Periodontal Cleaning

Frequently Asked Questions

1. QUESTION:
   What is normally done in a periodontal cleaning?
   My dentist recommended I have this cleaning done, and since I am very anxious about dental work, I researched the procedure on the internet, and everywhere said that it is normally done in steps, sometimes 4 or 5, and takes about an hour, with craping under the gums.

   Well, I went today and all they did was scrape my teeth, like in a normal cleaning. No polish, no fluoride, no flossing…..and it took like a half hour.

   So it didn’t hurt so bad, but the issue is this: My dental insurance pays 100% for regular cleaning, and only 25% for periodontal. I fell like I get more done in a regular cleaning!!! Should I ask the office what is going on? I work in the insurance field, so I am kind of wary that I am getting ripped off.

   • ANSWER:
     I’m a dental hygienist and I do this procedure daily. (and I know it was just a typo but I laughed out loud when you typed “craping under the gums” instead of “scraping”!!!! Don’t think I’ll ever do that!!)
     You should definitely speak with the dentist about the procedure you had done and ask him to explain to you how it was different from a regular cleaning. I always fully explain what I’m doing and why I’m doing it; an educated patient is the best thing for me.
     In a regular prophy appointment (just a normal routine cleaning) the teeth are scaled (“scraped”) both above and below the gumline (unlike what the other person who posted above said…the hygienist always cleans below the gumline).
     Then when all surfaces have been scaled, the hygienist will polish any residual stain off the teeth.
     A patient that requires a periodontal therapy needs this because over time, they haven’t taken good care of their teeth and gums and because of this, tarter has built up heavily below the gumline (where a brush can’t reach and if you haven’t been flossing regularily, the gunk under there that started out as soft plaque you could have flossed out is now hardened to a concrete-like chunk you can’t remove yourself) I tell my patients that the tarter is much like a splinter under your skin, it irritates the gum tissue both physically and chemically because it’s decaying bacteria that gives off toxins. The gums do not like it being there and your body tries to defend itself by sending white blood cells to the area, thus increasing blood flow and swelling in that area. Gum disease usually does not cause any pain, but you may notice that the gums are red and/or swollen and almost always have bleeding when you do brush and floss. Healthy gums should never bleed. After the gums have been irritated awhile, they react by pulling away from the source of the irritation, they recede. And the gums don’t just pull away and leave raw bone, when they recede, they trigger the bone underneath to start to dissolve too. The bone and the supporting soft tissue structure of the gums and ligaments are what hold you teeth in place so the loss of these structures is very significant….lose them and you will eventually lose your teeth! Your dentist and hygienist should show you the tarter build up and bone loss on your xrays. A patients xrays are the best teaching tools I have! Ask them to show you and explain. When you can see the cause and effect for yourself, it begins to make sense. So now, the treatment is to remove the source of infection/irritation and that requires a scaling or deep cleaning as some offices call it. If you go to a periodontist (a dentist who specializes in gum disease), the extreme method of doing this procedure is to do “flap surgery” where they do cut the gums into a flap, lay it down to expose the root surface which they clean thoroughly, then stitch the flap back in place. This is pretty extreme and it does work quite well but it’s painful and expensive and many patients simply won’t go through that. If you do this through your general dentist, they won’t do the flap surgery, just deep clean and they will do the procedure in steps, as you noted. Usually they will do a quadrant of the mouth at a time (such as lower right, then lower left, upper right, then upper left) and then after about a 2 week period when that’s all done, I have my patient come back in for one more appt. where I check how well the tissue is healing and go over any areas where it doesn’t appear to be healing as well, evaluate how well the patient is doing at home with brushing and flossing (if I see new fresh plaque and tarter build up, they aren’t doing a very good job and I go over it with them again) and then I polish the teeth. In my office, we break it down to 3 appts. because I do an entire arch at a time, the lowers on the first appt. and then the uppers on the next, then the follow up appt in 2 weeks. When I do a periodontal scaling and root planing, it differs from the regular cleaning on a patient without gum loss because I have to reach much further down onto the root surface below the gumline due to the bone loss. There is a gap, which we call a “pocket” between tooth and gum where all the bacteria and “crud” gets stuck. That pocket is deep in a perio-involved patient and we take our instruments (often using an ultrasonic cleaner that isn’t sharp, no scraping, just uses sound waves to “jiggle” the tarter off) all the way to the bottom of that pocket and also smooth off the rough surfaces of the root of the teeth as we go (it’s harder for new build up to attach to a smooth surface than it is to a rough one, that’s why we smooth it out.) This is a very thorough, deep cleaning. It should not hurt, no more than mild discomfort. You may notice alot of bleeding as she is working, that’s normal as the gums are swollen with extra blood and this is just releasing that inflamation.
     Yes, it’s more involved than a regular cleaning and again, if you look at the xrays compared to the xrays of a healthy mouth, you can see why. It’s important to remember that periodontal disease is not something we can CURE, it’s something we can MANAGE. When bone is gone, it’s gone, it will not grow back neither will the gums. BUT if the area is cleaned out well and kept clean by the patient at home and with regular 6 month cleaning appts. the perio problem can be slowed or halted at that point. You have valid questions and you should have been educated about this procedure, why you needed it and what to expect. Sounds like your dentist/hygienist dropped the ball on that. Go back and ask about it, ask to see the xrays, etc. Good luck!

2. QUESTION:
   Dental- Deep Cleaning Vs. Periodontal Cleaning. Whats the difference in the work and price?
   Dental- Deep Cleaning Vs. Periodontal Cleaning. Whats the difference in the work and price?

   • ANSWER:
     More info needed. General dental offices and Perio offices can perform “deep cleanings” called scaling and root planing. My opinion is that these two phrases are used interchangeably by some offices, depending on if they are a periodontal practice or a general practice. We dental people often use deep cleaning as a lay term, instead of saying scaling and root planing. Many people say What’s that? We use the S/RP terminology initially to explain the process and why they need it, however once we have embarked on the procedure we may call it deep cleaning for short. Different offices use different terminology to describe their procedures, so they may differ slightly or a lot. And the prices will vary by where you live, so what may be 200.00 dollars per quad here, may be 100.00 dollars somewhere else, or 250.00, It just depends on your area.

3. QUESTION:
   How much does a periodontal cleaning normally cost with insurance?
   I have dental insurance and I have to go in to have my gums cleaned out and my dad says it normally costs 0 or so but my dental place says it costs 4…WITH my insurance. Should I call my insurance company and check up on that?

   • ANSWER:
     I just had mine cleaned the total was 5.00.That was for what the dentist called a deep cleaning, but i didn’t pay anything with my insurance and i have a co-pay type of insurance.

4. QUESTION:
   Periodontal cleaning by the dentist does it hurt?
   I’ve got an appointment with the dentist to have periodontal clean, does this hurt? I’ve heard they cut open your gums to scrape all the plaque from your gums, I’m feeling a bit nervous about this!!

   • ANSWER:
     SARAH,
     YOU MAY HAVE SHOTS BEFORE THIS GETS DONE

5. QUESTION:
   Is it possible to use a periodontal scaler cleaning your own teeth to provide your own dental care?
   Or is it something only someone else can do.

   • ANSWER:
     You may damage your gums since you are not trained to do this. Only let the dentist or periodontist scale/clean your teeth.

6. QUESTION:
   What is the difference between periodontal and dentist cleaning?
   Is there any difference?

   Does the periodontal tools reach deeper than the dentist tools?

   • ANSWER:
     Dental cleaning is a routine measure to prevent gum disease. Periodontal treatment is a non surgical method to treat gum disease.

7. QUESTION:
   What has been your experience with periodontal disease and deep cleaning therapy?
   I just recently found out I have periodontal disease. Soon I will be having the scaling and planing done. I have to admit I am a bit nervous about the procedure. But also nervous about how to take care of my teeth properly once it is done.

   Please share your experiences with me. Or if you are a dental professional I would love to hear your advice.

   Thanks!

   • ANSWER:
     Scaling and root planing can be an uncomfortable procedure. You will be anesthetised for the procedure since the hygienist will be scaling your teeth below the gum line. I’ve had it done and I’m also in the dental field. What you can expect is to be a little tender and possibly sore in the area afterwards for maybe a day at most. I’m sure you’re hygienist or doctor explained to you why you were diagnosed with periodontal disease. It is not as uncommon as you think it is.
     After you’ve completed the treatment, you will have to be diligent with your home care. That means brushing and flossing twice daily. I’ve found that using an electric toothbrush has helped me with effectively brushing my teeth. You should ask your hygienist which brand would benefit you. Your hygienist will also recommend that you been seen for periodontal maintenance cleanings every 3-4 months. Please keep up with those as they are just as important as your home care.
     You can find more information about periodontal disease at
     www.ada.org/public/topics/periodontal_…
     Hope this helps…

8. QUESTION:
   Can I smoke cigarettes (or other things =) after periodontal deep cleaning?
   I just had this procedure done this afternoon. Please note that I had Arestin treatment done as well.

   Also, any suggestions on what to eat? My dentist told me nothing crunchy, sticky, hard or spicy, but also told me nothing with seeds (no berries) and no sandwiches because of the bread. SO HUNGRY!

   • ANSWER:
     Soup or how about ice-cream?

     I got a tooth pulled last week and was told definitely not to smoke for 24 hours, 24 hours!!! I lasted 4 but only because I had a nap. Been smoking like a chimney ever since and it’s healed up fine. ;D

9. QUESTION:
   what is periodontal cleaning?
   what is periodontal cleaning ? and why its cost so much, aspen dental charge me over 0 with insurance without insurance over k. Do i really need periodontal cleaning?

   Thanks advance

   • ANSWER:
     Periodontal treatment may vary from simple plaque and calculus removal to advanced periodontal therapy include bone graft to restore missed resorbed bone around teeth in pockets, but simple periodontal treatment would cost if its not covered by insurance depending on the skills of the operator,
     for more info u can contact me in my address (or messenger) as ahmadhashem41@yahoo.com

10. QUESTION:
    Is deep cleaning absolutely necessary b4 periodontal test?
    I just went to my dentist who advised me that i have to go see a periodontist regarding my receding gums. He also said i have to have deep scaling or deep cleaning first before he sends me to the periodontist & it’s gonna cost me 0. Is this true that i really have to do this first? i know i do it eventually anyway, but i want see the periodontist first and know all the dental works necessary so i can prepare better, financially that is. Please advise.
    Do you think this dental office is trying to dupe me?

    • ANSWER:
      Yes it is neccessary for a deep scaling first. Your dentist reccommended deep scaling because you probably have alot of calculus (hardened version of plaque) above and under your gums. By removing them, your periodontist can diagnose your case better and give the relevant treatment. It’s probably even cheaper to get your scaling done at your general dentist rather than the periodontist even though a periodontist will be even more thorough.

      Think about it. How is the periodontist (who is a specialist specialising in gums) able to access your gum condition if there are large chunks of calculus blocking his/her vision??? =)

11. QUESTION:
    What is involed in a periodontal cleaning?
    1st of let me say before 4 weeks ago I havent been to a dentisit in more than 10 years due to Extreme fear of the dentist. I ended up having to go and have 4 very painful wisdom teeth pulled. My last one was taken out 6 days ago. I know I should have gone before now so please no rude remarks. You just can understand how fearful I am of the dentist. Due to the fact it has been years since I had my teeth cleaned my dentist who is extremly nice, has told me that I need a periodontal cleaning. I knew myself before he told me that i needed a super deep cleaning. So before I left I paid for this “Gum treatment” so I wouldnt back out and it was already paid for. (5.00 I might add) And so anyways my appt is next Tuesday and I have researched online to find out what happens and cant really seem to find the answer I am looking for. I am wanting to know how painful it is. As I have been thru H**L latley with these wisdom teeth being pulled. I am just VERY nervous and am wondering if anyone knows or has had it done recently and how it was preformed…..ex…. shots for numbing, ect. Thanks for any advice anyone can give

    • ANSWER:
      It sounds like you need “scaling and root planing” (I think this sounds worse than it is). For very deep cleanings I prefer to have freezing, but that decision would be made by you with the dentist or hygienist. With freezing there should be very little discomfort, but some people still don’t like the scraping sensation (the freezing still allows perception of vibration even when pain is deadened). The dentist or hygienist will be using a series of specially shaped instruments designed to adapt to the roots of the teeth. These are slipped between the gum and the tooth, and used to scrape the tartar off the teeth. This may take more than one visit since it has been so long between cleanings. A lot of people don’t find this at all painful even without freezing, but I’m a wuss. Because it has been a long time between cleanings, it will probably be surprisingly gory (because of gum inflammation) so be prepared to have a lot of rinsing and suctioning going on.

      There is no way for you to remove the tartar below the gums yourself, and the periodontal disease (gum infection) will progress without the proper cleaning. However, once the cleaning is done, you can help to maintain healthy gums with proper brushing and daily flossing. You will still need to get regular cleanings done, but they should not be as intensive as this one will be.

      My mom (also a dentist) hates all kinds of dental work except for having her teeth cleaned!

12. QUESTION:
    I need help paying for my periodontal care?
    I am a college student and I dont have enough money to pay for periodontal cleaning. It costs so much! Does anyone know any programs that will help me. Also I am from Michigan.

    • ANSWER:
      There’s a company that most dentists offer called CareCredit. It allows you to make payments, its very convenient for people who don’t have insurance, low income, or someone like you who is a college student. Check into it.

13. QUESTION:
    hello,i just need to know how much cost a deep cleaning (periodontal) i live in florida sarasota just try?

    • ANSWER:
      It will depend on the type of deep cleaning you need. There are 5 types. Level 1 is minimal and Level 5 is extreme about 4-5 visits. Level 1 being least expensive and 5 being the most. I needed a level 3 a few months ago and they originally quoted me 0 but only paid 0 because of this wonderful plan I have: www.healthsavings.ourperfectcard.com is the website. I signed up online over 5 years ago now and they have saved me thousands on all services. From cleanings, exams, fillings, …etc. Even my braces had coverage. They even had my extremely affordable plan active in 2 hours and was able to use them the very same day. Good luck and hope this helps.

14. QUESTION:
    Will a deep cleaning of my teeth by a dentist cause the spread of periodontal disease from one tooth to more?
    I have never read about this risk on Wikipedia, WebMD, or any other dental health website.
    Flutter: Thank you… I went to a dentist and they refused to clean my teeth because of periodontal disease. They said that a cleaning would spread it and that I needed to get on a ,000 treatment plan immediately. I suspected they were lying. Thank you for your help v.v I’ll be going to a different dentist from now on.

    • ANSWER:
      No. It will actually help clear up any infection that you do have in your mouth. Sometimes when you get a really bad periodontal infection your dentist/periodontist will want you to get a root planing. Normally they’ll do a full mouth but they’ll at least do the whole quadrant where your problem is. You’re infection/disease will spread if you leave it untreated.

15. QUESTION:
    I have been told that I have to have periodontal cleanings every 3 months. Is that about right or too much?
    I had a root scaling and planing done last month on both sides of my mouth. I’d never heard of this before, and had just gone to the dentist for a long-overdue cleaning, but apparently my gums were in bad shape (not severe, but there was some tarter under the gums). Now the dentist tells me I have to come back for another 0 periodontal cleaning every 3 months for an indeterminate length of time to make sure that the tartar doesn’t come back. Is this really necessary? I’m prepared to go as often as I have to, but I can’t really afford to go every 3 months if that’s not necessary. I just don’t want to continue feeling like this dentist is “drilling” me for every penny I have. I’ve already spent more than 0 on the work I’ve had done so far (obviously, my dental insurance is a joke). I just want someone who knows about this sort of thing to tell me if I’m being treated right or ripped off. Thanks!

    • ANSWER:
      It is crucial that you go back and have your peridontal maintenance done in 3 mos!I don’t know the severity of your infection,but your hygienist or dentist will remeasure your periodontal pockets and chart you healing.Dental floss can only go as deep as 4mm,so even after your are first deep scaled,areas of over 4mm will exist.Basically your homecare is missing millimiters of bacteria(millions upon millions of anaerobic pathogens),so another thorough deplaqueing in needed until you readings are 0-4mm.Now I do feel that 0 is a bit high for a perio. maintenance visit,but I live in the south where our fees are less.There is a great product called Arestin,where we place antibiotic directly into any unhealed pockets.It greatly increases your chance of healing and may reduce your need for surgery later.Ask if your office does Arestin therapy.Make sure your dental provider is willing to explain your periodontal disease to you completely,I get the feeling you were not informed of the WHY you needed the 3 mos. cleaning interval.If you are not satisfied,go elsewhere or seek the help of a periodontist(gum disease specialist).80% of tooth loss today is due to gum disease not decay,so it is a serious problem!!It also affects over 80% of people over age 35.Invest in an excellent electric brush such as the Sonicare or Oral B triumph,they remove much more plaque than and manual brush.Also you may get an electric flosser such as the oral b hummingbird or reach access flosser to help you floss more efficiently.

16. QUESTION:
    Qestion about periodontal cleaning.?
    I had periodontal work done yesterday on the right half of my mouth. I’ll admit my mouth and gums are/were sore and tender. Last night when I went to sleep after brushing my teeth ( normal on the left, lightly on the right), this morning I awoke with a blob of coagulated blood in my mouth. I spit the blob out and then rinsed my mouth out with water. Is this normal? What may have caused this?

    • ANSWER:
      Not to worry. Bleeding from the gums is very common after periodontal work for a day or two. You handled it fine and most likely will not have this problem after another 24 hours. Good luck.

17. QUESTION:
    When u have deep cleaning done, does it prevent u periodontal disease?
    I strongly recommend someone telling me in the dental field, thank you.

    • ANSWER:
      It will help stop it from becoming worse. You have to make sure that you keep the gums clean everyday between the cleanings. You should use Listerine or Peridex something like that and make sure you brush for at least 2 minutes 2 times a day. If the damage is bad, it can not be fixed only maintained. Your gums are very important, they are the foundation. With out that you have no teeth. So no it doesn’t prevent the disease, but it will help you to not lose all of your teeth.

18. QUESTION:
    Periodontal cleaning?? What happens?
    What do they use to numb you up?? They don’t use novacaine do they? I don’t like needles. Does it hurt?

    • ANSWER:
      not everyone needs to be numb, it depends on how deep your pockets are. If they have decided they are going to numb the area they will use local anesthetic (its not novocaine anymore but it does the same job). It may hurt a little but its better to get that for 20 seconds than it is to be hurt for an hour when they are cleaning the deep pockets. Like I said though many times people don’t need freezing for cleanings

19. QUESTION:
    I need my teeth cleaned, and I also need a deep “root” cleaning for some periodontal issues.?
    I’m a college student and not much to work with. Would it most likely be cheaper to get dental insurance or just pay for it?? I realize this may be a hard question to answer…. or impossible.

    • ANSWER:
      I had a deep cleaning about a year ago as well so I’ll try to answer the question as best as i can. First of all, be sure you trust your dentist. If he’s someone you’ve never been to before, I would recommend trying to find out if he’s just trying to jip you by getting a 2nd opinion.

      In terms of whether insurance would be worth it, I think it is. I’ve known people who have gotten teeth cleanings without insurance and those alone ran -0. And this wasn’t a deep cleaning which is probably more because it’s with a specialized dentist. I was lucky and had good insurance which covered my deep cleaning, so I would say it is worth it especially since this way you’ll have coverage for basic dental needs like cleanings and such. Ask your parents if you can add on to their plan or you can research online with MetLife or Delta Dental for individual plans. Make sure the dentist you are going to is covered by which insurance you choose though. Good luck.

20. QUESTION:
    What methods are effective against preventing periodontal disease in cats?
    I’m doing a science fair on which method of cleaning prevents periodontal disease the best.
    Note: I’ve already got toothpaste, thanks.

    • ANSWER:
      Ever wonder why stray and feral cats don’t have periodontal disease while housecats do? That’s because those cats chew on raw bones. One of the best things for cleaning a cat’s teeth is to let them gnaw on raw bones such as chicken necks and wings (the soft bones will not hurt the cat and will be digested). Along this line, raw food helps, as tearing into muscle meat helps clean the fangs and middle teeth.

      Dry food or crunchy treats offer little to no help with periodontal disease in cats, although the theory of the “crunch” of the food is that it replaces a domesticated cat’s prey’s bones, and some dry-food manufacturers are adding ingredients that is supposed to help break down tartar. The theory with dry is good, but fails in practice. Cats don’t actually chew, but shear if they do anything, and only the molars benefit, not the all important fangs. Additionally, dry food can quickly collect bacteria which can be damaging to dental health.

      Periodontal health is also a function of genetics, nutrition while in vitro, as well as nutrition during the first few weeks of life, so good dental health starts with the health of the mama.

21. QUESTION:
    How long a recovery from periodontal surgery?
    I’m 27 years old and will be starting braces this October. I am seeing a periodontist at the end of July to fix some minor periodontal problems (deep cleaning/gum grafting) and the surgery I am told is minimally invasive. If I have the periodontal procedure done in August, will I heal in time to start braces in October?

    • ANSWER:

22. QUESTION:
    how much should a periodontal “deep cleaning” procedure cost? (for 5-6mm pockets, 4 quadrants)?
    It looks like I got a “quote” that includes some medicine, irrigation and other few items which are not covered at all by insurance. I was wondering if these are necessary (the items that the insurance does not cover) or is the dentist trying to make some extra cash.

    • ANSWER:
      Between 0 and 0. I never had that procedure done but would encourage you visit this website
      www.healthsavings.ourperfectcard.com
      I signed up online over 3 years ago now and they have saved me thousands of dollars throughout the years. I know for fact that all dental services are included : root canals, exams, xrays, cosmetic surgery …etc. They are very affordable and had my benefits active in 2 hours and was able to use the same day. This could also ease the cost of you dental procedures. Hope this Helps and Good Luck.

23. QUESTION:
    One dentist simply said “you need a deep cleaning & a root canal”. Another said “periodontal disease”?
    The second opinion said i had periodontal disease with bone loss and i need 3 fillings and a crown for a cracked filling. Wondering about the perio.. Why would the first dentist not say that? I am going for 3rd opinion, but now i am really scared. I smoke and do have some gum recession bottom front, but the first and second opinions seem a little too different… Do they wanna scare ya into comin back or what???

    • ANSWER:
      a deep cleaning is for someone who has calculus buildup (tartar) which happens when someone doesnt take care of their teeth and has periodontal disease.

24. QUESTION:
    How much does it cost to get a deep cleaning?
    I need a deep cleaning. I have periodontal disease they told me my pockets were about a 4 or 5…whatever that means. I have medicaid but I guess they dont pay for deep cleaning. What do I need to do? do I just find a random dentist and schedule an appointment for deep cleaning? are they going to charge me for an exam too or how does this work? what fees am I looking at and how much?

    • ANSWER:
      You can easily check your minimal health care rates in internet, for example here – health-quotes.talk4fun.net

25. QUESTION:
    What is included in a six months dental cleaning?
    What is the difference between periodontal maintenance and a normal teeth cleaning (the six months)?
    I have to ask this because my dentistry charged me with periodontal maintenance when I had only a teeth cleaning…

    • ANSWER:
      Hi,

      This terminology can get confusing. Usually, a periodontal maintenance is for people who need a deeper than normal cleaning every six months. Sometimes these patients might need to come in every 3 to 4 months. The basic cleaning is referred to as a PROPHYLAXIS, or prophy for short.

      You should also be getting bitewing x-rays and an exam every six months.

      If you feel you had a standard prophy but was charged more, talk to the dentist or the office manager.

      Best of luck,

      Dr. David

26. QUESTION:
    Can someone tell me the difference between regular cleaning and root planing and scaling (deep cleaning)?
    If I do the regular cleaning from my dentist regularly, would I ever need deep cleaning one day? Because if we do regular cleaning often, we won’t have periodontal diseases, right?

    • ANSWER:
      Regular cleanings coupled with good brushing and flossing, should prevent the need from ever having root planning and deep scaling. Regular cleanings are a preventive measure. Deep scaling and root planning are non surgical treatment methods to treat periodontal disease.

27. QUESTION:
    Is it possible for periodontal disease to spread from a tooth to another? What causes plague to form on tooth?
    My son brushes his teeth regularly, twice a day. Last December, his dentist told him that he has periodontal disease in his gum.
    This may be due to his oral hygience as he was unprepared for his cleaning kit when he was asked to work till the next day. It was about 10 months ago and is it too late to undergo treatment?? Can periodontal disease spread from a tooth to another? It was so unfortunate for him to have caught the disease, and what causes plague to form on the tooth/gum?? How to prevent it??

    Can anyone please kindly advise as soon as possible. Thank you very much.

    • ANSWER:
      Once a diagnosis of perio disease has been made, professional treatment is of the greatest demand to save the teeth and bone structure from this diseases devastating demise. Every tooth is subjected to damage from this “active infection” and the bone loss associated with this disease as well as the whole body. The same plaque found in perio disease has been found to be associated with heart attacks.

      Brushing your teeth twice a day is good, but it isn’t the solution to the problem. A person can brush ten times a day, but if it’s not done “correctly” and thoroughly then it’s just not going to do any good. Your son needs to spend at least “2-3 minutes brushing” with a “soft toothbrush,” brushing each tooth about “20 strokes” not just the front ones. Also “flossing” is of the utmost importance because it removes the plaque caused from bacteria found in the mouth, under the gums that brushing can’t reach.

      A diagnosis of perio disease means that he has developed pockets in the gum of some areas that surround his teeth. These pockets can range in depth, but all are “too deep” for him to be able to clean. We consider anything deeper than 3-4mm as too deep for a tooth brush or floss to reach to clean. He will need to have root planing done which removes all the debris from the pockets and along the roots of the teeth in question. This allows for some shrinkage of the tissue which decreases the pocket depth and possible reattachment of tissue with hopes that proper techniques in brushing, flossing, along with continued professional care and his excellent home care will help to eliminate the disease from progressing.

      It is unfortunate that he has “developed perio disease,” but he didn’t “catch it.” It progresses over time, usually from inadequate brushing and flossing techniques and lack of professional dental care. Although there is some research that links its cause to hereditary or genetics. The best treatment your son can follow is his dentist advice and see a periodontist for follow up cleanings every 3-4 months, they will alternate with his dental appointments. This may seem like a lot at first but will lessen with time, it’s to keep a close watch on the pockets depth and to eliminate the progression of this disease by maintaining and monitoring your son’s dental health. Perio disease can be devastating by destroying the surrounding tissue and bone structures that support the teeth, which left untreated will eventually lead to the loss of teeth. I hope you will encourage your son to continue with treatment to maintain his natural teeth and halt this disease. It can be stopped with proper treatment, your son isn’t alone with this disease. Good luck and I hope that I’ve given you enough insight to help you to understand this disease, how to correct it with his dentist and periodontist help and the causes of it so your son can change those habits to better his dental health.

28. QUESTION:
    Does getting a deep cleaning loosen your teeth?
    I went to the dentist yesterday. She said I have the beginnings of Periodontal disease, and they want to do a deep cleaning on me. I talked to a few friends and family members, and they all said that getting a deep cleaning can loosen my teeth, and cause them to separate. I also have concerns because I have 11 caps on my teeth (I used to drink ALOT of soda) and hope that they too won’t loosen with a deep cleaning. I am trying to weight the pros and cons of getting it done, so any feedback is appreciated.

    • ANSWER:
      To the contrary, the purpose of a deep cleaning is to remove all of the plaque,tartar, toxins, and infection, that will, by spreading into the supporting bone around the teeth, cause the teeth to loosen and possibly be lost. The caps won’t loosen unless there is decay all around them and if that would be the case, they would have to be re-done. You need to have this procedure. Best of luck.

29. QUESTION:
    Can you have periodontal disease even if your gums look pink and healthy?
    I floss daily. Maybe I have a bit of recession but usually no bleeding when I floss and my gums look pink and healthy. Can I still have periodontal disease? My new dentist is recommending deep cleaning (scaling and root planing). I’m skeptical…

    • ANSWER:
      if gums are firm and pink and NOT BLEEDING then they are healthy,i my opinion you wont require any root planing.

30. QUESTION:
    Why is periodontal disease a chronic disease?
    I have read a lot about periodontal disease. I understand it is an advanced stage of gum disease: accumulated plaque on your teeth and gums attacks the gum and the bone.

    But plaque can be removed by professional cleaning, and good oral hygiene helps to prevent accumulation of plaque.

    So, why is periodontal disease chronic then? Why can it be treated but not cured?

    Thanks.

    • ANSWER:
      Periodontitis is usually chronic because it is slowly progressing. Recall that first we see gingivitis (inflammation of the gums with no active bone loss) before the bone loss (periodontitis) starts. Gingivitis can be seen fairly soon after bad hygiene starts, and usually goes away when local causative factors are removed. Periodontitis, however, takes years to start and the bone loss is slow. It happens after years of gingivitis.

      When the teeth are cleaned and the plaque removed, the bone loss will stop (providing the patient improves their oral hygiene habits). This is how it is treated. Rather than saying that periodontitis is “incurable,” it is better to say that it is “irreversible” since the bone does not regrow and the bone loss is permanent. But as long as the bone loss is stopped, the patient does not have periodontitis.

      Hope this helps!

31. QUESTION:
    Does Periodontal Disease always require a deep cleaning?
    My dentist told me i had peridontal disease. I have to much plaque build up once they took it off i have some ridges in the back of my bottom teeth. All the trouble is with my four bottom teeth. They get really sensitive bleed easily gums are a little more pinkish than normal, irritated.

    She said it looked really bad ure gonna need a deep cleaning. She then saw my x rays and said u dont need a deep cleaning with a regular cleaning you’re fine.

    What do you all think? I bought the mouth wash they advised there. I’m flossing now and brushing well. I’m going to invest in a electric toothbrush? This really scares me I’m only 21.

    My mom got dentures when she was 40 … All her teeth became loose. I’m so scared of this.

    • ANSWER:
      First of all, you must take a good care of your teeth at home (brush, floss, mouthwash). Flossing is important which helps you to remove impacted food –> no calculus in between teeth and underneath gum line –> no deep cleaning. Mouthwash help to kill bacteria and naturalize acid in your mouth (bacteria produce acid) –> reduce inflammation.
      Electric toothbrush is a good idea since it makes you brush long enough and more efficiently.
      Of course, make sure you see your dentist to follow up regularly! Control it , don’t let it get worse!

      Second, you should know WHY you have periodontal disease in order to avoid from that risk factor. Otherwise, no matter hard you try to clean your teeth, you gum still gets inflamed.
      Here are risk factors leading to periodontal diseases
      1. #1 Smoking (quit if you do, 6times risk to have oral cancer)
      2. Alcohol
      3. Genetic (your mom oral health)
      4. Stress (easy gum bleeding)
      5. Bad oral hygiene
      6. Diet (too much sugar, soda..)
      8. some medical diseases (diabetics..)

      To answer your question, dentists do deep cleaning if you have calculus/plaque on the roots surface. Maybe after looking at the Xray, your dentist doesn’t see you have any on the roots so you don’t have to have deep cleaning done.

      Hope this helps

32. QUESTION:
    What is the cost of a deep scale cleaning stage II?
    That is when they have to cut your gums back to clean the root of each tooth due to periodontal disease.

    • ANSWER:
      In my office, it is 0 per quadrant. It may be more in a specialist’s office.

33. QUESTION:
    Question only for those who have had periodontal work to have the gums cut back to make cleaning easier?
    My dentist used a probe to find that I had some sockets between teeth beyond 10 on the probe scale. The periodontist he sent me to says that cutting back the gums (he already did the deep cleaning) could minimize further bone loss that comes from the issues I have. If you had your gums cut back, especially if it was a while ago so you know how it has helped over time, would you please describe how the operation went, how it went during recovery, how much time you lost from routine activities (work or school, eating, and such), and how it may have helped over time, or not. My copay after insurance will be in the $thou$and$, so I want to make sure it will be beneficial before I commit.

    • ANSWER:
      I can tell you if you have pockets that are 10 mm deep you need to have the treatment he proposed or you will lose your teeth shortly. This is severe periodontal disease with major bone loss. Only by doing this will you be able to stop the progression of the disease and be able to maintain your oral health by brushing and flossing. The actual procedure will be painless with the local anesthetic and although you will have some post op discomfort, it will be less than extractions. Good luck with your treatment

34. QUESTION:
    teeth cleaning in dental office !
    have a dental teeth cleaning appt. this thursday at 9:40, so it’s a regular cleaning, not a deep periodontal cleaning ! he said no novacaine included… which is making me as nervous as all hell breaking loose… i can’t stand the dental drill along my gumlines… i mean the pain… it’s too sensitive of an area … i mean i’ve had cleanings b4, but i dunno why i’m nervous now ! so if i am not numb… what can i take to make my mouth numb or not feel the pain at all? HELP PLEASE ! always…. the nervous wreck !

    • ANSWER:
      Teeth cleanings don’t hurt unless you are getting the deep cleaning because they don’t typically use the drill unless you need a deep cleaning. If you went six months ago like you are supposed to, then they really shouldn’t have to do much but a light scrape and buff. I always liked the routine ones, it’s the deep cleaning ones I always hated.

      If you are worried too much, if they need to use the drill ask them to apply a topical numbing agent. I am sure they would if you expained the fear. Most of the dental hygenists are very considerate.

      Good luck.

35. QUESTION:
    How bad is a periodontal treatment?
    I’ve neglected my teeth for a while and didn’t get any cleanings for (I’m ashamed to say) years. So now I have some serious issues, I had no idea it could get so bad and I broke out in tears in the dentist’s office.
    I need to get a deep cleaning and I’m not very thrilled, it’s expensive and I hear not very comfortable. How much does it hurt during and after? Will I immediately see a difference? I understand that it’s done in quadrants, does that mean 4 separate visit?

    • ANSWER:
      hi I had the deep cleaning done and it was a piece of cake. I did not feel any pain what so ever. You will feel a little pressure but not pain. Yes it is expensive I did my deep cleaning in 2 visits 2 quadrants at a time. The reason for that the dentist needs to see how your gum & teeth are responding to the treatment. It was well worth it. My gum and teeth are healthy now. good luck

36. QUESTION:
    I have a gum disease called periodontal disease, it has weakened my teeth, can my teeth be strong again?
    I have got a gum disease called periodontal disease and my teeth feel weak because of this, i have to get a deep clean (Scaling). This will leave a gap where the calculus have been removed and will leave my teeth quite loose. Will the gap close up and will my teeth strengthen? If not, how can I strengthen them?

    It scares me as I can’t even bite through anything with my front teeth unless the food is really soft, like bread for instance.

    • ANSWER:
      It is not your teeth, it is the foundation that is deteriorating. You have lost bone due to perio disease. Bone cannot grow back. That stuff HAS to be scaled off so it will not destroy what ever bone is left. Once you go through this process and your oral hygiene improves, you will no doubt be advised to show up for cleanings every three or four months, this is called perio maintenance. And this is forever now. All you can do, is stop it where it is and be very religious about your home care and keeping dental appointments. The gums will shrink down and firm up a bit without all that calculus sitting there. But the “gaps”, as you call them, will not fill in, bone is gone, never to return. Teeth that are really loose can be splinted together with bonding if needed. There are other things you can do if you end up losing a couple due to mobility. No worries, just follow their instructions to the tee, you cannot afford not to at this point. Yes, taking the calculus off will make your teeth loose, but leaving it there will make them “gone” in no time. So remember, it is not your teeth that are the problem, it is their foundation, ie…bone. They will tighten up a bit once you have a more healthy situation, possibly. It is hard to say without knowing the severity of the disease and the class of mobility. But hang in there, you will have a lot of dental homework to do for a long long time if you want to keep them.
      Peace

37. QUESTION:
    Should I avoid intimate contact with someone being treated with Ceftin for a bacterial, periodontal infection?
    There has already been some deep cleaning by the periodontist over a period of a couple of weeks, with surgery for more aggressive treatment scheduled next week. But right now my partner is in pain all the way down the neck from time to time, and was just given Ceftin by a medical doctor we had to visit while we are out of town. My partner doesn’t ask all the questions I would if I was the patient, and I still feel a little uneasy about the possibility of getting infected myself.

    • ANSWER:
      Hi! I’ve been in dentistry for over 25 years and this is NOT contagious. If this was another bacteria, often called ANUG(Trenchmouth), that that could be an issue. BUT no this is not spread from person to person. However, I would simply wait until the antibiotics have a chance to work and I would strongly recommend the person not engage in oral sex for several weeks. Since this area is still healing from the surgery, exposure to any bacteria is not recommended until it heals. If you have any other questions, please ask. ~M

38. QUESTION:
    Gum disease – How long have you had periodontal disease?
    How often do you visit your dentist? Did you get any special treatment done other than regular (deep) cleaning? How bad is it if you have pocket depths of 5 and 6? Is it too early to have gum disease in your 30s?

    • ANSWER:
      A person should be visiting the dentist and hygienist every six months for cleanings. The “deep” cleaning you are referring to is called scaling and root planing and is only done on patients with periodontal disease who have deeper pocket depths than someone with healthy gums. Patients with periodontal pockets should be visiting a gum specialist called a Periodontist as often as every 3 months in order to stop or at least slow the progression of the disease. This disease is caused by inadequate brushing and flossing over a long period of time and irregular professional cleanings. It is a complicated process but basically the bacteria in the plaque and calculus on your teeth and under your gums eventually causes bone loss around your teeth and the eventual loss of your teeth.

      Pocket depths of 5-6mm are considered fairly serious and need to be treated right away. The calculus on the root surface needs to be removed by a professional. Also, periodontal disease can absolutely occur in your thirty’s and is even more serious because if it starts progressing at such an early age you could lose your teeth at an early age as well. I hope this info. helps! I am a dental hygiene student.

39. QUESTION:
    What can cause aggrivated periodontal disease in otherwise healthy teeth?
    I need this surgery next week, which is quite unexpected. I had a cleaning last year with not a mention of this disease and I haven’t had a cavity in over ten years. My teeth “look” very pretty but I apparently have alot of bone loss. I have two areas of my gums that have been swollen for over two months and I brush and floss regularly! Is there anything that can cause this disease to progress so quickly? On my estimated bill the words CHEMO Agents are listed, what is this? I also have two loose teeth. My Dr. prescribed Pennicillin also, is this standard procedure?

    • ANSWER:
      Yes, it is standard procedure to prescribe antibiotics whenever perio disease is present. Overall, your dentist is trying to rid an infection located in your gums and around the bone of your teeth.

      Have you seen your physician for a checkup and blood tests recently? Several factors can cause periodontitis. Not to scare you, but diabetes is very common.

      I am happy to hear that you are going through with surgery. It will help tremendously. Also, consider seeing your dentist/hygienist every 3 months to monitor the bone loss. Have them give you your probing depths, how deep your pockets around your teeth are. Healthy is between 1-3 mm, 4mm is not great but easy to reduce, and 5+ is unhealthy.

      CHEMO agents a.k.a. chemotherapeutic agents. Examples of these include Alloderm, Arrestin, PerioChip, and Actisite. They are “site specific” and go into the pocket (gum area) around the tooth to help it heal. They don’t hurt!!! The periochip is about the size of a small clipped fingernail and dissolves around the tooth and gum. Sometimes these chemotherapeutic agents contain an antibiotic. Although the word CHEMO is used, in this case it isn’t related to cancer!

      Other things your dentist may recommend include Chlorhexidine Gluconate or Listerine. A search for chlorhexidine can be viewed on wikipedia.org

      I hope everything works out for you soon.

40. QUESTION:
    Periodontal disease procedure?
    I went to the dentist and she said I have periodontal disease. The first procedure she recommended is deep cleaning. After 3 weeks I have to go back for a Full Mouth Debridement and Irrigation. Then after two more 3 months apart visits, each visit with another Full Mouth Debridement and Irrigation. My question is that is the Full Mouth Debridements or Irrigations necessary since I have gone though the deep cleaning already? Do I have to have both the Full Mouth Debridement and Irrigation each visit or can I just have one?

    • ANSWER:
      Yes they are very necessary as this cleans the parts that are not usually cleaned when a deep cleaning is done, no it must be done at each visit as they only do a section of the mouth, they give you injections

41. QUESTION:
    Is there any hospitals in Ohio that treat emergency dental problems?
    I have a friend that is having Severe pain from her wisdom teeth and needs a periodontal disease cleaning, she went to a dentist they said her pain is from the gum disease. where can she go she needs treated right away, her dentist just referred her to a specialist and she cant get in for a month.

    • ANSWER:
      Hospitals dont do teeth. Only dentist. Can she try finding another specialist ? or maybe take painkillers in the meantime

42. QUESTION:
    Can someone w/ periodontal disease who follows a strict treatment regimen, receive cosmetic dentistry treatmnt?
    I have my teeth cleaned every 3 months, I brush 3 times a day, floss twice and rinse with a antiseptic mouthwash. I get root planing every 2 years. I have large gaps between a couple teeth as well as “long” teeth – both due to one flap surgery treatment. When I speak my lips cover these gaps but I am still very self conscious. My dentist says there is nothing that I can do. I’m wondering if he is right or not?

    • ANSWER:

43. QUESTION:
    What could happen if you used a person’s toothbrush who has periodontal disease for 1 time?
    I used it by mistake and after that I realized it and cleaned my mouth with listerine, please answer!

    • ANSWER:
      Periodonal disease is not a disease that is spread/contagious. Periodontal disease is when someone’s gum’s are recending rapidly. You can’t get it from using someone else toothbrush. Don’t worry. If you want to prevent/postpone getting periodontal disease, floss well. However, even if you take care of your teeth well, you could still get it when you get older. 3 out of 4 adults have it.

44. QUESTION:
    I went to the dentist today and have periodontal disease?
    I go to the community oral health because i have no insurance and they have no hygienist at this time. The doctor was so concerned he is having me back in a week to clean them himself. He said it is pretty bad so what can i expect in the future at the dentist?

    • ANSWER:
      You probably need root plaining and quad scaling. This is going to involve deep cleaning with the calvatron tip, scaling, etc. Your dentist may choose to numb you and clean left upper and lower at one time or right upper and lower at one time. Then again, he may choose to do all four quads at once.

      Depending on the severity of the perio, you may only need one quad scaling and then be done or you may need a few treatments.

      Atleast the perio has been caught and you are moving forward with treatment.

      Good luck!

45. QUESTION:
    Is there any way to cure my dog’s periodontal disease?
    Hi my dog, 4 year old male Maltese, has have periodontal disease.
    The vet told me to perform an operation and we did.
    The operation was to clean up his teeth to prevent further problem of his gums.

    During the operaion, one of his back teeth came out as it was loose.
    The vet said four of his front teeth may be coming out since it is also loose.

    Is there any way to cure his periodontal disease?

    • ANSWER:
      No. Trust your vet.

46. QUESTION:
    Periodontal Treatment Question?
    So my dentist wants me to have a deep cleaning for periodontal disease. On top of that he would like to treat each tooth that is infected with antibiotic. The antibiotic is not covered by my insurance and adds up to 0 that I would have to pay out of my pocket not counting the 0 that the insurance doesn’t cover for the deep cleaning! WOW!! But I can deal with the 0 its the 0 that I am worried about. So has anyone had this done and are those antibiotics really necessary? Will it be ok to just get the deep cleaning? I am sure the antibiotics are great and all, but for that money I can almost get some dentures. lol.

    • ANSWER:
      I would go for the deep cleaning…but the antibiotic is not covered because it doesn’t have a predictable outcome…
      I would do the cleaning then a follow up with the anitbiotic prescription mouth rinse Chlorhexidine Gluconate Oral rinse 0.12% (brand name Peridex) for 3 months and then have an evaluation at that time to see how the gums responded.
      I have found this is a good protocol and if you are under 40 will probably give a good result….over 40, when you re-eval, then see what happens…..

47. QUESTION:
    bad situation – periodontal disease and extractions?
    My friend has 3 teeth with abscesses – the bottom front 3, all right next to each other. he also needs a deep cleaning for periodontal disease. now, crowns are really expensive, even with my metlife (safeguard) plan. it would be about 400 per unit of a bridge. we cant afford that right now. (a deep cleaning with our plan is only 200)

    my question is – does he have to get all three teeth with abscesses extracted before he gets the deep cleaning? i know the obvious answer is “yes” but in light of what i said before, is it *absolutely* necessary? Three extractions in the front would leave him looking rather funny for a while :/

    It seems like a silly question, but bridges are just so darn expensive.
    any info is greatly appreciated.

    • ANSWER:
      BEST TREATMENT IS EXTRACT HOPELESS TEETH, GET A SCALING,DO BRIDGE AND GET REGULAR SCALING EVERY TEAR

48. QUESTION:
    Periodontal disease at 18? can i stop it at this young age?
    seeing a dentist in an hour or so and they are going to say i need a deep cleaning. is it possible to have gingivitis and gum recession? I use a firm toothbrush?

    • ANSWER:
      It is really bad to use a firm toothbrush, you can actually brush the gums right off. You need a soft toothbrush and brush in small circles and at a 45 degree angle. Keep up on check ups and 6month cleanings and you should be fine.

49. QUESTION:
    Is there a home remedy for periodontal (gum) disease?
    Dentist recomended deep root cleaning (below the gums). Not covered by insurance

    • ANSWER:
      No, unfortunately there is no home remedy for gum disease. However, treatment with antibiotics sometimes helps. I have included a couple of links for home remedies that you might want to try while figuring out what is best for you to do. Best of luck with it.

50. QUESTION:
    What do you tell your patients?
    Yet another dissappointing episode from a so called good dentist. During a periodontal clean a most painful sharp feeling was felt at the top ridge of the mouth.When will you folks get it into your head that you need to caution patients BEFORE the procedure that this may be the case rather than say nothing so that it comes a great surprise. You really are the hated profession aren’t you? In fact you are no better than the barbers who used to ply this trade before you did.A curse on the lot of you.

    • ANSWER:
      I ALWAYS warn my patients if I know a procedure wiill hurt! But, I use a technique that is less painful

      RDH