Our Treatments
Gum Disease
What is Gum Disease?
The medical term for gum disease is Periodontitis. This is a common problem that is caused partly by the presence of plaque. Plaque contains bacteria which are harmful to the gums and the bone around the tooth sockets. In some people, the presence of plaque just causes inflammation of the gum, a condition known as gingivitis. Gingivitis is a reversible condition which stops once the plaque is removed and effective oral hygiene is restored. In some people, gingivitis progresses to periodontitis, where the inflammation progresses to involve the bone around the teeth, resulting in bleeding gums, bad breath, abscesses and loosening of the teeth. If left untreated, teeth are eventually lost as a result of the disease.
Treatment is aimed at controlling the disease by reducing the plaque which accumulates around the teeth and their roots. It is very important to understand that homecare is vitally important and crucial to the success of treatment. Much of periodontal treatment involves education by the dental team in terms of effective ways of reducing this bacterial plaque around the teeth, using a variety of cleaning aids. Your dentist and hygienist will help by reducing plaque retentive factors that cause plaque to build up, making it easier for you to keep your teeth clean.
We will also monitor the progress and response to your gum treatment, and perform any necessary treatment to remove plaque build up under the gum line.
Effective gum disease treatment does require a lot of clinical input and time, and we appreciate that costs can mount up. We have therefore put cost-efficient practice plans in place to help with this and to ensure that finances do not present a barrier to accessing a standard of treatment that is considered best practice.
How does periodontitis cause a problem with teeth?
The accumulation of plaque forms something called a biofilm – this is a scaffold for bacteria to live on, thrive and multiply. Inflammation breaks down the gum attachment to the tooth in places and causes “pockets” to form and allows the bacteria to multiply. As the pockets get deeper, the nature of the bacteria changes, and more inflammation occurs, ultimately causing the supporting bone around the socket to be damaged and eaten away. Over time, the tooth loses its support, a bit like a tree losing its support if the soil around its roots is taken away. The tooth becomes more mobile and is eventually lost as a result.
This sequence of events gives rise to symptoms like bleeding from the gums, bad breath, wobbly teeth, drifting (changing position) of teeth, and localised collections of pus or abscesses. Sometimes the blood and nerve supply to the tooth can be affected if the pocket is deep enough, leading to a dead tooth, which can cause severe toothache.
What does treatment for periodontitis achieve, and how will I respond?
Following removal of built-up plaque above and below the gumline, the pockets which formed during the disease process will reduce in depth as the inflammation in the gum dies down and swelling of the gum tissue subsides.
The gum will start to heal down onto the tooth, and this usually results in some recession. That means that the gumline will be 1-2 mm higher than before. The bleeding will also reduce significantly as the gums are now tougher, well healed and no longer inflamed. In some cases teeth that have been a bit wobbly might firm up, which is a very good sign that you have responded well to treatment.
One exception to this is smokers – Smokers who suffer from periodontal disease might have very little bleeding as smoking tends to suppress the body’s inflammatory response. Bleeding is used a measure of periodontal disease activity, and in the case of smokers, might provide false reassurance that things are getting better. Smoking in general also reduces the likelihood of a good response to treatment, and increases the risk of losing teeth due to periodontal disease by about 3-fold.
A good response will result in reduced pocket depths and reduced bleeding. Good maintenance will result in much reduced plaque levels which in turn keeps the disease quiescent. This is why home cleaning and maintenance is such an important part of treatment.