Gum (Care Periodontal Therapist Services)

We are passionate about making sure all of our patients have the opportunity for healthy gums. In fact, our Dental Hygienists are now called Periodontal Therapists because they are experts at gum disease detection and delivery of treatment.

If you have any of the below you may have a gum problem:

  • Bleeding gums
  • Shrinking gums exposing more tooth
  • Bad breath
  • Flaring teeth
  • Black spots around the gums or teeth
  • Loose teeth

Our menu of gum care services includes:

  • Traditional cleanings
  • Advanced diagnostic saliva testing to determine your genetic risk or predisposition for gum disease
  • Saliva testing to measure harmful bacteria to gum health and to blood vessels
  • Treatment for diseased gums bleeding, swollen, or sore gums
  • Non surgical gum disease treatment
  • Surgical procedures necessary for advanced gum disease
  • Maintenance procedures to keep gum disease stable
  • Periodontal maintenance procedures to keep dental implants healthy or to get them healthy
  • Counseling to educate about how gum disease affects systemic health

Some common questions about gum disease:

My gums don’t hurt or bleed, so how do you know I have periodontal disease?

On a casual glance the teeth and gums can look healthy on the surface. During a periodontal examination we look for signs of disease, including deep crevices (pockets) between the teeth and gums, radiographic (x-ray) evidence of bone loss around the teeth, and visual signs of swelling, bleeding, or infection. Periodontal disease is a chronic bacterial infection of the supporting structures of the teeth (gum and bone). It often degrades these structures slowly and without pain.

I have been going to the dentist for years. Why haven’t I been told I have periodontal disease before?

This is an understandable question. Quite simply, your body changes over time. Just as you may have developed a cavity since your last appointment, health changes could have caused you to become more susceptible to the bacteria that cause a gum infection. Bacteria that have been present in your mouth for a long time can then cause periodontal disease. When you come in for your continuous care appointment, we evaluate both the health of the teeth and the health of your gum and bone support. We also determine your risk of having an infection in either of these areas. An infection may be throughout your entire mouth of localized to just a small area (one or more teeth). Presence of the infection anywhere is reason to have therapy to control it. Risk factors affecting the onset of periodontal disease include:

  • Genetic predisposition
  • Smoking
  • Diabetes
  • Heart disease
  • Respiratory disease
  • Osteoporosis
  • Radiation
  • Chemotherapy
  • Medications
  • Stress

Our goal is to recognize periodontal disease as early as possible and help you control it so it does not contribute to the deterioration of your overall health. We use a simple saliva test to determine your individual genetic predisposition and to measure the levels of harmful bacteria to help us better manage the disease.

Will my insurance cover my periodontal visits?  If I don’t have insurance, how much will it cost?

Most dental insurance companies provide some level of coverage for periodontal examination and treatment. The insurance company determines coverage based on the limitations of your plan, plus their review of the findings from your examination. Our business staff can help evaluate your plan to estimate your dental benefits. However, please be informed that any fee that the insurance company does not pay is your responsibility. All fees will be discussed with you prior to treatment. If your dental benefits seem unreasonably low, we encourage you to contact your benefits advisor or your employer and express concern about the limitations of your dental plan so that future dental plans can be evaluated more carefully. Outside financing or term credit is also available and easily obtained if you need financial assistance.

Why don’t you just clean my teeth and do the best you can?

Our goal is to provide excellent comprehensive oral care utilizing a team approach, and if we detect a gum infection, we cannot and will not ignore it. With periodontal disease, the risk to your overall health is too great if left untreated. Periodontal disease not only leads to tooth loss, it may put you at increased risk for other systemic illness like diabetes, heart disease, respiratory disease; or if you are a pregnant woman, it may cause a pre-term, low birth weight baby. All pregnant women should be screened and informed about periodontal disease.

My insurance only covers two cleanings per year.  Why do I need to comeback every three to four months?

Concerning your insurance benefits, it is true that most dental plans allow two cleanings per year for healthy patients.  This is expected to change in the future for patients that have a genetic predisposition to gum disease. If you have had prior gum disease treatment (Active Periodontal Therapy) and the disease process has been stabilized, maintenance visits are usually every three to four months.

Periodontal disease results in deep pockets between the tooth and gum.  Infected areas this deep are not fully accessible by brushing and flossing at home.  Bacteria in these pockets need to be disrupted every 90-120 days to prevent further damage.  This is done when the hygienist manually removes the bacterial toxins with special ultrasonic or hand instruments.

Please be assured if you have benefits available for periodontal therapy and maintenance we will do our best to get them allocated on your behalf.

Why is Periodontal Maintenance different and more expensive than a regular cleaning and why do I have to come more often?

If you have been treated with Active Periodontal Therapy in the form of deep cleaning (scaling and root planing) you need special care to keep the disease causing bacteria under control. These appointments are different than those for regular cleanings. Regular cleanings are only for those that have never been diagnosed or treated for gum disease. Following is an in-depth explanation of the necessary maintenance (Periodontal Maintenance or Supportive Periodontal Therapy) following your active gum disease treatment.

Once you have the bacteria that cause periodontal disease, you always have them. In most cases, they can be controlled, but they are never eliminated. After undergoing active periodontal care (in our office or in a periodontist’s office), the accepted and proper standard of care is to have four supportive periodontal therapy appointments each year.

Supportive periodontal therapy is much more than a regular cleaning.  When you return every three months for supportive periodontal therapy, the long-term outlook for you to keep your teeth becomes positive. Conversely, there is a high risk of your periodontal disease recurring to dangerous levels of activity if you have your teeth cleaned at only six or twelve-month intervals.

Supportive periodontal therapy visits include, but are not limited to, a review of your medical status, charting to monitor your periodontal condition, an in-depth disinfection of the periodontal pockets to disrupt the bacteria, possible application of localized antibiotics, polishing the teeth, and home care analysis. Extra skill, care, and judgment go into managing your teeth once you have periodontal disease. We pay particular attention to exposed root surfaces, areas between the roots of the teeth, and we evaluate if the interval between supportive appointments is appropriate for your present level of wellness.

If you are dependent upon insurance to provide the financial resources for your care, you may not be able to keep your teeth healthy. Some insurance companies will only pay for two cleanings per year. Do not interpret this to mean that because they only pay for two cleanings that this is the Standard of Care. Please be assured that the accepted Standard of Care following the diagnosis and prescribed therapy for active periodontal disease is to have four supportive periodontal therapy visits per year.

Gum disease is a major contributor and the primary cause of oral inflammation. This is an important part of your health to understand and keep under control. Managing gum disease is a major way dentistry can contribute positively to total body wellness.

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