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Non-­Surgical Procedures

Scaling and Root Planing

Non Surgical Periodontal Therapy also known as scaling and root planing or “a deep cleaning” is often recommended as the first step in periodontal therapy. Treatment is done by one of our hygienists using local anesthesia to provide comfort for the patient as the root surfaces in deep periodontal pockets are debrided to remove calculus or “tartar” and to smooth the root surfaces to remove bacterial toxins. This may take more than one visit with the hygienist and is followed up with a visit with Dr. Britten in four to six weeks to re­evaluate the periodontal tissues.

Periodontal Maintenance

A Periodontal Maintenance is a procedure that includes removal of plaque and tartar from above and below the gumline, all the way down the length of each tooth to where the root, gum and bone meet. Rough areas are smoothed out if needed, pocket depths are carefully monitored and inflamed pockets may be irrigated with antibacterial medications if necessary.

If you have periodontal disease which has resulted in bone loss, gum “pockets” deeper than 4 mm, bleeding gums, exposed root surfaces, or if you have had periodontal surgery or root planning, it is important to alternate cleanings between our office and your general dentist. Your general dentist will keep an eye on your teeth, while we focus mainly on the foundation around them. Periodontal Maintenance is one of the most critical factors in maximizing the longevity of the results received after scaling and root planing or periodontal surgery.

We are often asked, “What is the difference between a regular cleaning and a periodontal maintenance?” A Regular cleaning, or “prophylaxis,” is different because the hygienist removes soft plaque, tartar and stains from the teeth above the gumline and only slightly below. A regular cleaning is done with your general dentist 2 to 3 times per year depending on how quickly stain, plaque and tartar accumulate.

Occlusal Therapy

Our occlusion (bite) forces are evenly distributed among all of our teeth. When something occurs to alter a healthy occlusion; like loss of a tooth, clenching and grinding, occlusal trauma can occur. There are several signs and symptoms of occlusal trauma including, wear or chipping of the teeth, sensitive crevices on the teeth, gum recession, shifting teeth, tender muscles, headaches, or a “popping” sound when opening and closing your mouth. This trauma places excessive pressure on teeth and these forces can contribute to bone loss and result in the loosening of the teeth. The goal of occlusal therapy is to create an even distribution of these forces allowing the bone and ligaments to heal. This is done by an occlusal adjustment or equilibration to divide the biting pressure evenly across all of the teeth by reshaping the biting surfaces of the teeth and eliminating spots of excessive pressure when the teeth are brought into contact. The use of an occlusal night guard may be needed to control the pressures generated by clenching and grinding.

Diagnostic

The inside of the mouth is normally lined with a special type of skin (mucosa) that is smooth and coral pink in color. Any alteration in this appearance could be a warning sign of something more serious. Our biggest concern would be oral cancer. The following can be signs at the beginning of a pathologic process or cancerous growth:

  • Reddish patches (erythroplasia) or whitish patches (leukoplakia) in the mouth.
  • A sore that fails to heal after two weeks and bleeds easily.
  • A lump or thickening on the skin lining the inside of the mouth.
  • Chronic sore throat or hoarseness or difficulty in chewing or swallowing.

These changes can be detected on the lips, cheeks, palate, and gum tissue around the teeth, tongue, face and/or neck. Pain does not always occur and is not always associated with oral cancer.

We would recommend performing an oral cancer self­ examination monthly. Dr. Britten and his staff do an oral cancer screening at every visit. Do not ignore suspicious lumps or sores. Please contact us so we may help.

The top five most common contributors to oral cancers:

1

Tobacco and alcohol use

Tobacco and alcohol use. Most cases of oral cancer are linked to cigarette smoking, heavy alcohol use, or the use of both tobacco and alcohol together. Using tobacco plus alcohol poses a much greater risk than using either substance alone.

2

Infection

Infection with the sexually transmitted human papillomavirus (specifically the HPV 16 type) has been linked to a subset of oral cancers at any age.

4

Age

Risk increases with age. Oral cancer most often occurs in people over the age of 40.

4

Sun

Sun exposure can cause skin cancer on the lips.

4

Diet

A diet low in fruits and vegetables may play a role in oral cancer development.