Dental Hygienists Provide More Than A sparkle
The major cause of tooth loss is still periodontal or gum disease
. This is by and large preventable and almost always controllable. The general build-up of plaque at the interface between the gum and the tooth is the main reason for this chronic condition. The 'toxins' within the local bacterial plaque initiates a breakdown of the tissue that attaches the gum to the neck of the tooth and a 'pocket' is formed. The consequence is a deeper crevice around the teeth . Difficulty in cleaning ensues and over time this pocket will deepen. In a healthy environment this crevice is about 2mm in depth . The pocket that develops can easily reach in excess of 10mm. Beyond about 5mm the pockets become unmanageable and can deepen quite rapidly. At the same time bone loss ensues and consequent loss of the fibres that join the teeth to the bone. Then inevitably tooth mobility and loss will occur . Often at this stage the patient will develop a periodontal abscess.
Once the plaque bacterial film has been allowed to accumulate even for a relatively short period of time it will calcify and harden. This then makes it impossible to remove without a professional clean or descaling. In time inevitably this will lead to bone loss around the teeth and localised recession. This can be either totally painless until very advanced or develop into a periodontal abscess with unpleasant symptoms.
The latest suggestions of a link between periodontal disease and other non dental medical conditions is gaining momentum. The list includes diabetes , cardio vascular disease Alzheimer's ,strokes, chronic kidney disease , respiratory problems and Rheumatoid Arthritis.
We are also finding that there is a genetic predisposition to periodontal disease
At the Dental Practice there are often trained hygienists who will remove the scale also known as calculus. This collects both above and below the gum line. Often the patients can only see the deposits above the gum line and not the perhaps more troublesome layer underneath .The
Dental hygienists use both ultrasonic and hand instruments to do this a recent advance is the use of LED ultrasonics to ensure optimum visibility. Sometimes it is necessary to undertake a deeper cleaning called root planning and this procedure removes further deposits and inflammatory tissue from within the deeper pockets. This is often carried out with either local anaesthesia or the newer topical anaesthesia which is a gel placed directly into the pocket. They find the patients prefer this approach as there is no residual numbness.
Latterly air-polishing has been introduced to remove those stains from certain food stuffs or cigarettes that are reluctant to leave. They use a high pressure power spray essentially using bicarbonate under pressure, it takes a little longer but the results do justify it.
For more advanced states of periodontal disease a periodontist may work together with the hygienist and possibly consider some surgical therapy. this may range from removing the pockets grafts and/or repositioning the gum.
by: Arun Singh
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