Periodontal Deep Cleanings

Periodontal disease, commonly known as gum disease, affects about 47% of the adult population and is the number one cause of tooth loss in adults. Many denture cases begin because of this chronic condition and more adults lose teeth due to advanced gum disease or gingivitis (periodontitis) than due to cavity formation. With periodontal cleanings and proper at-home care, you can prevent painful and costly damage to your teeth and regain a perfect, healthy smile.

Deep cleaning involves scaling and root planing

Gum disease can advance with few signs or symptoms in early stages. Many patients diagnosed with this condition experience no pain and are surprised by the quiet yet swift damage that periodontal disease leaves in its wake. In simple terms, consider the gums and bone around your teeth as the foundation of a house. Just like a house, the foundation must be sound regardless of the beauty of the home.

Regular dental exams, professional cleanings, and good oral hygiene practices at home are essential to detecting and strategically managing periodontitis.

How Does Gum Disease Begin?

Our mouths provide a home to millions of bacteria, both beneficial and harmful. Bacterial waste forms a sticky substance, plaque, which adheres to the teeth. Brushing and flossing aim at removing bits of decaying food and the plaque that forms as bacteria feed on the nutrients left in your mouth. Left undisturbed, plaque mineralizes into tartar, and tartar harbors colonies of bacteria that release toxins.

Streptococcus Salivarus and bacteria that may contribute to gum disease close up

Gums react to this bacterial invasion with an inflammatory response from your immune system. Around the base of each tooth, there is a small collar of gum tissue that forms a small crevice or pocket. This warm, dark environment provides a perfect habitat for deeper tartar and bacteria to infiltrate.

Early inflammation results in bleeding gums, known as gingivitis. Bacteria left untreated and undisturbed successfully create a chronic infection in the periodontal pocket. In many cases, the bone begins to deteriorate around the teeth. While gums may be slightly tender at this stage, there's generally minimal discomfort as the bone begins to erode.

More than 50% of the bone around your teeth can disappear before any signs of looseness or pain appear. The bone around teeth never regenerates, so this loss becomes permanent and harder to control as the bacteria hide deeper into the gums. Untreated gum disease leads to abscesses and generalized tooth loss in many advanced cases.

Gum Pocket Diagnosis

There are several factors we take into account before we make a gum disease diagnosis. The small collar of gum, or pocket, around each tooth usually sits 2-3 millimeters deep, a space easily cleaned by floss or toothpicks. A small measuring device called a periodontal probe is used to accurately gauge the depth of the gum pockets. If you hear your dentist call out a number higher than 3 as they are probing, then you very likely need to see a periodontist. Deeper readings indicate more advanced disease.

Dr. Kelner will also evaluate the texture and shape of your gums and any movement detectable in each tooth. It's also vital to examine the levels, shape, and density of the bone around your teeth on digital X-rays. By collecting all of this data, a clear picture forms about your gum condition.

Gum Disease Treatment

After establishing a diagnosis defining the severity of gum disease, we can develop a personalized treatment plan. In milder forms with little or no bone loss, one or two visits with our hygiene team may bring the condition under control. When you leave our office after a thorough deep cleaning and with a strategy for daily home care, little additional treatment may be needed.

Over a few visits, a portion of your mouth at a time will be deep cleaned. The infected pocket around each tooth, including the mineralized tartar, must be carefully cleaned out. Polishing the teeth to establish smooth surfaces that help repel stain and plaque accumulation usually finishes this initial therapy.

Dr. Kelner may suggest a medicated rinse, an electric or ultrasonic toothbrush, and other specific strategies to help you with your home care routine. Remember, gum disease can be controlled but not cured. Dedicated daily efforts must be consistent to control the disease.

Maintenance Matters

Regular home care is critical to arrest the progression of gum disease. Within a few hours of cleaning, the bacteria begin to repopulate and adhere to the teeth. Plaque left undisturbed will start to harden and mineralize within 24 hours. Remember, deeper gum pockets require even more diligence to prevent the bacteria from undermining the foundation of your teeth.

Since gum pockets previously damaged by bacteria can be difficult to reach at home, a faithful maintenance schedule with your periodontist is essential. Dr. Kelner will customize a treatment plan just for what you need.

  • A deep cleaning, also called scaling and root planing, removes plaque and tartar both above and below the gumline. Regular cleanings help prevent problems, but deep cleanings are needed to treat active gum disease.

  • If your gum pockets measure more than 3 millimeters or your gums bleed during brushing or flossing, you may need treatment. We confirm this with a periodontal exam and digital X-rays.

  • Most patients with a history of gum disease need maintenance visits every 3 to 4 months. This helps remove buildup before it becomes harmful and allows us to monitor your progress. Most periodontal patients will opt for 4 cleanings per year, two deep cleanings with a periodontal practice, and two routine cleanings at a general dentist’s office.

  • Gum disease often causes no pain until it's advanced. It can lead to bone loss, tooth loss, and has been linked to other health issues like heart disease and diabetes. Early treatment prevents long-term damage.

  • Yes, you should always see a general dentist regularly. Most patients seeing a periodontist will alternate between routine cleanings with a general dentist and periodontal deep cleanings every 3 months. Four cleanings per year is ideal if you have advanced or chronic gum disease. Periodontal deep cleanings involve both tooth scaling and root planing. Cleaning below the gum line is often necessary to remedy and prevent gum disease and is not performed at a general dentist’s office.

Mouth-Body Connection

Research continues to establish clear links between bacterial disease in your mouth and ailments in other parts of the body. Studies show a strong link between oral bacteria and heart disease, stroke, arthritis, Alzheimer's, and even certain types of cancers. The relationship between a person’s oral health and their whole body health has never been better understood than it is today.

Bleeding gums provide a direct pathway into the bloodstream, a journey that oral bacteria can quickly take. If an open wound existed on your skin, infection would be a concern. Gum tissue that bleeds should be looked at no differently. This helps explain why researchers continue to identify oral bacteria deposits in various areas of our bodies.

Diabetes and other auto-immune disorders lower the body's ability to fight infection, allowing uncontrolled gum disease to advance faster and with more destruction. Research also confirms that the inflammation in the mouth can aggravate diabetes, making it harder to control. This two-way relationship between two chronic conditions emphasizes the importance of optimal oral health.