The dental hygienist carries out preventive treatments under the instruction of the dentist and is concerned with providing patients with treatment to improve their periodontal condition.
A healthy periodontium (the tissues that surround and support your teeth) can have a major influence on your overall health. Research has shown a link between periodontal disease and several medical conditions such as osteoporosis, heart disease and stroke, respiratory disease, pregnancy problems and diabetes. This research indicates that:
people with gum disease are almost twice as likely to suffer from coronary heart disease
pregnant women with periodontal disease are almost seven times more likely to give birth before term or have smaller babies
diabetic patients are more likely to develop periodontal disease
bacteria in your mouth can be aspirated into the lungs to cause respiratory diseases such as pneumonia, especially in people with gum disease.
Regular assessment of the conditions of your gums is recommended particularly for persons who fall into any of the following categories:
have osteoporosis, heart disease, respiratory problems, diabetes or are considering becoming pregnant
have a partner or family member who suffers from periodontal disease. Research has indicated that bacteria associated with periodontal disease can be passed through saliva.
Periodontal disease is a chronic bacterial condition affecting the gums and bone that can lead to teeth mobility and ultimately tooth loss. It begins with the bacteria in plaque (the sticky, colourless substance that continuously develops on teeth) causing inflammation to the gums. The early stage is referred to as gingivitis where the gums are reddened, swollen and bleed easily but the gums remain attached to the teeth. The most common cause is poor oral hygiene and this can be corrected quite easily with an improved oral hygiene regime. For some patients the cause can be related to consumption of certain drugs which can cause dry mouth.
The next stage of the disease (Periodontitis) can occur because the plaque and calcalus is allowed to develop unchecked and it penetrates below the gum line. It may also be a manifestation of certain systemic diseases such as heart disease, diabetes and respiratory disease. The bacteria in the plaque create toxins that cause a chronic inflammatory response leading to the destruction of the tissues and bone that support the teeth. As the disease progresses the gums seperate from the teeth and form pockets where bacteria can collect to cause further damage to the tissue and bone adjoining the teeth. Eventually teeth become loose and may have to be removed or fall out. Early intervention is critical to controlling the disease before irreversible damage is caused.
Because the disease often does not involve discomfort, it can develop to an advanced stage without the patient knowing.
The following warning signs may indicate the presence of periodontal disease:
- persistent bad breath
- red, tender or swollen gums
- gums bleed when brushing, flossing or eating
- loose or seperating teeth
- receding gums
- pockets developing between the gums and teeth
- pus in the space between teeth
- change in the fit of partial dentures.
The initial appointment with a hygienist involves a periodontal assessment to identify a patient's oral health. This includes an examination of the periodontal condition by visual observation of the health of the gums, checking for the presence of plaque and calcalus, recording the depth of any periodontal pocket and extent of recession, checking for bleeding and suppuration. The Florida Probe can be used to provide patients with a detailed written report showing the current condition of their oral health. Various reports can be provided and used to chart the change in periodontal condition over a number of appointments. This allows patients to monitor their periodontal condition and motivate them to take preventive action before their oral health deteriorates.
The most common procedure performed by a hygienist is the scale and polish which involves the removal of the sticky plaque that builds up on teeth and the hardened version called calculus. Scaling can be done with either a hand scaler and/or an ultrasonic scaler. After the plaque has been removed the teeth are polished using a dental paste. In cases of more advanced periodontal disease the hygienist may perform root planing which involves removal of calcalus along the full length of the root.
The hygienist can also perform a variety of preventive treatments to protect a patient's oral health. Flouride treatment can be used to strengthen the enamel, decrease sensitivity and improve the periodontal condition. Protective coatings can be applied to decrease sensitivity to hot and cold. Fissure sealants can be applied to the biting surface of the posterior teeth to protect it against decay. Various medicaments may be used to irrigate pockets in the gum to eliminate bacteria.
Patients will be given oral instruction to show the correct method of brushing and flossing. Advice may be given on oral hygiene products that the patient can use at home. The hygienist is very happy to answer your questions that you may have about any of our hygiene treatments or your oral health.
We have introduced several initiatives to support our goal of prevention and these include the following:
Caries programme
Some of our patients experience higher than normal levels of dental disease (caries) and this programme is a structured diagnostic approach to investigating potential causes for their condition. The programme combines a selection of tests to evaluate whether the cause is biological and/or behavioural in origin. Patients are provided with a written report showing their likelihood of avoiding future caries and recommending actions to improve their chances of avoiding further fillings.
Periondontal disease is the primary cause of tooth loss in adults from the age of 35 years onwards. Maintaining good oral hygiene will help ensure that teeth will last a lifetime. However, research has shown that up to 30% of the population may be genetically disposed to periodontal disease. Research has also shown that periodontal disease can be linked to many serious diseases such as heart and respiratory diseases. The consequences of periodontal diseases can range from bad breath to the significant lifestyle changes that are involved when teeth are lost.
Often the patient is the first to detect the onset of periodontal disease (bleeding gums, bad breath, change in the fit of dentures, loosening teeth, etc) and it is important that these symptoms are brought to the attention of a dentist so that early intervention can be made before the disease progresses.
The periodontal programme is a structured set of therapies designed to treat the existing periodontal condition of the patient. These therapies may include oral health instruction, scaling, fluoride treatment, root planning and/or treatment of diseased epithelium by laser depending on the severity of the periodontal disease. The treatment occurs over a number of appointments and the patient is provided with a schedule of therapies for each appointment.
Our prevention programmes can provide patients with very informative customised reports showing the periodontal condition of their individual teeth. Apart from informing patients about their periodontal condition, we have found these reports often motivate patients to participate more in their treatment as they can monitor their progress. This link gives an example of a typical report.
Laser-assisted caries screening
X-rays are a useful aid in helping a dentist diagnose the source of dental pain and may indicate the presence of caries. However, often caries is present without symptom and research indicates that x-rays may not detect many instances of caries. The diagnodent is a laser that can be used to scan teeth and detect early stages of caries. Clinical studies show the device to be 90% accurate in detecting decay compared to the 50-60% accuracy observed with x-rays. The hygenist will routinely use a laser that can detect very early onset of dental decay (Diagnodent) to identify teeth that are at risk and enable early intervention and avoid unnecessary destruction of tooth structure.
We offer a range of herbal hygiene products that are clinically proven to offer superior healing and are very effective in dealing with bad breath.
