are the best way to prevent recurrence.