Mac Lee: Get Involved in Dental Examinations to Ensure Appropriate Treatment | Live well

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Periodontal disease is recognized by the public as a serious dental infection of the gums. The good news is that there are proven, well-known and accepted non-surgical conservative treatments that can control the disease. Deep cleaning (or in dental terms, scaling and root planing) is one of the most successful treatments and the subject of this article. Because the public is generally not aware of all dental problems, gum disease can be underdiagnosed or overdiagnosed, both of which are poor service to the patient.

Classification of gum disease

To understand the different treatments for gum disease, it is important to have a basic understanding of the anatomy of the teeth / gums. To make the anatomy simple and visual, the junction of the gums and the roots of the teeth forms a “pocket”. In a healthy pocket, there is no bleeding or swelling, and the gum tissue attaches to the roots of the teeth to an average depth of three millimeters. In a healthy mouth, this attachment is a perfect seal that protects the underlying bone.

If the gums are infected, the seal on the pouch is broken and the tissue bleeds when touched or brushed. If the bone is not infected, the disease is classified as gingivitis, which is reversible with proper diagnosis and treatment.

Periodontitis occurs when bone loss occurs due to infection. The first step in the treatment of periodontitis is a deep cleansing. In periodontitis, the depth of the pocket increases dramatically. Pockets of 6 to 8 millimeters are not uncommon. This type of pocket depth is very serious not only for the health of your teeth, but also for the system. It is the kind of gum disease that sends bacteria throughout the body. And I must stress that bone disease is not painful and only a qualified dental professional, dentist or hygienist can properly recognize and treat the disease.

Regular cleaning versus deep cleaning can be compared to cleaning your car – gingivitis washes it and periodontal treatment in detail. The difference is the amount of skill, the time involved, and the cost.

Underdiagnosis

Dental exams always include looking for cavities and gum disease – always. Gum disease is detected by vision, x-rays and the use of a periodontal probe. Vision can detect bleeding, swelling, and infected gum tissue. X-rays show the health of the bone itself. The periodontal probe is a thin, dosed probe that is gently placed under the gum tissue to measure the depth of the pocket. If your dentist / hygienist does not take special bone-level x-rays or measure pocket depth with a probe, you are underdiagnosed. The tragedy of underdiagnosing gum disease is that periodontal infections are painless and the disease can persist for years. You can lose more than 50% or more bone without knowing it. With this amount of bone loss, the teeth become mobile and impossible to save. It is tragic to learn that all teeth have to be removed and replaced with dentures.

Overdiagnosis

Unfortunately, there are unscrupulous dentists and dental offices. Because the public does not know anything about dental matters, we can take advantage of it. Regular cleanings called prophies with treatment code 0110 and deep cleanings coded 4341 are paid for by most insurance plans. Deep cleanings bring in up to 10 times the income of regular cleanings. If you’ve been told you need a deep clean, ask why. If you have noticeable bone loss, it’s easy to see on an x-ray. Proper scaling and root planing are among the most difficult procedures to perform in dentistry. It takes time, experience, skill and dedication to get the job done right. It is also the first step in stopping this serious infection.

Participate in your dental exams

Every good dentist wants you to understand the treatment you are offering and to be a part of the decision. If you have tons of tartar but no bone loss, other procedures take longer and may require a few visits, but these are not true periodontal procedures and are not considered therapeutic.

Unfortunately, not all dentists take digital photographs. A digital photo will show you the patient what the doctor and hygienist are seeing and allows for great patient / doctor involvement and therefore an understanding of your dental situation. If they take pictures, ask to participate using a mirror.

Having a perfectly healthy mouth only makes sense. Having the right dentist for you and your family makes sense. Most doctors hate patients who search the internet, but I think that makes sense. To prove my point, search for “periodontal bone loss images” to see x-rays that show bone loss. Armed with this information, you won’t be overdiagnosed or underdiagnosed during deep cleanings.

Dr Mac Lee practices in Edna. He is an international speaker and trainer for dentists. He is dedicated to educating the public about dental disease. To learn more about dentistry, visit drmaclee.com or call 361-782-7191.


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