Once you have had your consultation or examination appointment with either the Hygiene Therapist or a dentist, you may be required to book an appointment for a hygiene visit.
On most appointments there will be a specific Treatment Plan that is designed for you that the Hygiene Therapist will be following.
STEP 1: Assessment
The hygienist will firstly look at the information that has already been collected. This will include, radiographs (X-rays), Periodontal Charting and other dental charting.
The hygienist will then review your medical history to assess for any changes.
The hygienist will thereafter look at the Periodontal Charting and also look into your mouth to compare our previous findings to what is currently present. If you have not had a Periodontal Charting done, then the hygienist will conduct one.
A periodontal Charting involves measurements of:
- The pocketing or detachment of the gum from the tooth.
This involves using a special probe to measure in mm exactly how much gum deterioration has occurred on any particular point around a tooth. We usually do this measurement for six points around each tooth, hence it is called a 6-point pocket charting (6ppc).
- The level of plaque on the teeth.
The hygienist will then score how much plaque is visible on each surface of each tooth. We can then calculate a percentage of Plaque present in your mouth.
- Number of points around a tooth that easily bleeds.
This is an important measurement that denotes how much actual inflammation is present on your gums. Again, it is calculated as a percentage.
STEP 2: Detail look at your Restorations
The hygienist will then examine your existing restorations. This can be any fillings, bridgework, crowns, veneers, implants and braces. The hygienist will look for any food and plaque stagnation areas. These will be areas of your mouth that are difficult to keep clean.
STEP 3: Disclosing
Here the hygienist may decide to use a special dye to highlight parts of your mouth which are collecting plaque. This is very helpful to many patients as they can visually see the plaque stagnation areas so can work more diligently on those sections of the mouth when toothbrushing.
STEP 4: Full Mouth Descale
There are a huge array of techniques the hygienist will use to accomplish the treatment of gum disease. However, in general, the treatments involve removing plaque and tarter from the teeth surfaces. Plaque and tarter contains bacteria and food debris that more often than not solidifies onto the tooth surface only to attract more plaque. Once solidified it is called “Calculus” or Tarter.
The first stage of treatment usually involves giving you a mouth that is “clean” of any plaque and tarter. This treatment does not involve any pain as the hygienist usually remains above the gum margin.
The hygienist will use special instruments called descalers and an ultrasonic to remove hardened plaque from your teeth. In general, this will be a cleaning that is not too deep to begin with. Subsequently, this type of cleaning may require local anaesthetic for a more thorough deeper cleaning.
The hygienist will complete this stage by polishing your teeth. Polishing teeth removes the transparent bio-layer. This is a protein layer which binds the plaque to the tooth surface. Hence, your teeth can remain plaque free for a while.
STEP 5: Deeper Descaling
On some patients their 6pcc reveals greater detachment of the gum from the teeth in various areas of the mouth. When this happens, the hygienist will not only carry out a full mouth descale (as Step 4) but may also need to administer some local anaesthetic prior to carrying out deeper descaling of the root surfaces of the tooth that is below the gum margin.
A detached gum or “pocket” means that there is infection present that will be difficult for the patient to clean. Any pocket that is greater than 4mm will require this type of work.
Firstly, the hygienist will place a numbing gel on the gums before administering the local anaesthetic. Then when you are fully numb, she will continue to use specific instruments that will descale the part of the tooth covered by the detached gum, deep in the pocket. Once the infection has been removed then the gum will heal back onto the tooth.
You may find that your gums may be a little sore after this treatment. You will be advised to do warm salty mouthwashes or use a fluoride mouthwash. In some cases, you may need to take some painkillers as necessary.
This is the standard first level of treatment when any pocketing exists.
STEP 6: Special Select Treatment
In some instances, the hygienist will also carry out select treatments that are part of your overall Treatment Plan. This can include Fissure Sealants, Fluoride Treatments and Teeth Whitening Treatments.
STEP 7: Oral Hygiene Instructions
In this modern era when a whole host of treatments are being undertaken like veneers, braces, bridges and implants, it is important that you understand how to look are your particular mouth.
A standardised cleaning method would not be as effective for you. Our hygiene therapists understand all restorative, cosmetic, implant and orthodontic procedures. This means that they can tailor-make your gum treatments to suit your specific situations and advise you accordingly. They can look after your teeth before, during and after other restorative treatment.
The hygienist therapist can show you the correct way to clean your teeth and what tools will be best for you. For example, there are now so many different variations of interdental brushes, types of toothbrushes, floss and mouthwashes. It can get a bit confusing. Our hygienists will help you to select the most appropriate tools for you that will best do the job.
You will also be given dietary advice to help you prevent dental issues and maintain a healthy mouth.
Home care is critical to help you keep your teeth, gums and mouth healthy at all times.
Plan for the next stage
After your treatment, the hygienist will record what has been done on that visit. They will discuss with you your exact home regime to follow and what will be done on your next visit.
The hygienist will also discuss how many visits you will need subsequently to complete your treatment.
For some patients you may be put onto a specific Periodontal Program which caters for the type of Gum Disease that is present in your mouth.