The various types of risk and how we determine them, and consider them in our practice are key to successful dental treatment planning. There are a total of 4 categories of risk I consider:

Risk Category I: Gums and Bone:

     Some people are susceptible to gum disease (gingivitis), or perhaps more importantly, bone disease (periodontitis), and thus lose a greater amount of bone in a shorter time than do other people. This can start and stop during a person’s life, and it does not always continue at the same rate. If enough bone is lost around a tooth, it will become loose and fall out, which can happen with a person never feeling pain at all!

     Our initial examination process evaluates the current risk level by measuring for inflammation around the gum of each tooth, assessing for loosening of the teeth, and viewing of the bone level, which is seen on dental x-rays. This is also periodically evaluated during your appointments with our hygienist, Ramona.

     Considerations to treatment recommendations may include such factors as the amount of build up on your teeth, the degree of bone loss, gum inflammation, medications, genetics, and age. If someone has a large home, and it has not been cleaned in many years, it would take longer to clean than a small home with regular cleaning service (one could also apply this to dental maintenance other than just cleaning…..). Likewise, treatment may range from a ‘simple, routine’ cleaning, to more time and labor intensive efforts requiring multiple appointments, perhaps with local anesthetic, including the use of antibiotics taken orally, or used locally, or other adjunctive treatment such as laser therapy.

     By considering a person’s ‘risk’ of periodontal disease, some individuals may be better treated if the affected teeth are not kept. The selective elimination would therefore reduce this risk category, making the outcome of treatment more predictable. Reducing a person’s risk level is the goal, and it may be achieved by initial therapy, antibiotic treatment, increased frequency of maintenance, and sometimes elimination of the selected ‘at risk’ teeth.

     Dr. Doug McMaster, a Tucson Dentist, has significant post graduate level training, specializing in cosmetic dentistry, and comprehensive care.