October is Dental Hygiene Month in the US

I am not one of those who are scared of dentists. In fact, I was more scared of the cost. You see, unlike in many European countries, dental care, even the most basic, is not covered by health insurance in Switzerland where I now live.

Thus, since we moved to Switzerland 4 years ago, I had my dental services done in Asia when every time I visit my family there. Asia, in fact, is very popular among “medical tourists” in terms of dental care.

Then a couple of weeks ago, I had pain in my teeth and gums that barely allowed me to eat. I hoped that the pain will go away but after 2 weeks on pain and discomfort, I finally decided to visit the dentist.

Now, let me tell you, dental care in Switzerland is the most expensive in the world. But it is also arguably the best in the world.

So I went to the dentist and I was told that the problem is not my teeth – no holes or caries anywhere – but my gums. Specifically the tartar or calculus that accumulated under my gums caused the problem.

MedicineNet defines tartar as:

“… is the hardened product of longstanding plaque accumulating minerals from the saliva and foods. Plaque is the soft accumulation of food debris and bacteria around teeth. These bacteria feed on left over food in the mouth to excrete toxins that irritate the gums and dissolve the bone. Plaque can be removed by proper brushing and flossing at home. Tartar can become as hard as a rock and then can require a dentist or dental hygienist with special tools to remove it. Dental plaque and tartar cause inflammation of the bone surrounding the teeth referred to as “periodontia.”

So what I had was gingivitis, inflammation or infection of the gums. And I am not careful, it can progress to periodontitis when the infection spreads from the gums to the ligaments and bone that support the teeth.

So I did a bit of research into the topic, well-timed since it is Dental Hygiene Month in the US.

And here are some reasons why we should take dental hygiene seriously:

• Periodontitis can cause tooth loss, especially among adults.
• Periodontitis increase the risk for heart disease and other serious health problems.

According to Mayo Clinic experts:

“…bacteria may travel to the arteries in your heart. There, they can trigger a cycle of inflammation and arterial narrowing that contributes to heart attacks.”

Tartar may  accumulate on the tooth crown (supra-gingival) and on the root of the tooth under the gums (sub-gingival calculus). Mine were most the latter, which is the most difficult to remove.

So how is tartar removed?

Treatment options are:

• Scaling: The instrumentation of the crown and root surfaces of the teeth to remove plaque, calculus, and stains from these surfaces.
• Root Planing: A treatment procedure designed to remove cementum or surface dentin that is rough, impregnated with calculus or contaminated with toxins or microorganisms.
• Periodontal Debridement: This includes the removal of plaque, and calculus both above and below the gingiva.
• Prophy / Prophylaxis: A preventive procedure to remove local irritants to the gingiva, including debridements of calculus and removal of plaque.
• Scaling and root planing can be done utilizing a non-surgical (closed) approach or a surgical (open) approach.

A non surgical approach is when access to the root surfaces is via the sulci or periodontal pockets.

A surgical approach is when full thickness tissue flaps are reflected to expose the root surfaces and gain direct access to them.

The efficacy of subgingival plaque and calculus removal utilizing a non surgical approach is limited. Pockets up to 5mm may be adequately debrided using a closed approach, but deeper pockets often will require an open or surgical approach.

I am scheduled next week for a periodontal debridement.

And I have learned my lesson: don’t go for cheap dental hygiene options.