I visited a dentist for the first time in several years for a routine exam and to get a lost filling replaced. The dentist informed me I had periodontal disease and I needed a special deep cleaning. I declined treatment since it was unexpected. Should I go back for treatment?

Secondary findings are common in all areas of health care. It happens when a person comes in with one concern and finds out that there are other problems as well. It is normal for a person to need time to process new information. I find that if a person has enough information and time, he or she usually makes a decision to proceed with a reasonable plan for treatment. I recommend you address any concerns with your dentist and have all of your questions answered prior to beginning treatment.

I have noticed that my son has bleeding gums from poor brushing. He has braces and has a year of treatment remaining. His orthodontist seems concerned. Should I should end treatment and try later when my son's oral hygiene improves?

It is a difficult decision for me to discontinue active treatment due to poor dental hygiene. I want to get you the finished result as does the parent and child. At my office, my team and I would have frank conversation with you about your son's poor home care. My recommendation could be to continue treatment but leave the wires out for two to four weeks for better cleaning. I would place your son on an antimicrobial mouth rinse to help reduce bacteria levels and high fluoride prescription toothpaste to help prevent white spots. If these measures fail to get the gingivitis under control, then I would recommend temporarily suspending active treatment by removing braces.

I heard that you now have a full service dental department. Is that true?

Yes. For years our patients and parents have wanted to make visiting my office a one-stop experience. I introduced dental exams and cleanings for our patients five years ago. We received an incredibly positive response from our patients once we began providing these services. On November 6, Dr. Todd Wahlin, formerly of Sundance Dental, started providing full dental services to our patients. Dr. Wahlin has nine years of experience and will provide all levels of dental health care, including IV sedation during the removal of impacted wisdom teeth. Many of my patients drive hours to be treated and appreciate that they can get everything done in one visit. For more information about our dental department or to schedule a free consultation, please call 1-800-4braces.

Q: I read an article that stated the amount of periodontal disease among adults over age 30 was worse than anyone thought. I also heard more adults are getting braces. Are these two facts related?

Dr Herman's Answer: The study found that 47% of adults over age 30 have some form of periodontal disease. Mild, moderate and severe rates were 8.7%, 30.0% and 8.5% respectively. The AAO and AAP put out a joint recommendation that undiagnosed periodontitis can worsen with orthodontic treatment, and orthodontists should be prepared to deal with this complication. For this reason, I have a periodontal health department within my orthodontic practice. I am prepared to diagnose and treat most periodontal conditions before or during orthodontic treatment. Call 1-800-4-BRACES for a free consultation.