Wednesday, December 9, 2015

Scaling and Root Planing: Reevaluation

The goal of scaling and root planing is to remove all plaque, toxins, and calculus both above and below the gumline. After healing has occurred, the tissues will shrink, and a reevaluation of the condition of the gum and supporting structures will reveal any areas that may need re-treatment. Your oral self-care habits will be reevaluated at the same time and any revisions to our recommendations will be made. We will be polishing your teeth at this appointment. As you will recall, we did not polish your teeth during the root planing and scaling appointments. Although the polishing can, in theory, be done then, we believe that allowing tissues proper time to heal will allow us to make the best reevaluation of our treatment and oral self-care recommendations. That is why there is a time period of several weeks between the root planing and scaling appointment and this prophylaxis and evaluation. Once all tissues have responded and the goals of scaling and root planing are met, a recare interval will be established for you.

At the recare appointment, we will once again be evaluating your oral self-care to determine whether we need to recommend different procedures to keep your oral health at its best. We will reexamine your periodontal tissues for evidence of healing by remeasuring the probing depths around each tooth. Any areas of bleeding will be noted and treated; your teeth will then be polished and a topical fluoride treatment will be applied.

Topical fluoride provides a bacteriostatic action to the oral bacteria during treatment and for several hours afterward. It appears to be harder for the bacteria that cause gum disease to multiply and cause problems when topical fluoride is used.

If the goals of scaling and root planing have not been met, we will either re-treat those areas that have reinfected or refer you to a periodontist for specific periodontal surgery. The periodontal surgery will correct some of the hard (bone) and soft tissue defects that were caused by the periodontal infection.

At this time we may also consider using one or more of the newer nonsurgical therapies available for localized sites that have not healed as much as we would like. The site-specific therapy may be recommended for the first time or as a re-treatment. We will then monitor the results to determine whether a referral to a periodontist is appropriate.

A final word about how often you should have your teeth cleaned:  modern dentistry considers a patient who has had gum disease to be always recovering, never completely "cured." If you do not take care of your teeth and gums, the problem can come back again. It is in the best interest of your oral health to have your teeth examined and cleaned at an interval of 3 to 4 months in most cases, not every 6 months as you have heard for years.

If you have any questions about the prophylaxis and reevaluation appointment, please call Omni Dental Group at (512) 250-5012.


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