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Smiles for Seniors
Barbara J Walters RDHAP#220
Registered Dental Hygienist in Alternative Practice
408-888-4610 fax #408-264-8165
887 Redbird Drive
San Jose, California 95125
e-mail: [email protected]
Explanation of Services and General Information of Dental Hygiene Treatment
The following information is provided to assist you in accessing the necessary treatment provided by Smiles
for Seniors. Smiles for Seniors is owned and operated by Barbara Walters, RDHAP. Barbara has been a dental
hygienist since 1979 and a Registered Dental Hygienist in Alternative Practice since 2008. License #220. This
special license is specifically for the access to dental hygiene care for the elderly and the disabled.
Dental hygiene procedures are generally very safe, however dental hygiene treatment is not guaranteed.
Many factors contribute to the success or failure of treatment including and not limited to: existing oral
conditions, extent and severity of infection, ability of patient to tolerate treatment, quality and frequency of
daily oral hygiene care. Dental Hygienists provide only preventive and therapeutic services defined by the
California Dental Practice Act.
Initial Comprehensive Oral Evaluation includes the following:
Medical History review, Blood Pressure and Pulse taken, Medications review, Dental History review and any existing
dental issues or patient concerns. Soft Tissue evaluation, oral cancer screening, dental examination to chart missing
teeth and existing dental work. Full mouth periodontal evaluation, including soft tissues, full mouth periodontal
probing, assessment of periodontal and supportive tissues.
An estimate of treatment recommended, possible referrals for dental treatment by a dentist or specialist will be given.
A treatment plan will be given in writing and financial arrangements made prior to initial treatment. There are different
types of dental “cleanings” depending upon the condition of the oral tissues and supporting structures and their overall
health.
Continuing care (prophy) is done only if complete dental health is present, patient has been seen in the past for regular
visits. There is no swelling in the gums and no bleeding present. This procedure removes the plaque, biofilm, calculus
(tarter), and stains from tooth structures. Typically scaling and polishing are all that is needed, sometimes an additional
fluoride application is recommended. The intent is to maintain dental health.
Therapeutic Scaling is done when overall dental health is present, some minor swelling and bleeding maybe present but
the supportive structure is still healthy. This is usually someone who has not had a cleaning for awhile and just needs a
little more treatment and several visits (usually at least two visits) to bring the mouth to a healthy maintenance level.
Periodontal Therapy and Root Planning (this is sometimes incorrectly referred to as a deep cleaning) it is indicated
when infection is present, and there is loss of supportive structures, not just the gum tissues but the underlying bone as
well. Periodontal Disease is very common and there are different stages and classifications of disease ( moderate to
severe Periodontitis). Treatment involves scaling and root planning, which means the removal of plaque, biofilm and
calculus deposits from the periodontal pockets (under the gums). Sometimes an antibiotic material is placed to help
control infection. This therapy requires multiple visits, treatment is done usually in quadrants and is in 1 or 2 hours
appointments depending on the patient and how cooperative they are and their level of tolerance. A topical anesthetic
is used and keeping the patient comfortable is important. There is always a one month reevaluation done after root
planning procedures at which time the gums are assessed and the teeth are polished..
Periodontal Maintenance and proper daily oral hygiene care is required for a satisfactory result in treating periodontal
disease. In some extreme cases, surgery may be necessary and the appropriate referral would be recommended.
Sometimes the disease is so advanced extractions are necessary. Our goal is to avoid this with continued follow-up care,
to maintain control of the disease. This is a continuation of the scaling, removal of debris, plaque, biofilm, calculus and
stains from the areas above and below the gum line areas( in the remaining periodontal pockets). The oral hygiene care
is also an important part of the ongoing treatment and will be reviewed at each follow-up visit, with suggestions or
modifications to help the patient maintain the best result possible. There is also a possibility that isolated treatment
(localized root planning) may be necessary to maintain problem areas, in the future. This is evaluated at the Periodontal
Maintenance appointments and it is recommended that the patient be seen anywhere from 4 to 12 week intervals,
depending on the consistency of their daily oral hygiene care. Many patients are on a regular interval of 2-4 months
but it is unusual for a patient to ever go back to a regular 6 months frequency. Unfortunately it is the nature of
Periodontal Disease to require the more frequent visits.
Fluoride Treatments: Patients who experience sensitivity or who are cavity prone, it will be suggested that they would
benefit from daily use of a high fluoride toothpaste and regular fluoride treatments, as well as special rinses. At all
hygiene visits, patients will have their oral hygiene reviewed and suggestions made to help them and possible
modifications made to help make their daily care easier for them. It is my goal to try and prevent future issues and
keep the teeth and supportive tissues as healthy as possible.
Frequency of maintenance intervals
This is always a difficult discussion as each situation and each patients needs are different, and sometimes it is a
compromise because of financial concerns. Please keep in mind that my goal is the overall health of the patient and my
recommendations will be based on what I feel their needs are, but I am open to negotiations and I realize the ideal is not
always practical. Please feel free to discuss any recommendations of treatment and possible needs to make
adjustments that will accommodate all interested parties.