Periodontal health is of particular importance to us. More teeth are lost to gum disease than tooth decay and many patients are unaware of the dangers of gum disease. We provide a full range of gum treatments including the treatment of gum disease, correction of receding gums with gum grafts, and cosmetic gum lifts.
What is periodontal disease?
Periodontal or gum disease is an infection affecting the tissues surrounding the teeth. These tissues include the gums and bone supporting the teeth. Periodontal disease is usually a slow, painless, progressive condition. Most adults with this disease are unaware they have it but if diagnosed and treated early the teeth can be saved.
Gingivitis is an early stage of gum disease where only the gum tissue is affected. In this stage, gum disease is reversible and treatable. Advanced gum disease affects the bone and tooth socket, known as periodontitis. It is imperative to treat advanced gum disease to stop further bone loss and prevent the loss of teeth.
What causes periodontal disease?
Plaque build up is the main cause of periodontal disease. Plaque is a white mass of bacteria which adheres to teeth, crowns, bridges, dentures and soft tissues. When plaque is not removed it irritates the gums causing them to become red, tender and bleed easily.
Over time, plaque hardens into tartar which requires removal by professional teeth cleaning. The constant irritation from tartar results in gums becoming detached from the roots allowing ‘pockets’ to form around the teeth. Bacteria in these pockets begin to destroy bone that holds the tooth in place which may result in the tooth becoming loose and eventually lost.
The main cause of plaque accumulation is poor oral hygiene and inadequate tooth brushing technique. Other plaque retaining factors that exacerbate the condition are:
Badly designed dentures (false teeth). These can attract plaque and may lead to further bone loss
Faulty restorations e.g. fillings with ledges that act as a plaque trap
Crowded teeth. Poorly contoured crowns will act as a plaque trap
Tobacco smoking. Oral hygiene appears to be worse in smokers compared to non-smokers. A study of periodontal disease in women smokers of 20-29 years old and non smokers of 30-59 years show a level of about twice that found in non smokers
Food packing between teeth
Orthodontic appliances (braces)
Grooves on root surfaces
Loose teeth can accumulate plaque and make the periodontal condition worse. Loose teeth may require extraction in order to save other teeth
There are also a number of host factors that can worsen periodontal disease such as diabetes mellitus, puberty, pregnancy, and menopause. The underlying cause is still plaque but these conditions can worsen your periodontal condition.
What are the signs and symptoms of periodontal disease?
Common signs and symptoms of gum and periodontal disease include:
Gums that bleed when you brush or floss
Red, swollen or tender gums
Pus along gums and between teeth
Changes in the appearance of teeth, such as length or spaces between teeth
Bad breath, bad taste in mouth
Changes to the fit of dentures
How is periodontal disease treated?
Treatment of gingivitis is usually completed by scaling your teeth, oral hygiene advice and tooth brushing instructions. Regular appointments to ensure effective plaque removal and healthy gums will follow this appointment. These appointments are typically between 2-6 months apart and are usually one hour in length.
Once periodontitis has begun to progress the treatment is as follows:
Full mouth root planing and removal of plaque retaining factors: This involves scaling the roots of all your teeth, usually completed using local anaesthetic. Your dentist and hygienist may also decide to use antibiotics in any infected pockets at this stage. Any obvious plaque retaining factors are removed to allow easier plaque removal. Tooth brushing instruction and interdental cleaning are demonstrated. This usually involves 4-5 one hour visits with your hygienist.
6 week review appointment: Teeth and gums are reassessed six weeks after full mouth root planing. If there is any persistent bleeding, either with tooth brushing or probing, or any pockets 5mm or deeper, further treatment will be recommended.
If the results are satisfactory you will then enter a hygiene maintenance programme:This involves 2-3 monthly one hour appointments with your hygienist. Every year a very detailed assessment is made of your remaining teeth and gums both clinically and radiographically. This appointment will also be an opportunity to discuss any future treatment with your dentist.