Which is Better for Cleaning Your Teeth: Ultrasonic or Hand Tools?

By Drs Lawitts and Yeates

October 23, 2014

Category: Oral Health

Tags: oral hygiene oral health

WhichisBetterforCleaningYourTeethUltrasonicorHandTools

Dental plaque (a film of bacteria that forms on your teeth) is known to be the main cause of periodontal (gum) disease. When the bacteria settle on your teeth they form a whitish film called biofilm. Those that are not removed cause formation of “pockets,” areas of separation between the teeth and their surrounding gums, in which plaque hardens into deposits known as calculus or tartar. The purpose of having your teeth cleaned regularly by a trained professional hygienist is to remove deposits of plaque and calculus. Removal of hard deposits on your teeth is called “scaling.” This can be done either by using hand-held scalers or by newer technology: ultrasonic power scalers.

Let's take a look at the strengths and weaknesses of both types of instruments.

Power Scalers

How they work: These instruments use the energy of ultrasonic vibration to crush and remove hard, calcified deposits of calculus. They also create shockwaves that disrupt bacterial cells. Use of these tools includes washing and flushing the pockets and any exposed root surfaces with water.

Pros: They are as effective as manual instruments for calculus removal in shallow gum pockets and significantly more effective in pockets greater than 4mm. They are very effective in removing calculus from root surfaces and from within periodontal pockets. Their small tips can penetrate deeper into periodontal pockets than manual instruments and are more comfortable to experience, and they are more effective for cleaning difficult nooks and crannies. Coolant sprays flush the area and remove bacteria and their by-products. They require less time than manual instruments.

Cons: A contaminated mist may form so that the hygienist needs to wear protective equipment. The vibration of the ultrasonic instruments may make it difficult to feel if the root surface is completely smooth and free of calculus. Power scalers affect some heart pacemakers.

Conventional Hand-held Scalers

How they work: These depend on the skill and knowledge of the hygienist to manipulate them and scrape away calculus (tartar) from teeth and within pockets.

Pros: They are equally effective for plaque and calculus removal from shallow gum pockets. They do not interfere with electronic equipment like heart pacemakers. They can be used more easily on teeth in which there are areas of demineralization (areas where minerals have been removed from the tooth's enamel, making it more vulnerable to decay). They are easier on the tooth's surface and are thus better for use with porcelain or composite restoration, or sensitive teeth.

Cons: They take longer to complete a cleaning. Sometimes they cause more discomfort than ultrasonic scalers.

In most cases the choice of scalers is not really an either/or situation. Most experts say that the best results come through using both types of instruments. As a result, cleanings can be done with effective and efficient outcomes and greater patient comfort.

Contact us today to schedule an appointment to discuss your questions about dental cleanings. You can also learn more by reading the Dear Doctor magazine article, “Dental Cleanings Using Ultrasonic Scalers.”

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Antibacterial Solutions can Help Fight Advanced Gum Disease Infections

By Drs Lawitts and Yeates

October 15, 2014

Category: Oral Health

Tags: periodontal disease gum disease

AntibacterialSolutionscanHelpFightAdvancedGumDiseaseInfections

Periodontal (gum) disease is an infectious disease that progressively weakens the attachment of supporting tissues to the teeth, including gums, ligaments and bone. If not stopped, the loss of attachment will eventually lead to bone and tooth loss.

A thin layer of plaque that builds up on teeth (mainly due to poor oral hygiene habits) is the main breeding ground for the bacteria that cause gum disease. Our main treatment goal is to remove as much of this plaque as possible from tooth and gum surfaces. Much of the plaque can be removed using special hand or ultrasonic instruments that deep clean dental surfaces, including the roots. But while effective, these manual techniques may not address the full extent of infection, especially if the disease is well advanced.

If severe bone loss has already occurred, deep pockets of infection may have developed. As bone loss progresses, teeth with multiple roots may also develop an anatomical problem known as furcation invasions where the roots of the tooth branch off. If there continues to be signs of disease, like gum inflammation, bleeding or pus formation, it’s these hard to reach areas that may still be a problem even after extensive treatment. If so, we may need to take a different approach with antimicrobial or antibiotic products.

The most effective antimicrobial substance for reducing bacteria in biofilm is a chlorhexidine mouthrinse. The typical 0.12% solution is only available by prescription — if taken for a prolonged time it can result in tooth staining, affected taste or mouth irritation. To assure the solution reaches below the gum line, it will need to be applied by us in the office, followed up flushing irrigation of the affected area.

Another alternative is topically applied antibiotics that can stop or even reverse the progression of gum disease. There’s evidence that topical applications can penetrate into these deeper areas of infection. A common antibiotic used in this way is tetracycline, which has been shown to stop inflammation and infection.

These treatments don’t eliminate the need for mechanical cleaning, and the prolonged use of antibacterial products can have a detrimental effect on “good” bacteria (needed, for example, to complete the digestive process). It will depend on the extent of the gum disease to determine how successful conservative treatment may be. It’s also important that you contribute to your own dental health with a renewed daily oral hygiene habit.

If you would like more information on treatments for gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Treating Difficult Areas of Periodontal Disease.”

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Tooth Trauma Doesn't Have to Mean Tooth Loss

By Drs Lawitts and Yeates

October 07, 2014

Category: Oral Health

Tags: dental injury dental emergency

Tooth decay and other oral diseases aren’t the only dangers your teeth face — accidental injuries also pose a risk. Fortunately, much can be done to save injured teeth, if you act quickly.

Dental injuries where part of the enamel crown has chipped off are the most common. Even if only one tooth appears damaged, adjacent teeth and bone might also have been damaged internally. Most chip injuries can be repaired either by reattaching the broken crown or with a tooth-colored filling or veneer. If the damage has extended into the inner tooth pulp then a root canal treatment might ultimately be necessary.

Teeth that have been knocked loose from normal alignment (dislodged) or where the entire tooth with its root has separated from the socket (avulsed) are rare but severe when they occur. It’s imperative to see a dentist as soon as possible — even more than five minutes’ of elapsed time can drastically reduce the tooth’s survivability. Dislodged teeth are usually splinted to adjacent teeth for several weeks; we would then carefully monitor the healing process and intervene with endodontic treatment (focused on the tooth’s interior) should something unfavorable occur.

With the possible exception of a primary (baby) tooth, an avulsed tooth should be placed back in the socket as soon as possible. This can be done by someone on scene, as long as the tooth is handled gently, the root not touched, and the tooth rinsed with cold, clean water if it has become dirty. If no one is available to do this, the tooth should be placed in milk to avoid drying out the root, and the patient and tooth transported to a dentist immediately. Once in the socket, the treatment is similar as for a dislodged tooth with splinting and careful watching.

The damaged tooth should be checked regularly. Your body’s defense mechanism could still reject it, so there’s a danger the root could be eaten away, or resorbed. Some forms of resorption can’t be treated — the aim then is to preserve the natural tooth for as long as possible, and then replace it with a life-like restoration to regain form and function.

If you would like more information on the treatment of injured teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Trauma & Nerve Damage to Teeth.”

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	Dr. Karen Lawitts	Dr. Nancy Yeates
	Dr. Lawitts was born and raised in Syracuse, NY. She received her Bachelor of Science and D.D.S degree from Northwestern University in Chicago.	Dr. Nancy Yeates graduated from Canisius College with a B.A. in Biology. She then attended Georgetown University School of Dentistry.

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Posts for: October, 2014

Which is Better for Cleaning Your Teeth: Ultrasonic or Hand Tools?

Power Scalers

Conventional Hand-held Scalers

Antibacterial Solutions can Help Fight Advanced Gum Disease Infections

Tooth Trauma Doesn't Have to Mean Tooth Loss

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