Periodontal and Hygiene Services

When you have an appointment with one of our hygienists, a thorough assessment of the health of your entire mouth is performed. An oral cancer screening is done to evaluate any unusual areas on your tongue, palate, inside cheeks, or lips. Your throat and tonsillar area is also screened for any unusual findings. Diagnostic criteria are used to determine the health of your gums and bone levels. This establishes what hygiene services are most appropriate for you. Adjunctive Services may also be recommended as needs are seen. Fees vary depending upon what services most appropriately suit your needs.

Diagnostic Criteria

  • Probing depths - an instrument with millimeter markings is placed in six places around each tooth to measure where the gum is attached to the tooth. Readings of three millimeters or less represent good attachment levels and indicate a reasonable space for you to easily remove the bacteria that cause periodontal disease.
  • Bleeding - is a sign of disease, and our goal is to see none when we stimulate the gums with instruments. The presence of bleeding alerts us that areas need to be addressed. Your efforts at home together with appropriate treatment in our office are usually successful.
  • Bone level assessment - by use of radiographs ( x-rays) show us whether the bone is healthy or loss has occurred from the presence of diseased tissue.

Hygiene Services

  • Adult Prophylaxis - A thorough removal of mild stain, plaque and tartar in the areas of the teeth visible to the patient with no diagnosable pocket depth below the gumline; little to no bleeding when this is accomplished. A recare interval of three, four, or six months in between prophylaxis visits is determined by how quickly these bacterial and calcified deposits reappear on your teeth.
  • Difficult Prophylaxis - This is usually the procedure needed for the patient that presents after a long absence from dental care, is fortunate to not have progressive periodontal disease but has a greater than average amount of buildup to remove in one visit.
  • Mini Prophylaxis - A shortened visit in between regular recare visits to address unusual amounts of stain , plaque and tartar or high risk for decay. When regular plaque control is inadequate, perhaps due to a compromise of eyesight or dexterity, these mini prophies maintain stability. Greater risks for decay may warrant our recommending fluoride applications as frequently as every four to six weeks.
  • Full Mouth Debridement - When someone presents with a large amount of removable plaque, calculus(tartar) and/or stain, often we need to remove the largest amounts on the first visit to be able to accurately probe the gum tissue, determining what services are necessary to return to health. Often, removing the majority of the bacteria will allow the tissues to return to a healthy state. In such cases, a regular prophylaxis is all that follows. Should the pocket depths and bleeding indicate progressive or uncontrolled disease, often a series of scaling and root planing appointments are necessary.
  • Scaling and Root Planing - The goal of scaling and root planning is to eliminate the source of periodontal infection by removing the causative plaque, calculus and bacterial toxins from the root surfaces. Using specialized instruments, we carefully remove debris beneath the gumline and smooth the root surfaces thus removing the source of the infection. This may take from one appointment for a select 1-3 teeth or up to four appointments if the whole mouth is involved.
  • Periodontal Maintenance - once you have been diagnosed as having periodontal disease and the disease is treated it will be necessary for you to come in for three month periodontal maintenance visits. At these visits, your bone levels will be measured and monitored, inflammation and disease progression will be carefully assessed. In addition, plaque and calculus buildup will be removed. This will allow us to help you control the infection and give you the best prognosis for future health.

Adjunctive Services

  • Fluoride - Fluoride is like vitamins for your teeth- The use of a paint on fluoride varnish is indicatd when there is a high risk or incidence of decay due to damaged enamel ,exposed root surfaces, or heavy plaque. The goal of fluoride is to strengthen the tooth structure and make it more resistant to the acids produced by decay causing bacteria.
  • Arestin - a minocycline antibiotic powder that is placed in between the tooth and gum in site specific areas of disease measuring 5 mm. or more. We place this in an attempt to keep the area free of bacteria and infection , allowing the pocket to shrink in size.
  • Desensitization - A few different materials are available to help tooth surfaces that are especially sensitive to stimulation. They can be used selectively in places you find uncomfortable to perhaps cold or sweet. Placement at the site of sensitivity often yields immediate results.
  • Sealants - Sealants are recognized as an effective decay preventing procedure by the National Institutes of Health and the American Dental Association. They are a resin material placed into the anatomic grooves and chewing surfaces of at risk teeth. Without anesthesia and often without the need for drilling, the tooth is treated with liquids that prepare it for the sealant adherence. Once the sealant material is placed, a high intensity light is used to cure it in place, thereby creating an impenetrable barrier. Depending upon the individual patient, periodic replacement of sealants may be indicated.