That hurt! Why is the dentist poking my gums?

Q and A with Dr. Thomas Bursich

Q: That hurt! Why is the dentist poking my gums?

The “poking with a sharp pointy thing” is actually a basic periodontal exam. The periodontal probing is part of a Comprehensive Oral Evaluation or American Dental Association code D0180.

Unfortunately, many patients have never received one before and this is sad.

Some people complain because the process can be uncomfortable. Scientific truth: Healthy gums will not bleed, nor will it hurt, even when probed. Unhealthy gums will bleed, and likely hurt. So it is a great way for a dentist to get a general picture of your gum health, and to tell you areas (if not the whole mouth) that you need to concentrate on in order to maintain a healthy oral status.

A healthy pocket will measure 3-mm or less. When it is 5-mm or more things are critical. Periodontal disease is an inflammatory process where the attachment of the gingiva is broken down and the bone in destroyed.

The depth increases as bone is lost. The bleeding is associated with inflammation and infection.

Believe it or not, we don’t enjoy hurting you or making you bleed. Bleeding gums are pretty unpleasant for us. Especially if we have to do some work and the aerosol effect is making that stuff fly around our faces. It would be fantastic if every patient we examine have no bleeding.

But unfortunately, neglecting to maintain adequate oral hygiene is quite common, and it is our job to diagnose this, as well as inform you of what is necessary to prevent this.

Q: Why has my dentist never done this before?

I don’t know. I can only guess. Training is one answer.

The other may be the periodontal probing is omitted when pressed for time. This is also laziness on the part o the dentist. Also, patients can give a lot of resistance to treating problems that do not hurt. So after a while, they choose their battles and give up.

Another reason is it is less expensive to treat periodontal disease, than to treat the effects of it. Since the financial rewards of extracting teeth and placing implants is a bigger expense.

Q: I have had periodontal therapy before and I still have periodontal disease. Why is that?

Periodontal disease needs be treated in the dental office and maintained at home. At home, a minimum of brushing and flossing every day and any other recommendations of the dentist. At the office, regular cleanings, ever three, four or six months as recommended by your dentist. Sometimes based on predisposition factors mentioned above, a cleaning every three months is recommended.

Even if oral hygiene is good there are other risk factors: diabetes, cigarette smoking, some medications (calcium channel blockers, Dilantin, etc.), the immune system (stress, poor nutrition, viruses), genetic markers. All play a roll.

You do have the option of asking the dentist not to do this, and to ignore the advice, but then you may as well have stayed at home in blissful ignorance.

For more information go to: https://www.webmd.com/oral-health/guide/gingivitis-periodontal-disease#1