This includes preventive treatment, such as routine cleanings; maintenance visits for those with a history of gum disease; “Deep Cleaning” for active gum disease; and surgical treatment (we refer surgery to specialists).  An average adult in good oral health should have their teeth cleaned twice a year.  Those with a history of gum disease, or deep pockets around the teeth (where the teeth have come “unzipped” from the gums) may need cleanings more frequently.  In both cases, the most important part of treatment occurs at home:  removing bacterial plaque on a daily basis with brushing and flossing.  Sad to say, even the new sonic toothbrushes aren’t a substitute for flossing, but the good news is you can skip flossing once a week and nothing bad happens.  I recommend not flossing on Monday—gives you something to look forward to besides going back to work.

Pain Control—if you find routine cleanings uncomfortable, you may want to try nitrous oxide, sometimes referred to as “laughing gas.”  This is available for cleanings at a reduced fee of $13, but you need to reserve it in advance.  Just specify “I want nitrous” when you make your appointment.  (Nitrous is also available for other dental appointments, at an hourly fee of $30.)

Patients with active gum disease, as evidenced by gums that bleed when brushed or flossed, or that show bleeding and pus when checked by the hygienist, will usually need Scaling and Root Planing treatment, sometimes referred to as Deep Cleaning.  This involves anesthetizing the teeth and removing all the bacterial deposits below the gums, usually only part of the mouth at a time.  After scaling is complete, the gums are rechecked in a few weeks to see if the disease is responding to treatment.  There is no cure for gum disease at this time, but we can usually get it into indefinite remission by Scaling and Root Planing, followed by maintenance visits.

For advanced cases of gum disease, surgery is frequently required.  The specialist we work with most often is Dr. Stig Osterberg here in Port Townsend.  He is an excellent surgeon and also places implants.  There are a few other types of surgery that he performs, such as exposing decay below the gumline prior to placing crowns.  Our office will explain why you need to see him and coordinate the process for you.  Generally, you will still get your routine care at our office, and only see a periodontist on a one-time basis, although there are exceptions to this.