Welcome to our office! As a general dentist, Dr. Wagner is trained in all dental procedures. In some situations, she may choose to refer patients to an appropriate specialist. Please feel free to click on the following procedures to learn more about them.

All content was written by Dr. Katie-Rose Wagner and she welcomes the public to use and share any of the information without her permission. She respectfully asks to be listed as the author for direct quotations.

Cleanings and deep scaling

During a dental cleaning (often called a prophylaxis, or "prophy"), the dentist or hygienist will use a variety of instruments to clean a patient's teeth. Depending on the amount of care that is needed to keep teeth clean and free of periodontal disease, patients may get a prophylaxis every 3, 4, or 6 months.

A "prophy angle", or prophylaxis cup, is a type of special toothbrush mounted on a motor. It has a rubber cup on the end, which can wrap around the teeth and clean under the gingiva, or gum. It is particularly effective in removing plaque (soft deposits of plaque and bacteria), food, and stain.

An ultrasonic scaler uses sound waves and water to vibrate debris off teeth. These instruments are extremely effective in removing soft deposits (plaque) as well as hard deposits, called tartar or calculus.

Hand instruments, such as scalers and curettes are used to remove plaque and calculus from the teeth. They come in many shapes and angles to reach all tooth surfaces.

There are two major classes of periodontal disease, which are conditions involving the gum and bone around the teeth.

Gingivitis is a reversible condition where the gingiva is inflamed due to plaque deposits that are not being removed with regular brushing at home. The most common sign of gingivitis is bleeding during cleanings. If you notice any areas that bleed when you brush or floss at home, those spots need to be cleaned more, not avoided. Your dentist or hygienist can show you ways to brush more efficiently and target areas that are collecting buildup. If patients focus on more effective oral hygiene techniques and target areas of plaque near the gumline, the gum will become less swollen and inflamed. Healthy gums should be light pink (not red), look "tight" (instead of puffy or swollen), and not bleed with brushing and flossing.

Periodontitis is when gingivitis has progressed to the point where the bone surrounding the teeth becomes affected. Due to the bacteria found under the gumline and the body's own defense reactions, the bone starts to "melt away", or lower. Teeth can eventually become loose if they do not have enough bone support. Though there are techniques to slow and sometimes reverse this process, bone loss is often irreversible. Another component of periodontitis involves pockets forming around the teeth, which are difficult to clean effectively and can make gum disease progress more quickly. Reducing the bacteria, tartar, and plaque below the gumline is the best treatment for periodontitis.

Deep scaling and root planing is sometimes needed for patients with periodontitis. During a deep scaling, the dentist or hygienist often focuses on one area of the mouth at a time and thoroughly removes hard and soft deposits, especially below the gum line. It may take several visits to treat the whole mouth.

Periodontal surgery is sometimes required if a patient has gum pockets too deep to reach with regular scaling. Surgery can also be done to correct or reverse periodontitis. During this procedure, small incisions are made in the gingiva to get access to all tooth structure. After the deep cleaning, the gum is sutured back together, and patients can usually return to regular cleanings and scaling. Ideally, treatment of periodontitis may help to reduce the height of the gum pockets so that all areas are accessible.