Maneet Dharia DDS, FIDIA

Ash Kaushesh DDS, MAGD, MaCSD, DDOCS, DABOI/ID
Implants, General, Cosmetic & IV Sedation
211 Swanson Avenue
Lake Havasu City, AZ 86403
(928) 854-8540

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Posts for: March, 2014

WhichisBetterforCleaningYourTeethUltrasonicorHandTools

Dental plaque (a film of bacteria that forms on your teeth) is known to be the main cause of periodontal (gum) disease. When the bacteria settle on your teeth they form a whitish film called biofilm. Those that are not removed cause formation of “pockets,” areas of separation between the teeth and their surrounding gums, in which plaque hardens into deposits known as calculus or tartar. The purpose of having your teeth cleaned regularly by a trained professional hygienist is to remove deposits of plaque and calculus. Removal of hard deposits on your teeth is called “scaling.” This can be done either by using hand-held scalers or by newer technology: ultrasonic power scalers.

Let's take a look at the strengths and weaknesses of both types of instruments.

Power Scalers

How they work: These instruments use the energy of ultrasonic vibration to crush and remove hard, calcified deposits of calculus. They also create shockwaves that disrupt bacterial cells. Use of these tools includes washing and flushing the pockets and any exposed root surfaces with water.

Pros: They are as effective as manual instruments for calculus removal in shallow gum pockets and significantly more effective in pockets greater than 4mm. They are very effective in removing calculus from root surfaces and from within periodontal pockets. Their small tips can penetrate deeper into periodontal pockets than manual instruments and are more comfortable to experience, and they are more effective for cleaning difficult nooks and crannies. Coolant sprays flush the area and remove bacteria and their by-products. They require less time than manual instruments.

Cons: A contaminated mist may form so that the hygienist needs to wear protective equipment. The vibration of the ultrasonic instruments may make it difficult to feel if the root surface is completely smooth and free of calculus. Power scalers affect some heart pacemakers.

Conventional Hand-held Scalers

How they work: These depend on the skill and knowledge of the hygienist to manipulate them and scrape away calculus (tartar) from teeth and within pockets.

Pros: They are equally effective for plaque and calculus removal from shallow gum pockets. They do not interfere with electronic equipment like heart pacemakers. They can be used more easily on teeth in which there are areas of demineralization (areas where minerals have been removed from the tooth's enamel, making it more vulnerable to decay). They are easier on the tooth's surface and are thus better for use with porcelain or composite restoration, or sensitive teeth.

Cons: They take longer to complete a cleaning. Sometimes they cause more discomfort than ultrasonic scalers.

In most cases the choice of scalers is not really an either/or situation. Most experts say that the best results come through using both types of instruments. As a result, cleanings can be done with effective and efficient outcomes and greater patient comfort.

Contact us today to schedule an appointment to discuss your questions about dental cleanings. You can also learn more by reading the Dear Doctor magazine article, “Dental Cleanings Using Ultrasonic Scalers.”


UnderlyingFactorsforGumDiseaseRequireLong-TermTreatmentStrategy

You’ve been doing “all the right things” — brushing, flossing, and keeping up regular office cleanings and checkups. But you’re still struggling with gum disease — in fact, you’ve recently noticed loose teeth and other signs of infection.

While the primary cause of gum disease is dental plaque and calculus not adequately removed by regular oral hygiene and cleanings, you may also be among a small group of individuals with other risk factors that can worsen the effects of the disease. One of the most common of these factors isn’t something you can do much about — the physical characteristics you inherited from your parents. In reality, some people are more genetically prone to disease than others because their body doesn’t respond effectively to certain bacteria.

Chronic stress may also play a role in your body’s resistance level: it can both increase your risk for the disease and magnify its effects. In addition, the type of bacteria causing the disease could be a factor — our mouths contain thousands of strains, with some bacteria more difficult to control than others.

If your gum disease persists regardless of all our best efforts, we may be able to test for whether any of these other factors are involved. Determining the presence of any of these underlying factors can help us fine-tune our treatment approach.

You should know, however, that it might not be possible to effectively address every factor involved. If that’s the case, at some point it may be necessary to consider a tooth replacement option. The best choice by far are dental implants — not only are they functional and life-like in appearance, with proper care they could foster a healthier environment in your mouth by being stronger and more durable than the diseased teeth they’ve replaced.

Our ultimate goal as dentists is to alleviate gum disease and restore health and function to your teeth and gums. If that isn’t completely possible due to uncontrollable factors, we then adopt a strategy to control the disease as much as possible to preserve your teeth for as long as is prudent. This can give you time, then, to prepare yourself mentally, emotionally and financially for future teeth replacement and restoration.

If you would like more information on periodontal disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Periodontal (Gum) Treatment and Expectations.”