What is periodontal disease?
Periodontal disease (or periodontitis) involves destructive inflammation of the gums in which supporting bone and ligament are lost. It is caused by an inappropriate immune response to virulent germs found in dental plaque. If left untreated, the teeth may become loose and eventually be lost. Most recent studies support an association between active periodontitis and poor systemic health, including cardiovascular disease, pre-term, low birth weight babies and diabetes (metabolic syndrome).
What does gum disease treatment involve?
Before beginning your periodontal treatment, we will complete a full scale and clean. This includes the removal of harmful plaque and tartar in and around the affected areas, including below the gum line. In some cases, we plane the tooth root so that the root surface is smooth, allowing the tissue to heal and re-attach to the tooth.
In order to help control the bacteria that causes periodontitis, we often recommend antibiotics or the use of anti-microbials (chemical agents or mouth rinses).
Plaque and tartar become difficult to remove when there are deep pockets present between the gums and teeth. Patients are generally not able to keep them free of plaque. If this is the case and these deep pockets persist, surgical therapy may be required to improve the health of the gums. Surgery also helps your specialist periodontist to gain greater visual and mechanical access to the affected areas. The gum tissue can be modified or sculpted to facilitate and simplify home care.
Periodontal Treatment at Pacific Periodontics
At Pacific Periodontics, we ensure surgical therapy is only adopted when absolutely necessary.
We are quite conservative with our treatment techniques and make decisions based upon the patient’s best interests at all times.
It is always important for us to avoid surgical techniques during the early stages of periodontal disease in order to preserve existing gum tissue and avoid further stress. Even in the most severe of cases, we may adopt non-surgical therapy before proceeding with surgery. We believe it is important for us to try and improve the gum tissue quality before resorting to surgical therapy. This approach also helps us to limit the area that may require surgery.
Common but preventable, gum disease occurs when the soft tissue that surrounds your teeth gets infected. This is usually caused by poor hygiene and is brought about by plaque that contains more than 300 types of bacteria, sticking to your teeth and entering your gum line. If left untreated, gum disease can escalate and is the leading cause of tooth loss in adults. Aside from poor oral hygiene, the following factors may contribute to gum disease: ·
- Illnesses like Diabetes, Heart disease, HIV
- Some medication
- Some contraceptives
- Poor diet choices
In some cases, gum disease can exist without symptoms, this is why dental check-ups are so important.
- Bleeding gums
- Inflamed, swollen gums
- Receding Gums
- Bad breath
- Changes to the colour of your teeth
- Loose or separating teeth
- Changes to your bite
Stage 1: Gingivitis
In the first stages of gum disease, your gums become red, swollen and they bleed. This stage is known as Gingivitis and can be fixed with implementing proper hygiene and a professional cleaning to remove the built-up tarter on your teeth and gum line.
Stage 2: Periodontitis
If Gingivitis is left untreated, given some time, it can escalate to periodontitis which can result in the loss of tissue and bone that support your teeth. Overtime without a supporting surface, you will gradually start to notice one or more of your teeth starting to loosen. This is regarded as the advanced stages of gum disease and urgent, professional intervention is needed.
Stage 3: Chronic
In the early stages, chronic periodontitis has few symptoms and in many individuals, the disease has severely progressed before they seek treatment. When symptoms do display themselves, they are similar to Gingivitis. Aggressive Periodontitis With aggressive periodontitis, bone and tissue loss takes place at a faster rate than with chronic periodontitis. This type of gum disease is known to be highly destructive and occurs in patients who are otherwise healthy. Common symptoms include the loss of tissue and bone in some areas of your mouth, or in your entire mouth.
Take care of your gums, contact us today to book a consultation.
Many world wide surveys conclude around 10% of the population are particularly susceptible to advanced periodontal disease. One’s susceptibility is primarily determined by the level of immune-resistance you inherit from your parents. Smoking is also now recognised as a major contributory factor. Certain medical conditions (eg. diabetes, rheumatoid arthritis, malnutrition) or medications (contraceptive pill, calcium channel blockers, and cyclosporine) may also be contributory. One thing which has been confirmed is that “without plaque there is no disease”. Thus if plaque is not regularly and appropriately removed through good oral hygiene, then there is an increased risk of accelerating the disease process.
The good news is that in most cases periodontal disease responds very well to treatment. This treatment involves the careful measurement of tooth support levels, professional cleaning (debridement), a review of your home care regime, and then regular supportive care. In most cases this is enough to halt the disease. Where the disease has become very advanced it may be necessary to carry out some minor oral surgery to provide both visual and mechanical access to appropriately clean out these sites.
Periodontal disease is usually considered a chronic (long term) problem. Timely treatment and diligent care by both the dental team and patient can often halt its progress. However; there is no permanent cure. This means it is extremely important that if you have this disease you attend the recommended regular reviews and supportive care. Otherwise the disease will slowly re-establish itself and the benefits from treatment will be lost.
Every effort will be made to assist you in keeping your teeth. In most cases, once treatment has commenced you can generally expect to keep your teeth for the medium to long term. Unfortunately, bone and gum tissue already lost due to the disease cannot easily be regained. Only if destruction is so great that a tooth is considered beyond help, or is causing you pain, would removal be recommended.
Retention of hopeless teeth can be detrimental to the adjacent (often more functional and important) teeth because they can act as a reservoir for the bad bacterial pathogens.
Please discuss any fears with our staff before treatment. Local anaesthesia (numbing injections) are very often used during the initial deep cleans. Numbing gels make these injections more comfortable. For particularly anxious patients, valium-like oral sedation is often used. It has the additional benefit of being a muscle-relaxant so you don’t get sore opening wide during a lengthy appointment. You must however arrange for a friend or family member to drive you home. Following treatment, most patients do not require painkillers after the first day. Many patients do report feeling tired the next day. This may be a result of your immune system going into overdrive to deal with the elimination of bacterial toxins. The appropriate painkillers will be issued or prescribed. Nearly all patients will find they are able to work the next day.
In certain localised defects, regeneration of lost bone and ligament can be achieved. Recently materials such as ‘BIO-OSS’ and ‘Emdogain’ are making these surgical procedures more predictable. Please ask our periodontists if ‘regeneration’ is attainable.
The cost of treatment is principally driven by the chair time required to control/ stabilise the disease. This will vary between different individuals depending upon the extent and severity of disease.
Gum recession – You may notice the gums shrinking, tightening and generally feeling firmer. This is quite normal as they become healthier and less swollen (inflamed). The amount of shrinkage/ recession will depend on how much underlying bone has been destroyed by the disease. Do still brush the gums, as this ensures full removal of plaque.
Sensitivity – Following treatment teeth may become more sensitive to cold drinks or food, but this usually passes in a few weeks, as long as good oral hygiene is maintained. Sensodyne/sensitive tooth gels, 6C tooth-mousse and Neutrafluor 5000 are products which can reduce the porosity of exposed root dentine, which in turn provides better insulation for the tooth pulp (nerve).