Deep Cleanings

At your first dental visit either Dr. Toole or one of our dental hygienists will complete a full periodontal exam in order to determine what type of hygiene care you need.  This exam will include evaluation of your x-rays, a visual assessment of your teeth and recording the pocket depths around your teeth.  A periodontal probe (small dental instrument) is gently used to measure the sulcus (pocket or space) between the tooth and the gums.  The depth of a healthy sulcus measures three millimeters or less and does not bleed.  The periodontal probe helps indicate if pockets are deeper than three millimeters.  As periodontal disease progresses, the pockets usually get deeper. 

Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into a category below:

Gingivitis

Gingivitis is the first stage of periodontal disease.  Plaque and its toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed.

Periodontitis (Gum Disease)

Plaque hardens into calculus (tartar).  As calculus and plaque continue to build up, the gums begin to recede from the teeth and the bone supporting teeth begins to break down.  Deeper pockets form between the gums and teeth and become filled with bacteria and pus.  The gums become very irritated, inflamed, and bleed easily.  Slight to moderate bone loss may be present.

Advanced Periodontitis (Advanced Gum Disease)

The teeth lose more support as the gums, bone, and periodontal ligament continue to break down.  Unless treated, the affected teeth will become very loose and may be lost.  Generalized moderate to severe bone loss may be present.

When left untreated, gingivitis (mild gum inflammation) can spread to below the gum line.  When the gums become irritated by the toxins contained in plaque, a chronic inflammatory response causes the body to break down and destroy its own bone and soft tissue.  There may be little or no symptoms as periodontal disease causes the teeth to separate from the infected gum tissue.  Deepening pockets between the gums and teeth are generally indicative that soft tissue and bone is being destroyed by periodontal disease. 

Treatment for Periodontal Disease

Scaling and root planing (Deep Cleaning):   Scaling and root planing is the process of removing all the plaque and tartar (hardened plaque) above and below the gumline, making sure to clean all the way down to the bottom of the pocket. Your hygienist will then begin root planing, smoothing out your teeth roots to help your gums reattach to your teeth.   To minimize any discomfort or pain, your provider numbs your mouth with a local anesthetic to numb the area.