Scaling & Polishing
Scaling is the removal of plaque and calculus from the tooth surface either with hand instruments or mechanically using ultrasonic cleaning machines. This eliminates gum infection which has resulted from accumulation of plaque and calculus.
The teeth are usually polished after scaling, preferably using a rubber cup and a fluoride- containing paste. Patients will be able to appreciate the feeling of a clean mouth, which must then be maintained by doing the procedure twice a year.
A definition of the term “dental curettage” is presented. It refers to the process of scraping a cavity or other dental surface using a curette, a narrow, spoon-shaped instrument. The procedure is performed to remove the lining of periodontal pockets and diseased tissues from root surfaces in gum disease (periodontitis) to allow the healthy underlying tissue to reattach itself to the root surface. In curettage procedures, instruments are used to cut away dead tissue.The idea is that such tissue can contribute to inflammation, infection, and bad odors, and that removal of the damaged tissue will promote the development of healthy tissue.
There are several different types of dental curettage, including ultrasonic curettage, which uses an ultrasonic dental instrument, and surgical curettage, in which a flap of gum is cut and rotated away so that a pocket of infected tissue can be cleaned out before the flap is rotated back and fixed in place.In basic dental curettage, a sharp cutting instrument is run into gingival pockets in front of the teeth to remove dead tissue, and dead or infected tissue will be removed from the gums. Local anesthetic is often used to make the patient more comfortable, and the mouth is frequently flushed with a sterile solution to sweep out the debris. This procedure is usually provided to people with advanced gum disease as a tool for managing the problem, and it may be required on multiple occasions.Curettage cannot eliminate the complete cause of periodontal infection so it is always preceded by scaling and root planning. A mild local anesthesia will be needed before curettage.
- Head of the curette is inserted into the pocket up to the base.
- The cutting edge of the instrument is toward the epithelium of the periodontal pocket.
- The pocket wall can be supported with finger pressure from the outside and a light stroke is given so that the inflamed epithelium can come out of the pocket.
- The process is repeated where ever indicated.
- Scoping motion of the curette will remove all the inflamed tissue, which is then followed by
flushing of the pocket.
- At last gingiva is adapted to the tooth with gentle finger
- In some cases suturing of the gums in between teeth is required or a periopack is given.
- Analgesic and antibiotic may be prescribed where ever needed. Curettage is indicated in the following conditions: As a whole it is used in periodontitis – inflammation and infection of gums.
- Can be used in conjugation with periodontal surgeries.
- Can be used in case of recurrent periodontal infection.
Gum contouring or the gummy smile procedure is used to reduce excess or overgrown gum tissue that is covering more of the teeth than is desirable. Often referred to as “gummy smile”, the gums appear too big when you smile and make the teeth seem almost smaller than the gums. This can be caused by a variety of things, including heredity (from your family) health conditions, and even the use of some common high blood pressure medications. A non-invasive soft tissue laser designed for treatments on the gums is also used to fix the following issues:
- Misaligned teeth
- Uneven grooves
- Uneven ridges
- Uneven lengths
- Inflamed or swollen gums
It can be done to the whole gum area or selectively to “even-up” the smile and it is a procedure that may be done even if there is nothing wrong with your actual teeth. Excess gum tissue is marked out by the dentist and then trimmed away using a special laser. After the procedure, the gum is left to heal and the results are immediate. The results are usually permanent. In some cases where a large amount of gum tissue is removed the healing process may take longer and it may be necessary to trim bone on the front of the tooth root to prevent re-growth of the gum tissue.
The muscles of the cheeks and lips are attached to the gums and tissue of the mouth by a section of soft tissue called a frenum. Sometimes a frenum can be attached too high on the gums, causing either gum recession or spaces between teeth, such as a diastemma (midline space commonly called African beauty).
In addition, there is another frenum under the tongue. If this frenum is attached too close to the end of the tongue, it can adversely affect swallowing and speech. Sometimes this is referred to as being “tongue-tied”. Frenectomy is a simple procedure where either part or all of the frenum in question is repositioned in order to return a healthy balance to the mouth.