Deep cleaning, also known as quadrant therapy, is a general term for a dental procedure which is undertaken to, either prevent or repress the advancement of damage causing periodontal disease, also incidence of dental caries.
This is an in-office procedure constituted by scaling, root planing and curettage. It can be carried out by both, the dentist (mostly, periodontist) or a well trained, licensed dental hygienist.
Significance of Deep Cleaning Of Teeth
Periodontal scaling involves removal of dental plaque and/or calculus from the surfaces of upper and lower teeth (surfaces include facial, palatal, buccal, lingual as well as mesial and distal). Besides covering the surfaces above the gingival margin (called supra-gingival scaling), gingival tissue below the gingival margin (sub-gingival scaling) is also targeted. This does include deep periodontal pockets which form as a result of deepening of the gingival sulcus, and are essentially a well protected breeding ground for noxious bacteria.
Simultaneously, Root planing (a part of advanced non-surgical periodontal therapy) ensures that as the surfaces are being cleaned, co-existing roughness on the crown or root surface is also eliminated entirely.
As a result of the polished surfaces of teeth and root, bacterial plaque finds it difficult to cling on or establish themselves in the oral cavity. According to the Oral Cancer Foundation, deep cleaning of teeth certainly aids in preventing or reducing the likelihood of developing cancer of the mouth. The dual therapeutic (do note, it is not a prophylactic measure) procedure ensures that the key etiologic factors responsible for gingival inflammation, invasion and loss of periodontal attachment are eliminated, which consequently allows the bacterial and infected periodontal pockets to begin healing.
This results in successfully treating and preventing further gingival recession and root exposure. Although this procedure is considered safe, there are a few, yet noteworthy health risks associated with this non surgical mode of treatment. This stands true in the case of older patients. This article discusses the risks elderly patients must be aware of.
Top 3 Risks Of Having Deep Cleaning Of The Teeth At The Age of 75
Mitral Valve Prolapse and Deep Cleaning
Mitral valve prolapse, also termed as the floppy mitral valve syndrome, is a heart disorder that involves the mitral valve. The pathologic thickening of this valve puts those affected (especially, patients nearing or above the age of 75) at a prominent risk of developing Infective endocarditis (bacterial infection that targets the heart). Due to the condition of Mitral valve prolapse, the chambers in the heart fail to work efficiently.
If elderly patients with an underlying cardiac disease go ahead with this dental procedure without taking a proper course of antibiotics, it is quite possible that harmful, slow growing bacteria get access to the systemic blood stream (known as bacteremia). There are a few bacterial species which are capable of adhering to either abnormal valves or pre-existing clots. Therefore, the risk of bacterial endocarditis must be taken into consideration while treating older patients and proper administration of prophylactic antibiotics must be given prior to deep cleaning of teeth.
Elderly Patients And Coumadin Therapy
The dentist needs to be particularly careful while treating elderly patients with cardiac ailments. Such patients are many a time on blood thinning (or anti-coagulants) medicines, mostly, Warfarin or Coumadin to prevent the occurrence of cardiac stroke, formation of blood clot that impedes the working of heart and so on. As deep cleaning of teeth is associated with gingival bleeding, the dental care provider always consults the patient’s cardiologist so as to evaluate whether or not the elderly patient in question can be kept off blood thinning drugs forty eight to seventy two (48-72) hours prior to the dental treatment.
This minimizes the chances of excessive bleeding from the gingival tissues while performing the process of scaling and root planing. Once the entire procedure has been completed, the patient can resume the intake of anti-coagulant drugs.
Discomfort and Dentinal Sensitivity
As the process involves deep and thorough dislodgement and debridement of the plaque or tartar layer, it is likely that the elderly patient may feel a certain degree of discomfort post the dental session. As you already know, patients around the age of 75 have a slower rate of healing as compared to young individuals.
Also, they are prone to many other types of problems. These include a greater degree of tooth sensitivity, prolonged bleeding from gums (even after the completion of deep cleaning) and sometimes, difficulties in eating comfortably, as well.
Further, if the aged patient has metabolic disorders; for example, diabetes, delayed healing may be a cause for problem too.