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Bleeding gums

Dental Cleanings - Long Island City, NY

Do your gums bleed when you brush or floss?

Healthy gums should not bleed so if you notice your gums bleeding as soon as your toothbrush or floss touches it, it is a sign that there is active inflammation. It is your body's way of letting you know that you are overdue for your dental check up!

In fact, you may already be at the first stage of gum disease, gingivitis.

What is Gingivitis?

Gingivitis is the first stage of gum disease and the definition of it means gum inflammation. It is typically accompanied by bleeding gums. The gingival bleeding can present in a variety of ways:

  • Gum bleeding around one tooth.

  • It could be indiscriminate and just bleed in the entire mouth.

  • Swollen gums

  • Red and poofy looking gums

What causes Gingivitis?

Gingivitis is caused by plaque and calculus sitting next to the gums causing them to be very inflamed. The gums will bleed very easily and is very inflamed because plaque and calculus are considered to be foreign to the body. There are a lot of bacteria within the plaque, it is basically a shelter or breeding ground for them!

Plaque is very prone to picking up staining as well such as black, brown, and even orange plaque.

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Our Ultrasonic - one of the tools to combat bleeding gums

What to Expect at your visit with one of our LIC dentists

Treatment for gingivitis is a regular teeth cleaning. We do a general cleaning and flush everything out with our ultrasonic, which vibrates at 32,000 times per second and squirts out a lot of water. Then we fine tune it with hand instruments by scaling the teeth.

 

Afterwards we do the final polishing. From start to finish the appointment should take no more than 45 minutes, maybe longer if you haven't been to the dentist in awhile.

Gingivitis doesn't hurt, what if I leave it as is?

Gingivitis when left alone will progress. The calculus and tartar will grow in size. Eventually the inflammation will spread from the gums to the bone and start eating away at the bone.

Once you start losing bone, it is no longer gingivitis and is now called Periodontitis. The definition of periodontitis means inflammation of the bone around the surrounding teeth.

You may even start noticing the gums bleeding for no reason at all. That is how you know it is getting serious! Is it possible for gum disease to kill you?

Sometimes when you are pregnant, you can get a specialized form of pregnancy gingivitis, which can cause a pregnancy tumor. Although it is not a real tumor.

Periodontitis

Periodontitis is inflammation of the bone. Teeth sit in bone like how a tree sits in dirt. If you start digging dirt away from the tree, it will start to wobble and eventually you can push it over.

When your teeth start feeling loose, you most likely have periodontitis. Your gums are also bleeding significantly more easily as well.

Periodontitis affects more than just your teeth and your gums, they affect the bone with an emphasis on that last part. This is a bone disease and that is serious.

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Treatment for Periodontitis depends on the severity of it.

Mild periodontitis

Treatment for mild periodontitis would be a deep teeth cleaning. Usually a deep teeth cleaning is split into 2 separate visits and you do need to be numb for each visit. This allows us to clean below your gums. A regular cleaning only cleans above the gumline.

Afterwards would be helpful to use a mouthwash like Listerine to get the bacteria under control.

Moderate periodontitis

Treatment for moderate periodontitis involves a deep cleaning and adjunctive therapy such as antibiotics placed below the gums. Gum surgery is also a possibility.

Severe periodontitis

Treatment for severe periodontitis would be to extract the non-restorable teeth. These teeth have lost so much bone that they no longer feel solid. They typically have a lot of mobility as well.

Review: Stages of gum disease

Healthy gums > Gingivitis > Mild Periodontitis > Moderate Periodontitis > Severe Periodontitis

The final outcome of severe periodontitis is full dentures. Basically the bone inflammation is so bad that all of your teeth get loose and they all need to be taken out. You can't put veneers on loose teeth because that is the same as trying to build a house on top of shaky foundation.

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What is a deep teeth cleaning?

A deep teeth cleaning is a regular cleaning plus more.

  • A regular cleaning cleans above the gum line.

  • A deep cleaning cleans below the gum line and also the root of the tooth.

  • Usually includes numbing gel and a dental numbing shot to reduce pain.

The technical term for a deep teeth cleaning is scaling and root planing. That is what dentists call it and it is used to treat advanced stages of gum disease. Gingivitis is the first stage of gum disease. The advanced stages it can treat are mild and moderate periodontitis.

Here is an example of a deep teeth cleaning before and after photo
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Look at that difference once you remove the plaque and tartar on teeth. Some of the areas even had black tartar on teeth. Some people even say it looks like grout.

Plaque vs Tartar

Actually what is the difference between the two? Sometimes we use them interchangeably but they are a bit different.

  • Plaque is the early stage of tartar

  • Plaque is very soft and contains a lot of bacteria

  • Tartar on teeth is very hard to palpation

  • Plaque you can brush off since it is soft even with light pressure

With that being said, the scientific term for the hard plaque is calculus. I know what you're thinking...

How to remove tartar from teeth without dentist or at home

Unfortunately no, you cannot remove it at home all by yourself because once plaque becomes tartar, it is extremely hard. It does not come off easily, not even if you brush with a very hard toothbrush for an hour. The only person who can remove it for you would be one of our long island city dentists.

We need to use our ultrasonic scaler which vibrates at over 30,000 rpm to get it off. We also go over it afterwards with hand scalers to scale off any residue.

A bonus is if you see extra black tartar on the teeth. This type is very mature tartar and much more difficult to come off. Hopefully that gives you an idea of what a before and after photo of a deep teeth cleaning is and why you should have it treated.

Just to reiterate, you can remove plaque at home without a dentist but you cannot remove tartar without a dentist.

What to expect for a deep teeth cleaning?

Let's go over the entire process and procedure from start to finish so you know what to expect.

  1. We need to get you nice and numb with anesthesia first so we apply some numbing gel all around your gums and your teeth.

  2. We apply the dental numbing shot

  3. We debride all of the calculus by removing all of the tartar with an ultrasonic scaler.

  4. We scale and root plane your teeth with hand scalers. The hand scalers give us tactile sensation to feel each individual piece of calculus that may be hiding beneath your gums.

  5. Sometimes we flush out your gums with an antibacterial mouth rinse.

  6. For post operative instructions and what can you eat after a deep teeth cleaning, check out our blog post.

  7. We typically do half the mouth at a time and you would return for the other half on a separate visit. This is just for your own comfort so that you don't get the numbing shot too many times... Although some people prefer to just get it all over it and do everything at once. Troopers I dare say!

Usually after scaling and root planing, we do want to keep a closer eye on you so we do recommend that you come back for your next dental cleaning in 3 months instead of the usual 6 months. Once we see you improving in gum health, we will bump you back to the biannual 6 month check ups.

Teeth deep cleaning cost

If you have dental insurance, they should cover the majority of the cost of the visit. Typically your insurance will cover about 80% of the treatment from our experience but it can vary depending on your specific plan. Your out of pocket cost would be the copay and deductible.

The only caveat is that your insurance does require additional documentation such as dental x rays along with your periodontal exam to be submitted so that they can verify that you do indeed have periodontal disease. What they look for is tartar on the x rays and also for bone loss.

So you can't get scaling and root planing if you decline the annual bitewing x rays or full mouth x rays. We wouldn't have evidence to submit for your insurance claim.

Are there any disadvantages to doing a deep teeth cleaning?

There aren't any disadvantages to the procedure per say because it is a necessary treatment if you have periodontitis. There are only advantages because you are treating gum disease.

In fact, you can't do scaling and root planing if you don't have any gum pockets. The gum pocket depth is measured by a periodontal probe from 1mm to 10mm+

Basically a healthy tooth will have gum pocket depths ranging from 1mm to 3mm. An unhealthy gum pocket would be 4mm and above. Sometimes if the gum infection is really bad you can get a pocket of pus on gum.

If you have an unhealthy pocket depth, you're automatically getting a deep cleaning. If you have healthy gums, you can't do root planing even if you want to because you're unable to plane the root surface.

If anything, patients often complain about their teeth being more sensitive after the deep cleaning procedure. The reason being that the tartar on teeth were covering all of the exposed root surfaces and therefore blocking cold beverages from touching their sensitive teeth. After the procedure, they are all gone so now they feel extra sensitive.

People may wonder why they don't just leave the calculus on their teeth and the reason is that yes it may decrease sensitivity but overtime they will lose all of their bone surrounding the teeth that they just get so loose, all of the teeth fall off!

I guess if you have no more teeth there wouldn't be anymore sensitivity.

Last but not least, don't forget that gum disease can cause receding gum lines. If you have a crown it can form a gap between the crown and the gums.