How often should I visit a hygienist?

It may be recommended by your dentist that you visit the hygienist regularly. The frequency of visits will be determined by your clinical needs but also by your own personal desire to have your teeth cleaned and polished regularly.

Your dentist may also recommend that you see a hygienist for a thorough clean before beginning a complex dental treatment such as dental implants

How often should I visit a hygienist?

With more adult teeth being lost through gum disease rather than tooth decay, regular dental hygiene treatment is essential to keeping your gums and teeth healthy. Regular visits to a hygienist combined with dental check-ups and looking after your teeth and gums at home will greatly improve the appearance of your teeth and your oral health. Good oral hygiene is vital in eliminating gum disease and decay, which can eventually lead to tooth loss.

Hygienists offer a professional teeth cleaning service, a process called scaling and polishing. During the appointment your hygienist will carry out an initial dental hygiene examination. They will then:

• Scale your teeth to remove any plaque or tartar build-up in those areas brushing cannot reach
• Perform a clean and polish to remove any superficial stains on your teeth
• Offer tailored advice on how to maintain good dental health and demonstrate techniques you can use at home

Your hygienist will also provide advice about diet and preventing tooth decay. They can spot signs of gum disease and will refer you to a dentist or periodontist if they see anything that needs further treatment.

Hygienists can also help you maintain brighter, whiter teeth. Scaling and polishing, as well as Airflow therapy and cosmetic treatments can remove surface stains, leaving you with a fresher, brighter smile.

What is gum disease?

Gum disease is a common condition that affects the tissues around your teeth. It causes swelling and redness of your gums, and sometimes pain. Up to 90% of adults in the UK have some gum disease, even if it’s only a small amount.

Gum disease can be prevented by maintaining a good oral hygiene routine, including regular brushing, check-ups with your dentist, and hygienist appointments

What are the symptoms of gum disease?

Usually the first signs of gingivitis are:

• Bleeding gums when you brush your teeth or eat something hard like an apple
• Red and swollen gums

If your gingivitis has developed into periodontitis, you may also have:

• Bad breath (halitosis)
• A bad taste in your mouth
• Gum recession and sensitive teeth
• A wobbly tooth or teeth
• Gum abscesses (pus that collects under your gum)

The symptoms of acute necrotising ulcerative gingivitis (ANUG) include:

• Very painful ulcers that bleed easily
• Bad breath (halitosis)
• A metallic taste in your mouth
• Difficulty swallowing or talking
• Having a lot of saliva in your mouth

Feeling generally unwell – possibly with a high temperature (fever)

How is gum disease treated?

The type of treatment you have will depend on how serious your gum disease is. The aim of treatment is to control any existing gum disease and prevent further problems.

You may be able to treat mild gum disease (gingivitis) with a daily brushing and flossing routine. Your dentist or hygienist will arrange regular check-ups with you to monitor the size of any pockets in your gums, as well as how easily your gums bleed, to make sure these get better over time.

If your dentist thinks you have periodontitis, they will use a periodontal probe to measure the depth of any gaps between your teeth and gums. They may check how easily your gums bleed and how much plaque and tartar you have on your teeth. You may also need to have X-rays to check the state of your teeth and jaw bone.

If you have more serious periodontitis, your dentist may refer you to a periodontist. This is a healthcare professional who specialises in treating periodontal diseases

Gum disease is often caused by a build up of plaque bacteria, the best way to remove this is by twice daily tooth brushing. But no matter how well you clean your teeth there will always be hard to reach areas that are tricky to keep clean. In these areas, plaque bacteria can accumulate and may eventually mineralise to form a tough, crusty deposit called calculus or tartar, which is impossible to remove by brushing alone. If not removed, more plaque can build up around the tooth and potentially under the gum line, leading to the progression of gum disease, cavities, bad breath and other problems. To reduce the risk of gum disease or to help stop it from becoming more serious, your dentist may recommend that you have a professional clean, called a scale and polish, to get your teeth properly clean.

Scale and Polish

The first ‘scrape’ stage removes the deposits of plaque and tartar from above and below the gum line. Often an ultrasound scaler is used first to get rid of the bulk of the tartar, followed by specialised hand held instruments to scrape away any stubborn remains.

The next step is to 'polish' the teeth to make the surface really smooth. While polishing removes stains leaving teeth bright and shiny, it is not just a cosmetic procedure. It also smoothes away minor imperfections and patches of rough texture on the teeth to protect against further plaque build up. Your dentist or hygienist will advise you how often you should have a scale and polish. It's important to remember that professional cleaning is an addition to a good daily oral health routine, and should never replace twice daily brushing with a fluoride toothpaste.

Deep Cleaning

Deep cleaning your teeth might sound like something you should do after you've missed a few visits to the dentist or eaten a particularly sticky, messy meal. A deep cleaning is actually a specific procedure performed by your dental hygienist to treat gum and periodontal disease. It's often completed because a person has not had regular professional cleaning appointments every six months.

When going to the dentist, the dental hygienist will use an instrument called a probe to measure the area around your teeth to see if you have any pocketing (area between the tooth and gum where bacteria will form). The depth of the gum tissue between the teeth and gums are called pockets when it is five millimeters or more. It is recommended that every adult receive a periodontal evaluation each year to determine whether additional treatment is needed. Measuring pocket depth is just one part of a comprehensive dental evaluation.

Deep cleaning is also known in the dental world as scaling and root surface debridement. Scaling involves removing plaque and tartar from the surface of the teeth and from the pocket area between the teeth and gums. The dental hygienist can perform scaling and root surface debridement using either ultrasonic instruments and or manual scaling tools.

The other part of deep cleaning is root debridement. The dental hygienist will use a scaling instrument to remove plaque and tartar from the surface of the roots of your teeth. A scaling and root debridement procedure will require a minimum of two visits as an appointment. A follow-up visit may be necessary to confirm that your gums and teeth are getting healthier and there is no increased pocket depth.

Airflow polishing The treatment is an effective method designed to remove simple tooth staining caused by certain foods such as curries, red wine, tea, coffee and smoking. This is an effective method of removing stains from the tooth’s surface.

The hygienist uses a pressurised jet of compressed air/ water and fine powder particles in a controlled stream to clean the teeth. The innovative spray technology can access all those hard to reach areas that traditional scaling cannot. The procedure is harmless and extremely effective. It removes stain only and does not change the base colour of the teeth.

Before you begin Airflow polishing, your dentist will assess your teeth to check for tartar deposits. If deposits are found, your dentist will recommend their removal with a hygienist visit prior to airflow to ensure you achieve the best possible results from this treatment. In some circumstances more than one appointment will be required for difficult stains.

Implant Care

For the most part, caring for dental implants is the same as maintaining your natural teeth. Your implant-supported restoration must be kept clean and free from plaque build up with brushing and flossing. Dental implants are made from synthetic materials, so they are not affected by tooth decay. However, gum health is important for long-term implant success. Good oral health care and regular dental check-ups are important for maintaining your gum health after a dental implant

Plaque and bacteria that form around an implant can cause inflammation and lead to peri-implant disease, such as peri-implant mucositis (gum inflammation around implants) and peri-implantitis (bone-loss around implants). Daily cleaning of all the surfaces above and below the gumline is critical to preventing peri-implant disease.

Pay extra attention to the areas where gums and implant meet. Sometimes this can be hard to see where the implant is, so remember to ask your dental professional exactly where your implants are placed. In case pain or suspected inflammation, a dental professional should be consulted as well.

Thorough oral hygiene is necessary to prevent diseases to develop around the implants. With proper home care and regular professional maintenance, you can make your new teeth last throughout life. There are various types of implants which may need different home care.

The role of the hygienist during the maintenance phase of treatment is to monitor the health of the tissues and identify any potential for disease. We do this by superficially scaling and probing and monitoring and adjusting patients oral hygiene status and routines at each appointment.  Recall maintenance appointments are tailored to the needs of the individual and at these visits, appropriate oral hygiene advice can be given and assessments made as to what recall interval is best for the patient.