What does it mean when your dental hygienist recommends root planing? To put it simply, root planing is a method of cleaning the roots of your teeth in order to avoid periodontal (“peri” – around, “odont” – tooth) disease.

Periodontal disease happens when dental plaque, a biofilm of bacteria, is not regularly removed and begins to build up on teeth near the gum line. The bacteria cause inflammation, and this in turn causes the gum tissue to detach from the teeth. The widening spaces between the gum tissue and the teeth, called pockets, are environments in which bacteria can continue to collect and cause further inflammation and infection. Ultimately, this can lead to infection, bone loss, and loss of teeth.

Root planing is a technique designed to avoid such dire results. The bacteria, along with products they manufacture as part of their metabolism, can become ingrained in the surfaces of the tooth's root (the part of the tooth that is below the enamel). These bacterial products will form hard deposits called tartar or calculus.

Deep Cleaning Your Teeth
Of course, the best idea is to brush and floss away the plaque before the bacteria begin to build up on your teeth. If this is not done and pockets begin to form, the bacteria and toxic products are more difficult to remove in order to deep clean your teeth.

The first step is scaling. My hygienist or I will remove superficial collections of calculus. If material still remains within deep pockets, root planing is the next step. It involves actually planing the surface of the root, smoothing the surface free of calculus, bacteria, and toxins that have ingrained into the root surfaces.

Root planing is most often done under local anesthesia so that you remain comfortable while the cleaning procedures are done. The initial cleaning may be done by an ultrasonic instrument that vibrates particles off the root surfaces and flushes the pockets with water. Small hand instruments called curettes are used to finish the process. Antibacterial medication may then be used to help clear away infection from the pockets. Sometimes you may experience some tooth sensitivity to hot and cold after the root planing. If needed, this can be treated by applying fluoride to the root surfaces.

Depending on the extent of your gum disease, it may not be possible to remove all the deposits at one appointment, and it may be necessary to have multiple appointments over a few weeks to remove the remaining deposits. Often after three to four weeks the inflamed tissues have healed, leaving you with healthy gums once again.

Contact us today to schedule an appointment to discuss your questions about dental hygiene and root planing. You can also learn more by reading the Dear Doctor magazine article “Root Planing.”

Studies have shown that as many as 75 out of every 100 people fear dental visits; and for 10 to 15 of them, the fear is so great that they never get treatment — leading to serious dental problems and worse. Untreated disease in your teeth and gums can negatively affect the health of your entire body.

How can you conquer your fears so you can get the treatment you need? The answer includes (a) working with us to overcome your fears and have a positive experience while undergoing dental treatment, and (b) using oral sedation or anti-anxiety medication to help you quell your fears and relax.

Overcoming Your Fears

People develop fear of the dentist when they have a bad dental experience themselves, or sometimes when they hear of a bad experience someone else has had. The more you are afraid, the more you feel the symptoms of fear, and the more you connect those symptoms with the experience. You need to stop this negative memory sequence and replace the feelings of fear and loss of control with memories of good experiences and feelings of being in control.

It helps to know that you are not alone in your fears and that you can do something positive about them. First, make an appointment to discuss your fears with us, your dental professionals. Start with small procedures that cause only mild anxiety, and give yourself adequate time to get over your fears.

Using Oral Sedation

You have already gradually reduced your fear through your discussions and previous appointments. When you are ready to go to the next step, consider using oral sedatives or “anxiolytics” (meaning that they dissolve anxiety) to help you feel relaxed and comfortable.

Oral sedation — so called because you take it by mouth — allows you to let your guard down and focus on feeling peaceful, yet you remain awake and in control. The medication is either placed under your tongue and dissolved there (sublingual) or swallowed whole. Since it is taken by mouth, it does not require an injection, so it is easily taken by people who are afraid of injections.

The oral sedative and anxiolytic medications dentists use have been subjected to rigorous research and testing and have a long safety record after decades of use.

By using this two-step process you can reduce your fears and begin to get the care you need. And we, your dental professionals, are able to work more efficiently because we can focus on the work at hand, knowing that you are comfortable and relaxed.

Contact us today to schedule an appointment to talk about any fears you may have. You can also learn more by reading the Dear Doctor magazine articles “Overcoming Dental Fear & Anxiety” and “Oral Sedation Dentistry.”

Yes, dental x-rays are a safe and vital tool we use for measuring and monitoring your oral health. We feel it is imperative to ensure that our patients have the facts — especially when it comes to their oral healthcare. This is why we want to respond to this important question about the safety of dental x-rays.

We want you to know what they are, how they are used, what makes them a safe and effective tool, and why they are so important to dentistry and your health. X-rays are a form of electromagnetic radiation, in fact, just like natural daylight, except they have a much shorter wavelength. And because they are a form of ionizing radiation, they can easily penetrate bodily tissues without causing any harm when used properly. The reasons we use them are obvious; they help us literally see what is unseen. For example, they enable us to see bone structure and roots of teeth among other things, and are commonly used for diagnosing tooth decay. Furthermore, today's x-ray machines and other image capturing techniques are so sophisticated and sensitive that the amount of radiation required for diagnosis is almost nothing when compared to what you get from the background radiation present in everyday living. In fact, the average single digital periapical (“peri” – around; “apical” – root end of a tooth) film is equal to 1/10 the amount of everyday natural environmental exposure. These facts make it clear that dental x-rays are completely safe and, thus, are nothing you need to be concerned about.

Learn more about this topic by reading the Dear Doctor magazine article “X-ray Frequency And Safety.” If you need to schedule an appointment, contact us today.

We in dentistry, advise parents to have an orthodontic evaluation some time before your child is 7 years of age. At this time, some of your child's adult teeth have come in and some primary (baby) teeth remain. This is a good time to check for developing problems. Treatment that begins while your child's teeth are coming in is called “interceptive orthodontics.” It provides an opportunity to achieve the best results in orthodontic treatment.

Once this evaluation takes place, it may mean that orthodontic treatment may need to take place in two-stages. A first phase of orthodontic treatment may prevent, intercept or minimize future orthodontic treatment. The first stage may be a process of guiding the growth of the jawbones that support the teeth. This is called “growth modification.” Then when the adult teeth have erupted through the gums, it may be time to do the second and final stage.

If a second phase of treatment is necessary it will probably require braces. These are small metal brackets that are bonded to the teeth. Thin flexible wires are threaded through them, and the wires are designed to push or pull on the teeth to provide a small amount of pressure that makes the teeth slowly reposition themselves within the jawbone. A light and controlled force pulling on a tooth causes new bone and ligament (the fibers that hold teeth in place) to be formed. These are living tissues that are constantly changing and remodeling themselves.

If you wait until your child's permanent (adult) teeth have all come in to start this process, it will be too late to correct some types of orthodontic problems, such as some types of malocclusions (“mal” – bad, “occlusion” – bite). It's better to work together with your child's stages of growth and development in order to have an optimum correction, both in looks and function.

You may be wondering whether a two-stage treatment costs twice as much. In fact, it is likely to be less expensive than a late one-stage treatment would be. Sometimes, the first stage may correct an underlying problem and make further treatment unnecessary. If a second phase is needed, it is likely to be easier and less costly.

Contact us today to schedule an appointment to discuss your questions about orthodontia for your child. You can also learn more by reading the Dear Doctor magazine article “Preventative & Cost Saving Orthodontics.”

When it comes to sensitive gums during pregnancy, Nancy O'Dell, the former co-anchor of Access Hollywood and new co-anchor of Entertainment Tonight, can speak from her own experience. In an interview with Dear Doctor magazine, she described the gum sensitivity she developed when pregnant with her daughter, Ashby. She said her dentist diagnosed her with pregnancy gingivitis, a condition that occurs during pregnancy and is the result of hormonal changes that increases blood flow to the gums. And based on her own experiences, Nancy shares this advice with mothers-to-be: use a softer bristled toothbrush, a gentle flossing and brushing technique and mild salt water rinses.

Before we continue we must share one important fact: our goal here is not to scare mothers-to-be, but rather to educate them on some of the common, real-world conditions that can occur during pregnancy. This is why we urge all mothers-to-be to contact us to schedule an appointment for a thorough examination as soon as they know they are pregnant to determine if any special dental care is necessary.

Periodontal (gum) disease can impact anyone; however, during pregnancy the tiny blood vessels of the gum tissues can become dilated (widened) in response to the elevated hormone levels of which progesterone is one example. This, in turn, causes the gum tissues to become more susceptible to the effects of plaque bacteria and their toxins. The warning signs of periodontal disease and pregnancy gingivitis include: swelling, redness, bleeding and sensitivity of the gum tissues. It is quite common during the second to eighth months of pregnancy.

Early gum disease, if left untreated, can progress to destructive periodontitis, which causes inflammation and infection of the supporting structures of the teeth. This can result in the eventual loss of teeth — again, if left untreated. Furthermore, there have been a variety of studies that show a positive link between preterm delivery and the presence of gum disease. There has also been a link between an increased rate of pre-eclampsia (high blood pressure during pregnancy) and periodontal disease. Researchers feel this suggests that periodontal disease may cause stress to the blood vessels of the mother, placenta and fetus.

To learn more about this topic, continue reading the Dear Doctor magazine article “Pregnancy and Oral Health.” And if you want to read the entire feature article on Nancy O'Dell, continue reading “Nancy O'Dell.”