Periodontal cleanings are performed as part of the treatment regimen for gingivitis and periodontitis, forms of periodontal disease classified as mild, moderate or severe. Adults generally require periodontal cleanings, but teenagers with poor oral hygiene habits and those eating a diet lacking in sufficient nutrients can develop gingivitis. A general dentist, a dental hygienist, or a periodontist can perform a periodontal cleaning as part of the treatment for this disease.
Gingivitis, as described by Colgate Professional on its website, manifests itself as swollen, red, inflamed gum tissue that might occasionally bleed. If not removed, plaque, a sticky white substance that accumulates on the teeth, will begin to harden into calculus (tartar) and accumulate around the gum line causing the problems associated with this condition. Treatment requires the use of hand instruments called scalers, and might include electronic instruments designed to aid in the removal of the plaque and calculus. This is followed by a prophylaxis, polishing of the surfaces of the teeth to smooth them and delay future accumulation of plaque. At-home oral hygiene instructions are given to the patient, and an appointment for a dental office cleaning is recommended every three to six months to prevent future occurrences of gingivitis.
On its website, Periodontal Associates offers X-ray and photographic images of patients in different stages of periodontal disease. In its mildest form, periodontitis involves the accumulation of calculus, not only appearing at the gum line as in gingivitis, but also beginning to advance beneath the gingiva (gum tissue). This condition will require immediate attention to prevent infection, the destruction of gum tissue and deterioration of bone support for the teeth. The cleaning procedure for mild periodontitis requires office visits for scaling by the dental hygienist at which time the patient will receive specific instructions for at-home care. It is important to return for follow-up appointments to determine the success of at home maintenance and to continue with regularly scheduled cleanings performed in the dental office.
In moderate periodontitis, the deterioration has begun to advance with the initial stage of pocket development (separation of the gum tissue from the affected teeth). Bacteria forms within the pockets causing infection and eventual destruction of supporting structures. If this condition is not resolved, it will lead to deterioration of bone support, loosening and the eventual loss of teeth. With proper care, which includes strict compliance with an oral hygiene routine, regular dental visits for examination, treatment and cleanings, a worsening of this condition to the next stage of this disease can be prevented.
When gum disease has reached the level of severe periodontitis, pocket depths are extreme, bacteria and infection have begun to destroy gum tissue, bone and other supporting structures, the teeth have loosened, possibly necessitating some extractions. Treatment at this stage can require four or more visits with the hygienist for deep scaling to remove plaque and calculus from the teeth and root surfaces, and the removal of diseased gum tissue prior to surgical procedures performed by a periodontist. The surgery, as described by the University of Maryland Medical Center in their report on periodontal disease, often involves grafting to replace gum tissue and bone destroyed by this disease. As with every stage of periodontal disease described above, success of treatment relies heavily upon diligent home care and regularly scheduled follow-up visits with the hygienist and dentist.
During visits with a hygienist for periodontal maintenance, scaling, root planing and a prophylaxis are performed. The hygienist will evaluate the success of at-home maintenance and make any necessary suggestions for improvement. Appointment intervals for periodontal maintenance are usually every three months. It is also vital to maintain oral health by having a dental checkup every six months to remove any existing decay, replace worn or loose fillings, and to replace extracted teeth with removable appliances, fixed bridgework or dental implants.