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Periodontics (treatment of gum disease)

Our Periodontic specialists: Clifford R Nissen

What is Periodontal Disease?

Periodontitis is inflammation of the periodontium, i.e. the tissue holding the tooth. If left untreated it can lead to tooth loss and bad breath. It is a major cause of tooth loss in adults.

Bacteria contained in the plaque on the surface of the tooth causes an inflammation of the gums and if left untreated affects the gums, bones and other supporting tissues of the teeth. It leads to a pocket forming between the root of the tooth and the gum where bacteria can easily proliferate and calculus develop. Although most individuals suffer gum inflammation from time to time, 10% of the population appear to suffer from more severe forms of gum disease.

What causes Periodontitis?

Three major factors are thought to be responsible for periodontal disease, and inadequate oral hygiene is a contributing factor. Family history, stress and smoking are all important risk factors. Certain general diseases such as diabetes may also increase susceptibility.

How do I know if I have the disease?

The signs and symptoms of periodontal disease are extremely variable but can include reddening and swelling of the gums, gums that bleed on brushing together with signs of loose teeth, a bad taste in the mouth and bad breath. However, because pain is rarely a symptom until the disease is at an advanced stage, it is possible to be unaware of the signs.

Treatment of Periodontal disease:

How is Periodontal Disease Treated?

Periodontitis can only be treated by your dentist and hygienist. Because of differences in the severity of the disease only he/she can decide what treatment is needed. Since dental plaque is the principal cause of gum disease treatment is focused on plaque control. This is achieved through improved oral hygiene and the cleaning of the teeth and their roots to remove plaque and tartar from under the gums. The final objective of any treatment is to clean the gum pocket. Sometimes, to reduce sensitivity and discomfort during treatment, a local anaesthetic may be required.

If you are a smoker please ask for help and advice as smoking cessation is also an important part of successful treatment.

Treatment of periodontitis is usually divided into three phases as follows:-

Treatment to Stabilise Your Gum Condition:

At your Initial Consultation we will help you develop the skills required to routinely clean plaque from above the gum level and around all the teeth. Calculus, or tartar, must be professionally removed by a dentists or hygienist. During this treatment phase we record how well you are removing plaque from your teeth. The benefits will include fresher breath, with firmer gums and less mobile teeth.

After an interval of several weeks of healing we assess the response of your gums. This Reassessment Appointment is extremely important as it is then that we can determine how successful our therapy has been and whether further treatment will be required. If this proves to be the case we will explain to you, at this appointment, what is involved and why. We can follow this with a full written treatment plan and an estimate of cost.

Treatment to Correct the Effects of Gum Disease:

Where gum pockets are deep, above 5-6 mm, periodontal (or gum) surgery may be required . This is often the case around the molar (back) teeth, but is not limited to these areas. We always endeavour to avoid the need for surgery, but whether or not we achieve this is dependant upon the success of the Initial Phase - and especially your own personal success with your oral hygiene. It is in your own interest to maintain a good level of oral hygiene so that we can be sure to give any necessary surgery all possible chances of success.

Sometimes it is possible to to regenerate some of the lost gum and bone around the teeth through a small surgical procedure. If this would be of value to you is determined at the Reassessment Appointment. Understandably, many patients are apprehensive about surgery in the mouth. However, gum surgery is a straightforward procedure and is not as drastic as it can at first appear.

After periodontal surgery initial healing is quite rapid (within a week). However, if you require further treatment - from your own dentist for example - it is important to wait about three months in order to allow the treated gums sufficient opportunity to mature.

Prevention and Maintenance Phase:

After your active treatment has been successfully completed it will be necessary for you to see the dental hygienist regularly (either at 33 Beaumont Street, or if you prefer, at you own surgery if you were referred by them). Research has shown that the ideal interval is one appointment every three months for the first year. Provided you maintain good oral hygiene this interval can then be extended to every six months. Sometimes re-treatment of a resistant area is required. Your hygienist will keep the progress of your gum disease under close review.

What we have provided here is by no means a complete explanation of all aspects of treatment. Our periodontal team will keep you up-to-date at all stages of your treatment and explore all treatment options available to you.

Cosmetic Periodontal Treatments

Patients do sometimes have cosmetic concerns relating to their gums. For example, gums may be too thick or too short. These can be corrected by a number of specialised surgical techniques. Successful treatments include silicone gum mask or veneer to hide any unsightly gum recession or gaps between teeth. For more information about this treatment please e-mail our specialist Dr Clifford Nissen.

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