Patient 1 - BEFORE

Patient 1 - AFTER

Patient 2 - BEFORE

Patient 2 - BEFORE

Patient 2 - DURING

Patient 2 - AFTER

Patient 2 - AFTER

The dental patient has been placed under general anesthesia and placed on its side (lateral recumbency). The red arrow points to the endotracheal tube which connects to the anesthesia machine and delivers the gas anesthesia to the patient's lungs. The body is tilted so that the head is lower than the rest of the body to discourage swallowing or aspiration of water or debris. The patient's upper jaw is to the top left of the photograph and the lower jaw is to the lower right. The brown material on the teeth is dental tartar or calculus - a mineralized deposit consisting of bacteria (live and dead), food particles, and salivary minerals. Tartar can occur on the enameled surface of the teeth as well as below the gumline. The gum tissue closest to the teeth is affected by a condition called gingivitis - inflammation of the gingival or gum tissue. The grayish white material at the gumline is the result of a bacterial infection in the gingival tissue.

The process of cleaning the teeth involves hand scaling or scraping off of large pieces of tartar, high-speed water-cooled scaling to remove the remaining tartar, and polishing to smooth the enamel surface of the tooth. Both the inside and the outside surface of each tooth is cleaned in the same way. The remaining discoloration of the teeth is stain and cannot be removed without damaging the enamel surface of the teeth. Gingival tissue affected by gingivitis and infection bleeds easily during the cleaning process. This patient was put on oral antibiotics following the dental cleaning in order to control the infection in the gingival tissue.

This patient has been prepared in the same way as Patient 1. She has moderate to severe tartar and gingivitis primarily affecting her upper left fourth premolar (carnaisal tooth, green arrow). The affected tooth has dramatic gingival tissue loss, exposing the underlying tooth roots, possibly due to some previous trauma

A close-up view of the affected upper left fourth premolar showing the heavy layer of brown tartar and the exposed roots.

The teeth have been scaled and polished. The affected tooth roots are indicated by the green arrows. Now that the tartar has been removed the discoloration of the enamel from white to gray is apparent. This discoloration indicates that bleeding has occurred within the tooth at some time in the past.

The affected tooth has been extracted. The remaining hole in the gum tissue will be left to heal on its own. This patient was put on a course of antibiotics to control the infection in the gum tissue.

The extracted upper left fourth premolar tooth. The blue arrows indicate the two cranial (front) roots and the red arrow indicates the caudal (back) root. The green arrow indicates the discolored enamel crown of the tooth.