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Professional Maintenance: Essential for keeping teeth
The Wisdom Tooth by Wynn H. Okuda, D.M.D.

The other week I was talking with colleagues of mine, and we were discussing patient preventive activities in the dental office and at home. We concluded that there seems to be a trend for certain people to not find the time to keep up with their "recare" visits, due to busy careers, personal life, etc. Because it is a serious concern when patients don’t stay current with their hygiene and examination appointments, I wanted to address this in this month’s article.

We all know that periodic maintenance on certain items we own, such as a car, is the essential way to ensure optimal condition, maximize longevity, and minimize expenses. Some low cost maintenance activities, for example changing oil, may seem more bothersome than it’s worth. What’s eye opening is that if they are not performed they may cause extensive, costly and maybe irreparable damage. With the consequences known, why is it so difficult to stay on top of preventive activities? Because with our busy schedules, many times we need to turn our attention to address other crises and put out other fires. It’s easy to ignore, skip or delay preventive activities when everything seems fine.

It’s the same way with your teeth. There are some people who make it a priority to see their dentist and hygienist every three to six months (or as recommended), and their oral health stays close to optimal because of this. Then there are people who don’t, and may find themselves faced with otherwise avoidable dental procedures, disease, tooth loss and expenses.

So when your dental office calls you to schedule or confirm your appointment, if you are one to not make such appointments a priority, stop and reconsider. If you plan to keep your natural teeth for a lifetime, which should be everyone’s goal, I highly recommend that you take advantage of these preventive visits. The following are addressed during periodic hygiene and examination appointments:

Periodontal Disease. If you don’t know already, periodontal or gum disease is the major cause of tooth loss in adults, in that three out of four adults have gum-related problems. It is a silent, but lethal disease. Periodontal disease starts with plaque, a sticky, colorless layer of bacteria, that forms on your teeth between brushing. (By the way, am I the only one wondering if the castaways on the television show "Survivor" are allowed to have a toothbrush and floss, or is that a luxury item?) The risk of acquiring gum disease increases with age, as the bacteria in plaque can build-up and become a problem in certain age ranges. If not removed thoroughly with daily brushing and flossing, it hardens into tartar or calculus, which irritates the gums. This may cause gums to pull away from the teeth. If this progressive problem is left untreated, bone level around the affected teeth may recede or lower, resulting in loose teeth. Initial warning signs to watch for include gums that are red, swollen, bleeding, or having bad breath.

At your professional cleaning appointment, the hygienist removes the tartar or calculus build-up, which you are unable to do by yourself through brushing and flossing alone. The hygienist also polishes the teeth, making it more difficult for plaque to adhere to teeth. Your hygienist can inform you on areas in your mouth where you tend to have tartar or calculus build-up, so you can concentrate on these areas during your daily maintenance. Almost everyone can bear some improvement on brushing and flossing habits and techniques, so keep an open mind to instruction that can make your time spent more effective. If you do show signs of periodontal disease, depending on the severity, your treatment plan may include special cleanings or procedures, with the goal of returning the gums back to good health.

Tooth Decay. Even today, tooth decay can still be a problem in adult patients. Everyday the foods we eat, such as sugars and starches, turn into acids that attack our teeth. Your tooth’s ability to ward off acid attacks and prevent decay depends on previous fluoride exposure, diligent brushing and flossing, and genetic predisposition. If you find this to be a problem, ask your dentist if a fluoride rinse or gel would be of additional benefit to you.

A type of newer tooth decay, which is more common in adults and more prevalent these days, is "root decay". Because people are living longer, keeping their teeth longer, and because of specific situations, the gums may begin moving away from the tooth, exposing the root surface of the tooth. Because the root surface is softer than enamel, root decay can form more easily. A periodic examination can help monitor gum recession, plan preventive procedures before decay starts. For some patients, more frequent professional cleanings may be recommended.

Care for Special Restorations. Another reason to keep your preventive appointments is that your specially trained hygienist is the only one who can ensure certain restorations are maintained correctly. With different dental restorative materials, there are various cleaning and polishing requirements to keep it looking its best and lasting long. For example, with porcelain restorations there is a specific way to polish it, where its natural-appearing luster can be maintained. If the wrong polishes are used, your beautiful smile may become "scuffed up", resulting in a dull appearance. If you have porcelain restorations, using an abrasive polish that is routinely used on natural teeth can irreversibly scratch and dull the porcelain. It’s like using a harsh cleanser on a porcelain sink, when you should be using something gentler. Similarly with dental implants (which are titanium screws placed in the bone, on which stable restorations are added) trained dental professionals will ensure that the cleaning process does not scratch and mar the metal surface.

So the next time you are due for a professional tooth cleaning and exam, think long term and stay on schedule. A lot can change in your mouth in six months, and these maintenance appointments are the way to optimal dental health. Yes, as with your car service appointments, it’s easy to skip or put off these visits, as everything may seem okay. In the worst case scenario with you car, you can always buy a new one when the old one is rusted out. However, your smile is different as you are only born with one set of adult teeth. By keeping up with these preventive dental activities, you stay one step ahead of tooth decay and periodontal disease. Your periodic cleaning and exam appointments, coupled with solid home care, are the keys to keeping your smile for a lifetime.