You go to the dentist for an exam and dental hygiene appointment…and all you are thinking is “please…don’t find anything wrong!”
Yes…we know. And it puts us in the unwanted position of feeling sometimes like a hitman! But I challenge you instead to view your dentist as a professional who assesses your risk of various dental diseases, and provides healing treatments based on that assessment. What do I mean by this? Maybe it would help if I broke down your dental examination into areas of risk for future problems. Today we will talk about the first area we check, the most important area that is the support system for the entire mouth…
Periodontal (Gums and Supporting Bone)
Your risk for periodontal disease is partially based on the answers to several questions we may ask on your health history or in our office.
- Do your gums bleed or are they painful when brushing or flossing? If so, they are already infected with bacteria and treatment is indicated. This treatment may include better toothbrushing habits at home following thorough hygiene therapy in our office.
- Have you ever been treated for gum disease, or been told you’ve lost bone around your teeth? Gum disease is a bit like diabetes…we can treat it, but it doesn’t go away. However, with treatment and excellent home care, the progress of the disease can be slowed or halted.
- Have you noticed an unpleasant taste or odor in your mouth? This indicates gum infection and bacteria in most cases, but can also be a symptom of an underlying medical problem. Either way, we can help you with this problem so you aren’t embarrassed by bad breath in social situations.
- Is there anyone with a history of periodontal (gum) disease in your family? Gum disease does have a hereditary influence, although you aren’t doomed to dentures just because your mother and grandmother had them…as long as you are willing to put in the effort. (we don’t want you in dentures, either!)
- Have you experienced gum recession? This can happen as a result of gum infection, muscle pulls near the gumline of your teeth, or an unbalanced bite. The cause is important to find so we can help with the correct solution. Recession doesn’t ALWAYS mean infection.
- Have you ever had teeth become loose on their own (without injury), or do you have difficulty eating an apple? Teeth loosening most often means aggressive periodontal disease with serious bone loss. Sometimes loose teeth can be stabilized if caught early enough, but if not it may be best to deal with this before the infection spreads to other teeth.
- Have you experienced a burning or painful sensation in your mouth not related to your teeth? Any areas of pain in your mouth can prevent you from taking your best care of your teeth and gums, and we may be able to help make those areas more comfortable. We can even use lasers to speed up healing of mouth ulcers and other irritations.
When we examine your mouth, we look at your answers to the above questions, and we also make certain measurements of your gums and teeth, both in your mouth and with dental x-rays. Low or no bone loss, no or very slight tooth mobility, no deep gum pockets all put you at low risk for periodontal disease. As any of these areas progress, your risk for future problems increases, suggesting more treatment could be needed now or in the future. The combination of information we have from this examination will help us classify your risk for periodontal disease and recommend the best treatment tailored to your best oral health. Patients with other complicating factors (like genetics, smoking, diabetes for example) are placed in a higher risk category, as are patients who clench and grind (brux) their teeth or have crowded teeth that don’t have even pressure when chewing.
Do you HAVE to have treatment based on your risk levels? No…but you would be wise to listen carefully to the recommendations we provide. The best possible scenario is we find a problem early and treat it early, allowing for a great prognosis. “Watching and waiting” means waiting for things to get worse, to progress further, and to have more uncertain responses to treatment.
Dr. Andrea Stevens is a cosmetic and family dentist in practice in Kanata, Ontario. If you have dental questions, you can call her at 613-271-7091 or visit her at drandreastevens.com Please also feel free to leave comments or questions below, and Dr. Stevens will be happy to answer.