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Q: Doc, I haven’t been seen by a dentist in a while and want my teeth cleaned but were told I need a “deep cleaning.” Why can’t I just have my teeth cleaned like I wanted?

A: Well, this question has a very simple answer. You can have your teeth cleaned just like you wanted but it will serve no purpose other than to waste your time, money and adversely affect your health.

Some patients who haven’t had their teeth cleaned in a while require more than just a regular cleaning. This absence of dental care allows an accumulation of bacteria, plaque and tartar to form around the gumline. This serves to irritate the gum tissue making it inflamed and red. This is called gingivitis which literally means inflammation of the gums.

At this stage it is common to have bleeding when brushing or flossing. If gingivitis is not treated it always progresses into periodontal disease which is essentially a bacterial infection. As the bacteria progress further into the tissue and below the gumline the bacteria become very pathogenic and destructive. As the infection progresses into the bone these bacteria begin to produce toxins as a waste product which acts like poison.

As the toxins increase the bodies defenses begin to act. The combination of the poisonous toxins and your bodies response is to dissolve the bone that support the teeth. This stage can be deceptive to patients because periodontal disease is never painful until it is too late to save the teeth. Some patients do not experience any symptoms or discomfort and therefore believe that everything is fine.

Some of the most common symptoms are redness, inflammation, bleeding gums when brushing or flossing, bad taste, bad breath, shifting or moving teeth or a change in your bite. A regular cleaning will not cure any of these problems as we are only working above the infection. In fact, a regular cleaning can worsen the infection by allowing the surface to heal trapping the infection underneath. This can result in a painful abscess.

There are a few different types of treatment for this disease depending on the stage. Gingivitis is the earliest stage and treatment involves the gentle removal of bacteria and tartar from just below the gumline. Unless a person has particularly sensitive teeth local anesthetic is not necessary. Once the disease has progressed and begun to alter the level of bone a more aggressive treatment is necessary. Typically, this involves keeping the patient comfortable with local anesthetic. Once numb the hygienist flushes out the bacteria and removes the accumulation of tartar from below the gumline. There is no cutting or sewing involved.

Generally, there is little to no discomfort and patients can resume their normal schedules the same day. Severe bone loss or infection may necessitate treatment with a laser to preserve and regenerate bone levels. Once treatment is completed it is essential that patients return for regular maintenance or else the infection will recur. This means that patients must be seen for cleaning three to four times per year.

If you have gingivitis or periodontal disease having it treated now will be of great benefit to your overall health later.

Dr. Eck welcomes your questions at www.marcodentalcare.com or (239) 389-9400.

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Questions can be sent to Fred Eck, D.D.S. at Marco Dental Care, 950 N. Collier Blvd., Suite 305, Marco Island, or call 389-9400. Web site: marcodentalcare.com. Dr. Eck received his Doctor of Dental Surgery at the University of Detroit Mercy and is licensed by the Florida State Board of Dentistry.