Frequently Asked Questions About Dental Hygiene
Dental Hygienists are trained healthcare professionals. They are licensed to practice with the Dental Council of NZ. A dental hygienists major role is the prevention and non-surgical treatment of periodontal (gum) diseases. A dental hygienist will help guide and promote healthy oral behaviours to help stabilise and maintain good gum health. Dental Hygienists are skilled in gum scaling and rootplaning (specialized cleaning of the root surface of your tooth).
As part of providing exceptional dental hygiene care, our hygienists may:
- Complete oral health assessments that include a review of your health history, screen for oral cancers, record gum health and signs of gum loss (recession).
- Take and interpret xrays
- Remove plaque and calculus (tartar) from above and below the gumline
- Apply agents to the teeth to protect against cavities (such as fluoride and dental sealants)
- Provide topical and/or local anesthetics if any treatment is uncomfortable
- Show you oral hygiene techniques to improve your home-care to help you maintain healthy teeth and gums
The dentist will refer you to a hygienist if there is gum inflammation caused by plaque and tartar buildup. To stop gum disease from progressing, the dentist may recommend periodontal therapy or deep cleaning performed by the dental hygienist to treat and get rid of bacteria in the gum pocket. Our dental hygienists have specialized equipment to clean deeply into these unhealthy gum pockets which cannot be reached by a toothbrush.
Gingivitis is the inflammation of the gums caused by plaque, and is the earliest form of gum disease. The bacteria in the plaque irritate the gums making them bleed, and they become red and swollen. You may notice this sometimes when you brush or floss your teeth. Usually there is no discomfort from gingivitis, so you may not be aware you have it.
If the Gingivitis is not treated, the inflammation can work its way down under the gum towards the bone and tissues which are the main supporting structures of the tooth. This causes a deepened space down the side of the tooth called a periodontal pocket. As these pockets get deeper the supporting structures of the tooth are destroyed. Over time this will cause teeth to become loose, resulting in tooth loss. This is termed as Periodontal (gum) disease.
The problem is once gum disease has already progressed it cannot be cured because once bone loss has occurred around a tooth the bone will not grow back. However, gum disease can be treated by removing the plaque out of the gum pocket through scaling and rootplaning therefore stopping the infection from progressing any further. The treatment aim is to gain stability and stop further gum disease progression.
The problem is that until the gum disease gets quite severe, there are very few symptoms. Pain is not a symptom until the gum disease is often very advanced. By that stage it is often too late as there has been too much bone loss around the tooth and the tooth may already be loose.
Everybody is different depending on how healthy your gums are. Normally, if you have a history of gum disease, we try and see you every six months, to help prevent it occurring again. Occasionally we need to see you more often, if you have deep gum pockets, or if you are having difficulty with your home-care. This ensures the gum pockets remain as plaque-free as possible helping maintain gum health. By the time we see bleeding around a pocket it is telling us that the gum condition is active and maybe getting worse again. It is important to remember that you cannot clean down into the pocket yourself at home, so professional hygienist intervention combined with good homecare is important to achieve optimal gum health.
Gum treatment of a healthy mouth should not cause discomfort. Treatment of red, inflamed gums can be uncomfortable for some people, so we have various pain control techniques available. It is important for you as a patient to let us know if you are experiencing any discomfort as this can be controlled.
This will depend on the severity of the gum condition. With deeper pockets and heavy calculus deposits the appointments of deep scaling and rootplaning may be divided up into different appointments. For example, the lower right side of the mouth may be worked on in one appointment and the other three quadrants at separate appointments. Alternately one half of the mouth might be treated per appointment. This gives us time to fully focus on one area of your mouth and ensure it is plaque and tartar (calculus) free.
Appointments are usually booked in for 50-70 minutes in duration.
The success of your hygienist treatment with us will be strongly determined by how well you look after your teeth and gums at home. Plaque is in our mouth all the time and it is waiting to get back down into those gum pockets again once you leave the practice after your gum treatment. Thorough gum brushing, and cleaning inbetween your teeth is very important. The dental hygienist will help advise you on how to look after your gums at home.
The primary cause of gum disease is plaque. If you have no plaque you will not get gum disease.
However there are many factors that can contribute and make gum disease worse. Some of these factors with latest research are:
- Smoking: If you smoke you are four times more likely to have gum disease compared to someone who has never smoked
- Diabetes: 2-4 more times likely to develop gum disease
- Pregnancy: pregnant women who have gum disease may have a seven-fold increased risk of delivering a pre-term, low birth weight baby
- Cardiovascular Disease: 2 times more likely to develop gum disease
- Genetic factors: Evidence suggests that there is a significant genetic component to susceptibility of periodontal disease. We now know that there are at least two genes related to gum disease. Genetic testing for these genes is something that is carried out in the USA and is not available here in New Zealand as yet.