WHAT IS THE DIFFERENCE BETWEEN A PROPHY AND A PERIODONTAL MAINTENANCE? by Dona Fujioka, R.D.H.

Patients often ask about what the difference is between a prophy, a regular cleaning and a periodontal maintenance cleaning. The concern is mainly because of the fee that is being charged and the frequency recommended.

A PROPHYLAXIS (1110) or regular cleaning is only for people who do NOT show any signs and symptoms of periodontal disease, including bone loss, bleeding, mobility, exudates and recession. It is a preventive procedure for those who do not yet have periodontal disease. The CDT (Current Dental Terminology) definition says, D1110 is for “the removal of plaque, calculus, and stains from the tooth structure in the permanent and transitional dentition. It is intended to control local irritational factors.”

A PERIODONTAL MAINTENANCE (4910) is a post-therapeutic procedure to maintain results following periodontal therapy treatment. The CDT definition for D4910 states that the procedure is used “following periodontal therapy and continues at varying intervals. It includes removal of bacterial plaque and calculus from supragingival and subgingival sites, and polishing the teeth.” Periodontal maintenance is a more in-depth cleaning. The goal in this procedure is the debride the pockets of periodontal pathogens that reside in calculus, on root surface biofilm, in sulcular epithelium and free-floating in the sulcus or pocket. Most patients who have undergone periodontal therapy treatment have deep pockets. These pockets are difficult for patients to clean at home. Even with good home care, periodontal bacteria can repopulate these areas in as little as 9 to 11 weeks. This explains the necessity for a periodontal maintenance visit at frequent intervals, which can either be every 12 or 16 weeks. The intervals are dependent upon the patient’s oral hygiene.

To establish or maintain a periodontally healthy mouth, proper care has to be taken at home and at the dental office. While thorough cleaning is required for patients who do not yet have periodontal disease, an even more extensive cleaning is needed for patients who do have the disease.





SOURCE: RDH Magazine
Diane Glasscoe Watterson, RDH,BS,MA and Bill Landers

Smoking and Your Mouth by Douglas Urban, DDS

So you have considered quitting smoking? It’s too expensive, you can only smoke in your garage, and people avoid your smoke plumes. If that wasn’t enough let me nudge you a bit further to making the final decision to quit. Consider your mouth, throat and lungs to be the inside of your chimney. It gets black and sooty in your body as well as your chimney.

Sadly most of my patients that require a lot of dental work in their adult years have a history of smoking. This results in more dental chair time and expense. Furthermore, the chances of a favorable long term outcome from treatment are diminished due to smoking. Let me explain why this is so.

First, smoking increases the chance of acquiring oral cancerous lesions. These lesions are painful to remove and healing is slow and painful. Also, oral cancer can kill you.

Tobacco smoke can cause white patches and brown patches to develop in the mouth. White patches can be precancerous and brown patches may be due from increased melanin pigmentation. Regardless, your mouth has changed for the worse.

Tobacco smoking will increase the severity of gingivitis and periodontitis. I can’t save teeth if there is no supporting bone to hold them in place. Acute necrotizing ulcerative gingivitis is a condition where the gums in between the teeth become very sore and chewing is difficult. A higher percentage of my patients with this diagnosis are smokers.

Smoking can cause delayed wound healing by diminishing the blood flow. Also, the microfiber attachment of the gums to the teeth breakdown and allow bacterial infiltration in the deepened crevices.

Smoking will cause chronic coughing and sinus infections as the body recoils from the ash that gets in the airways. This increased inflammatory load on the body can diminish the immune system. Consequently, fungal infections and ulcerations will occur.

On the lighter side smoking can create a condition of black hairy tongue (looks just like it sounds) altered taste, bad breath and tooth stains.
I know that most of you reading this are not smokers. Avoidance and denial keep smokers from seeing warning signs. However, you might have friends or loved ones (children) that smoke and you would like to help them quit. I hope I have given you enough ammunition as a dentist to be of help.

For answers to your dental questions, contact
Douglas Urban, D.D.S.
Cerritos, CA 90703
562 924-1523
DrDouglasUrban.com