Start Your Cosmetic Dentistry with Basic Oral Health and Hygiene

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Start Your Cosmetic Dentistry with Basic Oral Health and Hygiene

Published on: September 28th, 2007 11:26am by: sharling

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Good cosmetic dentistry can make all the difference to your image. But it can be undermined by periodontal disease.

What is periodontitis?

"It occurs when inflammation or infection of the gums is left untreated, or treatment is delayed," explains Dr. Steven Goldy, a cosmetic dentist in Beverly Hills, CA. "Its silent progression starts with a growing colony of toxin-producing bacteria called plaque and in time this plaque gets mineralized from bathing in saliva and becomes calculus (tartar)."

The calculus that exists underneath the gum line is the most destructive element of periodontal disease. A periodontal pocket forms (crevice/space between the gum and bone) along with swelling, bleeding and tenderness of the gum tissue. The infection and inflammation spreads from the gums to the ligaments and bone that support the teeth. This loss of support can cause the teeth to become loose and eventually fall out. So taking care of these issues is absolutely vital before doing any cosmetic dentistry.

And not only can this affect your teeth - scientific research has uncovered a relationship between periodontitis and other serious health conditions such as heart disease, stroke, diabetes, respiratory disease, pregnancy; and pre-term, low birth weight babies. Genetic makeup, smoking, stress, hormonal changes and various medications are also risk factors.

Early detection and appropriate treatment is the key to halting disease progression and a serious long-term commitment is necessary for a patient to arrest the disease process.

Treatment is divided into two types: Surgical and Non-surgical.

Surgical treatment is usually carried out by a periodontist, and although some general dentists try their hand at it, we always refer our patients to a highly qualified and experienced specialist in this field.

Non-surgical treatment
The goals of non-surgical periodontal therapy are:
A. Healthy gum tissue that is not red, puffy, swollen and does not bleed easily.
B. Fresher tasting/better smelling mouth.
C. Continuous personalized home care/oral hygiene.
D. Healthy periodontal pocket depths
E. Avoidance of surgical periodontal treatment.

The extent and success of non-surgical treatment varies from dentist to dentist. In our dental offices in Beverly Hills we offer a proactive, comprehensive Soft Tissue Management (STM) program which utilizes various modalities that offer my patients the best chance of treating their conditions without surgery. It includes:

Scaling: this should not be confused with a dental prophylaxis/teeth cleaning that is performed only in a healthy mouth for primarily preventive purposes.

Root Planing: a meticulous and technique-sensitive procedure to remove bacterial plaque, biofilm calculus and diseased root surface to allow for healthy reattachment of the gums. This usually requires local anesthetic.

Irrigation: although there are different ways to accomplish this; we use a specialized electric device which pulsates medicaments into a periodontal pocket. The most common medicament is an FDA approved antibacterial mouth rinse that is available only by prescription. The goal is to minimize the amount of bacteria in the pocket. This procedure is usually carried out along with Scaling and root planing.

Antibiotic therapy. Although there are a few different topically applied antibiotics; we prefer “Arestin” a crystal/powder form of minocycline (cousin to tetracycline) that is manually placed in a pocket (indicated in pockets over 4 mm that do not respond to scaling/root planing alone). Arestin dissolves in the pocket over a 21 day span.

Personal Oral hygiene. Besides the conventional brushing and flossing, there are specialized toothbrushes (Rotadent: recommended and sold only by participating dentists) and other periodontal aids that assist in the daily removal of plaque at home. Our well-trained dental hygienists/dentists will tailor an individual program for each patient undergoing our STM program. This is essential for successful treatment.

Recall/Supportive periodontal therapy. There is some evidence and immense clinical observation to support the fact that 90 days is the time necessary for bacteria to re-establish to the point they can cause more damage to periodontal tissues. This time interval is often the benchmark for successful follow up aftercare from STM.

Once your mouth is in a healthy condition you dentist can plan the cosmetic dentistry procedures needed to give you that beautiful and confident smile.

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