Dental Prophylaxis vs. Periodontal Maintenance. What's the Difference?

Over many years of practice we have frequently found patients getting confused over the difference between a dental prophylaxis and periodontal maintenance. If you have never had periodontal disease before then this article may not be very relevant to you, but if you have then hopefully it will clarify any confusion you may have had.

It is important to understand that a dental prophylaxis (prophy) is intended for a health mouth. The American Dental Association (ADA) defines a prophy as a dental prophylaxis performed on the dentition that includes scaling and polishing procedures designed to remove plaque, calculus, and stain from those surfaces of the tooth above the gum line.

In the strictest sense of the definition a prophy is a procedure performed on a patient that does not have subgingival (below the gumline) deposits or periodontal pocketing. The typical prophy patient gets their teeth cleaned every 6 months, exhibits good home-care habits, has healthy gingival tissues, and has no pockets over 4mm.

Periodontal Scaling, also referred to as Root Planing, or Deep Cleaning is a procedure designed to remove bacteria, calculus, and their accompanying toxins from areas below the gum line. It is indicated for patients with periodontal disease. Periodontal procedures are for the most part subgingival in nature. Periodontal scaling requires more skill, time and expertise than a prophylaxis, and typically requires local anesthetic. Patients with periodontal disease will exhibit bone loss and pocketing around the affected teeth. It is a bacterial proliferation of pathogens that overwhelm the host defenses and spurs the host's own immune system to initiate a breakdown of the supporting tooth structures. We also know that periodontal disease is not a "curable" disease, but it is controllable in most patients. Therefore when a patient has experienced periodontal disease in the past, we must be ever-vigilent to monitor them for signs of active disease long after the disease has been brought under control.

The Periodontal Maintenance procedure is designed to follow active periodontal therapy. This procedure is intended for patients who have completed periodontal treatment whether it be surgical and/or nonsurgical (root planing). It includes the removal of the bacteria from deep pocket areas, scaling and polishing of the teeth, periodontal evaluation, and a review of the patient's ability to control their plaque. Typically an interval of three months between appointments results in an effective treatment schedule. Periodontal maintenance treatment following periodontal therapy is not synonymous with a prophylaxis or regular cleaning.

Periodontal Maintenance is quite different from a regular prophy because it is controlling the disease process, whereas a prophylaxis is preventive in nature and not therapeutic.

About the author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley also holds a fellowship position with the International Congress of Oral Implantologist (ICOI). Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997 -2014.

Treating Gum Disease to Reduce Prostate Symptoms

You might be asking yourself, how in the world can prostate problems be related to gum disease?
Well according to a study conducted at Case Western Reserve School of Dentistry and the Departments of Urology and Pathology at University Hospitals Case Medical Center, symptoms of prostate inflammation, or what is referred to as prostatitis, were reduced by treating the patients’ gum disease. Studies like the Case Western study have clearly shown that gum disease not only affects the mouth but it is a system-wide condition that can cause inflammation in various parts of the body.

The Case Western study showed there was a very high correlation between men who had prostatitis and those with moderate to severe gum disease. Following a 4-8 week period of gum treatment for a group of men who had moderate periodontal disease and concurring prostatitis, the study showed that 77% of theses men also experienced a decrease in inflammation of their prostate glands and decreased PSA scores without any treatment being directed towards the prostate condition itself.

Prostatitis is just one of many systemic diseases such as cardiovascular disease,  diabetes, and kidney disease, that have shown a clear connection with periodontal disease. For these reasons and for the prevention of gum disease itself we always recommend regular dental visits along with twice a day flossing and brushing.



About the author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley also holds a fellowship position with the International Congress of Oral Implantologist (ICOI). Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997 -2014.

Help Support your Healthy Teeth & Saliva

Essential For Those With Dry Mouth Conditions

A Quantum Leap in the Science of Oral Care

    Developed after 40 years of research on saliva chemistry at Stony Brook School of Dental Medicine in New York, BasicBites™ which is a sugar free chocolate flavored soft chew, helps maintain the proper acid-base (pH) levels that are necessary for the prevention of tooth decay and also bad breath conditions. When the oral cavity experiences a reduction in salivary flow the pH in the oral cavity becomes more acidic, thus greatly increasing the risk of gum disease, tooth decay and even halitosis. For more information on how to resolve a halitosis condition see our other web site. This more acidic oral environment results in an overgrowth of the gram (-) anaerobic bacteria (halitosis causing bacteria) in the mouth. This more acidic environment also greatly increases the risk of tooth decay in individuals suffering from xerostomia or dry mouth conditions. Xerostomia is common in older patients whose metabolisms have either slowed or are taking medications that reduce their salivary flow. BasicBites™ acts to neutralize the acidic environment caused by xerostomia, and by "sports" or "power" drinks such as Gatorade®. These drinks are very acidic and are known to produce pitting in the teeth, especially in children.

The saliva-mimicking technology in BasicBites™ consists of two main ingredients – arginine bicarbonate and calcium carbonate. Arginine is an amino acid found in saliva and naturally present in many foods. When used twice a day, BasicBites™, will support the proper pH levels on the surfaces of the oral cavity. Keeping the pH of the surfaces of the teeth balanced is extremely important in preventing tooth decay. The bacteria responsible for dental decay produce acids that dissolve the enamel and produce what is commonly referred to as a cavity. BasicBites™ will produce a thin alkali coating on the teeth and other surfaces in the mouth and counters the acids being produced by these bacteria. Because of the proclivity to tooth decay we recommend that people who experience dry mouth conditions or are prone to tooth decay chew two BasicBites™ per day. BasicBites™ also provides calcium to the diet, and studies show that many adults today have insufficient levels of calcium in the bodies and need to take calcium supplements, especially post-menopausal women.  Each BasicBites™ contains 20 calories. If you have any questions about BasicBites™ please feel free to ask us about this new product. We do keep it in stock it in our office if you feel you might benefit from it.

About the author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997 -2014.

New Clinical Recommendations: Maintain Oral Health During Pregnancy

New clinical recommendations from the American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP) are urging expectant mothers to be diligent about maintaining their periodontal health as research has indicated that women with periodontal disease may be at increased risk of adverse pregnancy outcomes such as giving birth to a preterm or low weight baby.

Tenderness, redness, or swollen gums are a few of the indications of periodontal disease. Other symptoms include gums that bleed from toothbrushing, flossing, or eating, or even loose teeth. It is not uncommon for pregnant women to experience what is called “pregnancy gingivitis” during their pregnancy. These symptoms should not be ignored and it is important to see one’s dentist regularly during pregnancy. See Different Types of Gum Disease on our web site and see information about the different types of gum problems and how they differ.

The clinical recommendations released by the AAP and EFP state that nonsurgical periodontal therapy is safe for pregnant women. Routine brushing and flossing accompanied by regular trips to the dentist for prophylaxis and a comprehensive periodontal evaluation during pregnancy may decrease the chance of adverse pregnancy complications. By maintaining your periodontal health you are not only supporting your overall health, but also helping ensure a safe pregnancy and a healthy baby.

About the author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997 -2014.

The Link Between Oral Bacteria and Joint Failure

Joint Failures Potentially Linked to Oral Bacteria

 ScienceDaily (Apr. 18, 2012) — The culprit behind a failed hip or knee replacements might be found in the mouth. DNA testing of bacteria from the fluid that lubricates hip and knee joints had bacteria with the same DNA as the plaque from patients with gum disease and in need of a joint replacement.
This study is one of many that came from the Case Western Reserve University School of Dental Medicine that have linked oral bacteria to health problems when they escape from the mouth and enter the blood. Working with University Hospitals Case Medical Center researchers, the dental, orthopedic and arthritis researchers suggest it might be the reason why aseptic loosening or prosthetic wear of the artificial joints fail within 10 years when no infection appears to be present. The pilot study's findings were reported in the April issue of the Journal of Clinical Rheumatology.
Dr. Nabil Bissada, chair of the Department of Periodontics at the dental school, said the objective of the study, "Identification of Oral Bacterial DNA in Synovial Fluid of Patients with Arthritis with Native and Failed Prosthetic Joints," was to see if bacteria like Fusobacterium nucleatum and Serratia proteamaculans found in patients with gum disease were present in the fluid. "For a long time, we've suspected that these bacteria were causing problems in arthritis patients, but never had the scientific evidence to support it," Bissada says.

The researchers recruited and studied patients seeking care at the University Hospitals Case Medical Center for osteoarthritis (the wearing of the joints) and rheumatoid arthritis (an autoimmune disease). These study participants had both natural and artificial joints. Researcher extracted samples of their synovial fluid, which is much like oil that keeps a door from squeaking. These patients also had signs of periodontitis or gum disease and undergone exams where dental plaque was obtained for the study.

Plaque build-up from the bacteria, associated with gum disease, breaks down the walls of the pockets around the teeth. The inflammation process from the bacteria acts like a gate that gives bacteria access to the blood stream. Once in the blood, the oral bacteria can induce inflammation in remote sites. These oral bacteria have been linked to heart and kidney diseases, and premature births and fetal deaths. Because these bacteria cannot be found with routine lab tests, DNA sequencing analysis of the oral bacteria and the joint fluids are performed. 

About the author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997 -2014.

Periodontal Disease and Your General Health

Welcome to the first article of our new blog. Our dental office, Anthony Dailley DDS www.dailleydds.com regularly sends out similar electronic newsletters to our patients to keep them abreast of the lastest developments in dental health. We hope our blog will provide readers with additional knowledge about their dental health and what modern dentistry has to offer. Below is an article about how gum disease can effect much more than just one's oral health.

Anthony Dailley DDS

The relationship of periodontal disease to disorders elsewhere in the body has attracted a great deal of attention from the dental and medical professions, as well as from the public.  Numerous studies have emphasized that the oral cavity, and the periodontal tissues specifically, can affect other tissues and organs.  In essence, these studies have connected the mouth to the rest of the body and have resulted in physicians and nurses becoming more aware of diseases of the teeth, gums, and other structures in the oral cavity. Many studies recently published in medical and dental literature suggest that the mouth truly is a window to the body.  In fact many systemic diseases can manifest themselves orally well before any other signs or symptoms have become apparent medically.  The oral cavity is affected by inflammation (in particular periodontal disease).  The toxins produced by the oral bacteria that are responsible for periodontal disease can harm wherever they travel to in the body. Scientist have observed a connection between oral health and heart conditions.  In a study published in the International Journal of Cardiology found that patients who had suffered recent heart attacks had noticeably worse oral health compared to those patients with healthy hearts.  Multiple studies, including a recent report in the Journal of Clinical Periodontology show a startling correlation between patients with periodontal disease and those with heart disease.  The more severe the gum disease, the thicker and harder the walls of the arteries.  This is even true for young adults with no symptoms of heart problems.  There are increasing links between oral health and conditions such as diabetes, kidney disease, preterm labor, osteoporosis, and even Alzheimer's disease.  A 2007 report in the New England Journal of Medicine noted that patients who had their periodontal disease treated emerged not only with healthier gums but with healthier endothelial function which is a measure of health or the lining of the blood vessels.  The alarming fact is that more than 80% of adults aged 20-64 in the U.S. have some form of periodontal disease.  Maintaining good oral hygiene habits and regular visits to the dentist to prevent and manage periodontal disease are becoming more important as it relates to one's general health. “We all think that cholesterol is important to heart disease. The health of your gums is a more  important predictor of whether you will have a heart attack or not.” Mehmet C. Oz, M.D. F.A.C.S Director,Cardiovascular Institute Columbia University Medical Center, New York, NY   About the author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997 -2014.