Quit smoking for healthier, cleaner gums
When P attended her first appointment at Dentist Direct, her main complaint was the loose front teeth. The thought of having a gappy smile before the age of 40 was terrifying for her.
Dr. Neil Mitchell, general dentist, who carried out the initial check-up including intra-oral photographs and a full mouth XRay, noted the gum issues of P and referred her to me, a dental hygienist.
I reviewed P’s medical history, noting that she had been a smoker for about 25 years. Although she has had some desire to stop she was not ready to set a quit date. We briefly discussed methods to stop smoking such as hypnotherapy, nicotine replacement therapy and going “cold-turkey”, so that she could make an informed decision.
I explained how periodontal disease occurs and how the smoking makes it worse and what the initial treatment would involve.
It was important that P understood that gum disease required commitment to keep the teeth and gums super clean at all times. There is no cure for gum disease — we can only control and manage it. P will always be susceptible to relapse in the future as the treatment is only successful in 60-70 per cent of the cases in smokers, compared to 80-90 per cent in non-smokers.
When treating gum disease, it is really important to know where and how advanced is the disease. A “pocket chart”, like a mouth roadmap, is made measuring six places around each tooth.
The separation between the tooth and gum is recorded in millimetres. The healthy range is 0-3mm. P had a recording up to 6mm in some areas with hard build up’s of tartar beneath the surface.
The next phase involved removing the hard build-ups and using an ultrasonic scaler to disrupt and flush away the bacteria living beneath the gum surfaces. The pocket chart helps in concentrating on the most affected areas.
P now had to make sure the treatment was successful by carefully following the home care instructions — removing all traces of plaque, from every tooth. I showed her how to use special interdental brushes and advised a follow-up period using probiotic lozenges to give a healthy bacteria, a bit like what Yakult does in the stomach.
Three months later, P had her first review to make her new pocket chart and see how successful we had been,. And, to our delight, most of the pockets had reduced to a healthy depth. She will require a lifetime of keeping good oral hygiene habits and regular dental health appointments to prevent the disease relapse. Stopping smoking would be the best thing she can do for her overall health.
(Rachael England trained as a Dental Hygienist in the Royal Air Force, UK. She currently works for
Dentist Direct Dubai.)