In the US alone, there are currently around 30 million people living with diabetes and another 86 million with pre-diabetes. Diabetes is a metabolic disease that causes a person to have high blood sugar, for a long period of time. People that have diabetes can suffer from a wide variety of health issues and we are learning more and more about the relationship between diabetes and having a healthy mouth.
As diabetes progresses, so does the likelihood of an individual developing chronic periodontitis or disease of the gum tissues. If a patient that has diabetes develops periodontitis or gum disease, it’s likely the both conditions will worsen if both are not treated and kept under control. There is huge amount research currently being done regarding uncontrolled diabetes and its interference with glucose (sugar) regulation in the body. Interference with glucose regulation makes the diabetic condition worse; leading to other medical conditions. Diabetic patients commonly have swollen and inflamed gums and can notice a bad taste in their mouth. When our gums become inflamed, our inflammatory response sends mediators into the blood stream which cause a negative effect on glucose regulation, therefore worsening the diabetic condition.
By properly treating periodontal disease, sugar levels have a much better chance of returning to a more normal state and improving overall health. Home care for a diabetic should be strict and consist of brushing twice a day, flossing once a day and seeing a dentist twice a year. In some cases, diabetics may need to see a dentist more often. Please contact your dental team at Norman Dental if you have any questions or concerns about how diabetes can affect your overall health.
Prophy vs Perio Maintenance
Dr. Matthew Norman and Michelle Phillips, RDH
One of the most common questions that we are asked by our patients is, “what’s the difference between a prophy and a periodontal maintenance”? We want to address that question in this edition of our blog.
When you have your comprehensive or new patient exam at Norman Dental, the doctor and your hygienist will perform a thorough evaluation of your gums to determine which type of cleaning best suits you. The doctor or hygienist will measure a space between your gum and the tooth, which is known as a “pocket”. A healthy pocket depth is 1-3 millimeters. Areas that are observed to have pocket depths deeper than 3 millimeters may need to be cleaned more thoroughly than healthy areas. Your dental team will also be looking for areas that bleed while taking these measurements, as a healthy pocket does not bleed. Bleeding indicates the presence of inflammation, which is usually caused by bacteria located within the pocket. Inflammation in the gum tissue can cause bone loss around the teeth. This information is how your dental team determines whether a prophy or periodontal maintenance procedure best suits you. We will discuss each procedure in more detail below.
A prophylaxis, or prophy, is a dental cleaning on a healthy mouth. The insurance code specifies this procedure to involve the scaling and polishing of all coronal surfaces (the crown of the tooth). Therefore, no scaling or cleaning occurs below the gum tissue. Scaling is followed up with polishing to remove the fine debris and stain from the teeth. A typical “prophy” patient comes every 6 months for their professional hygiene appointment.
A periodontal maintenance consists of a more involved “cleaning”. The hygienist starts by using a Cavitron or ultrasonic scaler. The ultrasonic scaler is designed to clean below the gums and to break away heavy calculus/tartar that accumulates on the root surface of the tooth. Microscopic vibrations from the scaler loosen the hard deposits away from the tooth and the water flushes the debris away. This process also forces oxygen into deeper pockets. This is helpful because much of the bacteria that causes periodontal disease is anaerobic, meaning it needs an environment without oxygen to survive and grow. When the ultrasonic scaler introduces oxygen into the gum pockets, it kills the bacteria present. Next, the teeth are hand scaled and polished to remove fine deposits below and above the gum line. Finally, the hygienist will irrigate the deeper pockets with an antibiotic rinse to kill any residual bacteria present. Typically, when you have been classified as a patient needing a periodontal maintenance procedure, your status usually never changes. This is because bone loss around the teeth is irreversible, and the presence of bone loss causes the periodontal health to be compromised. A typical “periodontal” patient comes every 3 or 4 months for their professional hygiene appointment.
Whether it is a standard prophy or a periodontal maintenance procedure that best suits your individual need, your Norman Dental team will work with you to endure your teeth and gums stay healthy for a long time to come!