What is Periodontal disease?
Periodontal disease is often referred to as gum disease, although the periodontal tissues include the jaw bone and related fine tissues, as well as the gums. The most common cause of periodontal disease is bacterial plaque, which builds up rapidly in our mouth and must be daily brushed and flossed away. The two main broad groups of periodontal disease are gingivitis – the early, reversible and less serious, form of periodontal disease; and periodontitis, which causes receding gums and the permanent loss of supporting bone.
What treatments are available for gum problems?
Treatments for gum problems are wide-ranging and dependant on each individual case. Gingivitis treatment for bleeding gums will involve undergoing a professional cleaning treatment with the hygienist, followed with tailored advice on how you can stick to a robust oral hygiene routine at home. If your gum problems have progressed to periodontitis, we will advise you on the treatments we can employ to slow and halt the progress of gum infection or gum recession.
Periodontal disease and tobacco
Research has established a strong link between periodontal disease and tobacco usage – but many smokers do not even realise they have gum problems. Because nicotine has a dampening effect on the inflammatory status of the gums, signs and symptoms of periodontal disease are often masked, further delaying timely diagnosis and appropriate treatment. Periodontal disease also tends to be more severe in smokers, with deeper gum pockets, delayed healing and a poorer response to periodontal treatment. Quitting smoking is essential to restoring your periodontal health and also reduces your chance of oral cancer. Other modifying risk factors include diabetes, stress, certain medications or medical conditions. We can work with your doctor to help moderate some of these periodontal-medical associative effects.
The warning signs
These are usually quite mild and inconspicuous – in fact, it is estimated that 4 out of 5 people are unaware they have gum problems or a gum infection, because periodontal disease can often go unnoticed for years. Early stages are painless and symptomless, so obvious visible changes in the mouth are rare. You or your partner may notice persistent bad breath or shrinkage of your gums. When brushing and flossing, you may notice bleeding gums. Your gums may also feel tender or spongy, or look swollen, or you may notice you have receding gums. Your teeth can also become looser and start to drift from their original position – however, in the majority of cases, people with periodontal disease experience few or no obvious symptoms.
Diagnosis and treatments
Diagnosis is made after a thorough history is taken and an extensive oral examination is carried out when you visit us. We map out the surrounding tissue support of each tooth gently and carefully with the use of a periodontal probe. This is combined with a thorough examination of x-ray pictures of the affected teeth.
Loss of periodontal support is reflected in a higher number from the measurements with the probe, so called periodontal (gum) pockets. Pocket depths of more than 3mm are suggestive of varying levels of periodontal disease. During probing, any tenderness or bleeding are also signs of inflammation and unhealthy gum tissues.
The X-ray images can show us the two-dimensional levels of the bone around your teeth, the presence of local features that promote the buildup of bacteria plaque e.g. tartar, faulty fillings and adverse tooth surface anatomy.
Treatment options to arrest the bone loss and re-establish healthy gum support can then be discussed in detail with you.
Gum disease treatment methods
When it comes to treating gum problems or gum infections, we always aim to begin with the least invasive approach using non-surgical means. This involves decontamination and thorough professional cleaning that reaches under the deep periodontal pockets to the root surfaces. This is the fundamental cornerstone of periodontal therapy and, in many cases will be the only treatment you require, supplemented by a good home maintenance routine and supportive therapy. Non-surgical management can include any of the following:
- Scaling and root surface debridement
- Bacterial analysis and antimicrobial therapy
- Occlusal analysis and adjustment
- Splinting of teeth and instruction about plaque control
In some, more advanced, periodontal cases, such as advanced gum recession, problems may persist despite non-surgical treatment and your best efforts at home. A range of minor periodontal surgical procedures are used to smooth or correct defects and irregularities in the bone and soft tissue surrounding the diseased teeth, with the ultimate aim of re-establishing periodontal health. These include:
- Pocket Reduction Procedures
- Regenerative Procedures
- Crown Lengthening
- Soft Tissue Grafting (receding gum treatment)
- Cosmetic Procedures
In all cases, patients at Perio & Implant Dental Referral Centre will be given a clear and fully costed treatment plan that explains what to expect from their specialist gum treatment in Richmond.