Plaque, or the sticky film of bacteria that cover your teeth, is the primary causative factor of gum disease and caries. When plaque stays on the teeth for long periods of time and interacts with saliva, calculus (tartar) forms. Brushing twice a day and flossing at least once a day are important factors in reducing the amount of disease-causing plaque. Regular cleanings are not only important in removing plaque and calculus, but also in reinforcing good oral hygiene, finding areas in the mouth that are being missed in brushing and flossing, and checking for early signs of gingivitis, periodontitis, and caries. Periodontitis often goes without symptoms until severe damage is done to the bone surrounding the teeth. If it has been a while since your last cleaning, we may need to do a two or three step cleaning in order to remove excessive amounts of plaque and calculus or to adequately clean deeper periodontal pockets. After this we will try to get you on a maintenance or preventative program to keep your gums healthy. Periodontitis is an infection of the supporting tissues of the teeth. The milder form, gingivitis , is an inflammation of the gums that is reversible, although it may lead to the more aggressive disease, periodontitis. Periodontitis occurs when pathogenic bacteria attack the supporting tissues of the teeth, leading to bone loss. This will eventually cause the teeth to become loose, drift and fall out. Diagnosis involves measuring the distance between the top of the gum and where it meets the tooth. This is called a periodontal pocket and a deep pocket signifies bone loss and/or inflammation. The good news is that the primary factor that causes periodontitis is plaque. Therefore regular cleanings and good home care can slow down or stop periodontitis. Other factors that can make you more susceptible to periodontal disease:

• Tobacco smoking or chewing
• Systemic diseases such as diabetes
• Some types of medication such as steroids, some types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers and oral contraceptives
• Bridges that no longer fit properly
• Crooked teeth
• Fillings that have become defective
• Pregnancy or use of oral contraceptives

Often chronic periodontitis does not show any symptoms (such as pain) until that last stages when it is too late to save the teeth. There are some signs to watch out for, such as a bad taste in your mouth, red, swollen and bleeding gums, loose teeth or moving teeth, etc. Of course the best way to diagnose a problem is to see your dentist regularly for check-ups and cleanings. If periodontal disease is diagnosed, there are several treatments we may use. These include, but are not limited to, 3-6 months cleanings, surgical procedures, antibacterial products and the use of special cleaning instruments.

Fluoride
Fluoride is a compound that is found naturally in water and can be incorporated into the enamel of teeth when they are formed, making them more resistance to the acid produced by decay-causing bacteria. Smaller amounts of fluoride can also be incorporated into teeth after they are formed, which is why drinking fluoridated water and using a fluoridated toothpaste is important. Swallowing large amounts of toothpaste or ingesting too much fluoride can cause stomach sickness or a condition called fluorosis in which the enamel takes on a dark stain. The American Dental Association (ADA) states that community water fluoridation is the single most effective public health measure to prevent tooth decay. Community water fluoridation is the adjustment of fluoride found naturally in water to levels optimal for oral health. Community fluoridation has been practiced and studied for more than 60 years and has been found to be safe and effective. If your child has a high level of decay or you live in an area without optimal fluoridation levels, please contact our office for a risk assessment to see if supplemental fluoride is needed. For more information on community water fluoridation, please read the ADA pamphlet on Fluoridation Facts.

Sealants
Pits and fissures are small grooves on the biting surfaces of molars that can develop decay more readily than other smoother surfaces of a tooth. This is because these grooves are often so deep and skinny that toothbrush bristles cannot adequately remove decay-causing bacteria from them. Sealants are a plastic material that is bonded to the tooth and will prevent decay from getting in the teeth. They are relatively easy to apply and are proven to reduce decay on biting surfaces of teeth.