Periodontal (Gum) Therapy
What is Periodontal Therapy?
Periodontal treatment (‘peri’ means around, and ‘odontal’ refers to teeth) is the management of diseases and defects of the supporting tissues around teeth and dental implants. The goals of treatment are to preserve the natural teeth, to maintain and improve health, comfort, appearance, function of the gums. There are two main conditions of the gums (periodontal tissues) that are treated: periodontal disease and soft tissue defects.
Oral assessment, treatment and prevention to make your teeth last a lifetime
Periodontal disease (commonly known as gum disease) is a bacterial infection that directly affects the healthy gum attachment (periodontium) around teeth. The bacteria adhere to the surfaces and if they are not removed through daily cleaning then it can start a minor reaction (gingivitis) and often progresses deeper to cause a major inflammation, pain and tooth loss (periodontitis). When this happens, the gums separate microscopically from the teeth, forming ‘pockets’ that then fill up with more plaque.
Periodontal disease is a widespread health problem estimated to affect up to half of the adult population. It is the primary cause of tooth loss in adults 35 years of age and older. Advancement of the disease leads to bone loss around the roots of the teeth with visible gum recession and open ‘triangles’ between the teeth. It often leads to the loss of many teeth and compromises function and aesthetics, as well as affecting general health and quality of life.
Common warning signs:
- Plaque and calculus (tartar) build-up
- Red, puffy or bleeding gums
- Gum recession
- Tooth loosening
- Drifting teeth
- Chewing difficulties
- Halitosis (bad breath)
At present it is impossible to cure gum disease, we can however control it. As with any other disease process the earlier it is diagnosed the easier treatment is, and better the prognosis. Unfortunately, the disease is silent to the individual.
What causes this problem?
The main cause of gum disease is bacteria in dental plaque, which collect onto the surfaces of teeth, but other factors affect the health of your gums.
Common warning signs
- Poor dental hygiene
- Smoking or tobacco use
- Underlying medical problems
- Tooth grinding or clenching
- Poor nutrition and obesity
What does Periodontal Therapy involve?
Diagnosis – A comprehensive overview of the existing gum health and any disease activity around your teeth and gums is undertaken. The assessment involves measurement recorded on a tooth-tooth-basis, 2D x-ray imaging, analysis and reporting of gum disease risk indicators and then provision of specialist diagnostic and treatment interventions.
Treatment – Akit will compromise a plan of non-surgical treatment, the goal being to remove the infected plaque and tartar in the pockets around the teeth (deep cleaning under anaesthesia) and returning your gums to good health. He will personalise a recall and home care maintenance programme for you to keep you tissues clean by yourself. Regular visits with in-house dental hygienists will help you to keep on top of your cleaning to sustain health.
The gums may feel a little sore for 24 hours after deep cleaning. Healthier gums mean that you should be able to keep your teeth for longer. As the tissues heal, the gums may recede a little (0.5-2 mm) making your teeth temporarily more sensitive to thermal fluids. This can usually be managed with home topical desensitising pastes. In severe cases a gum veneer or cosmetic gum surgery may be indicated.
Akit also works in partnership with a number of leading Periodontists (specialist in Periodontal treatment) for stop the progress of more advanced gum disease or when non-surgical treatment does not achieve optimum health. They are specially trained in the detection, diagnosis and advanced gum therapies such as microbiological and genetic testing, surgical cleaning, grafting techniques to re-grow lost bone and gum, administration of local medications, photodynamic laser therapy, splinting teeth.
Periodontal treatment is an investment in your health and is less costly than replacing teeth.
Maintenance – In all cases long term management is essential and most patients can expect to see the dental hygienist two-four times a year. Once you are susceptible to the periodontal disease then you are always susceptible in the future including around any implants (known as peri-implantitis). An essential part of management is also planning for tooth loss and regular reassessment with Akit or the Periodontist.
If, when teeth are lost, it is your wish to replace them with a fixed or removable restoration then it may be necessary to electively extract teeth before absolutely necessary in order to be able to have an implant supported restoration that you seek. Gum disease by its nature involves loss of the supporting bone; there is a point beyond which there may be in sufficient bone remaining to anchor a dental implant.
Akit is aware that patients with gum disease have been battling it for many years and that there is a huge psychological hurdle to overcome before teeth can be extracted. He is very sympathetic to this situation and will spend as much time as necessary counselling you on realistic expectations and treatment outcomes especially with regard to the impact this may have on your life.
Cosmetic Gum Surgery
Periodontal surgical procedures can be used to improve the appearance of gummy smile or uneven gum lines. During this procedure, excess gum is removed and sculpted to expose thereby resizing the teeth.
Sometimes there is too much visible tooth causing the root to become exposed due to gum recession, which makes your teeth look long and make you look older. Gum recession can be successfully treated by soft tissue grafting . During this procedure, a small piece of soft tissue, usually from the root of your mouth is transplanted to the exposed root surface.
Periodontal Diseases and General Medical Health
Periodontal disease is a chronic inflammatory disease and is now linked to other diseases. New research supports the possible association between gum disease and systemic conditions. There is a two way interaction between oral and general health. These include diabetes, skin disorders, hereditary diseases, joint problems, low immune system and osteoporosis.
There is an association between gum diseases and other chronic inflammatory conditions, such as diabetes, cardiovascular disease (atherosclerosis, heart attacks and strokes) and complications of pregnancy (pre-term birth and low birth weight infants). Therefore, treating inflammation may not only help manage gum diseases but may also help with the management of other inflammatory conditions.
When an inflammatory condition is suspected or diagnosed, it is important to consult with both a general physician and a dental health professional to see if you have underlying periodontal disease.
Periodontal evaluation may be especially important if you:
- Have a high risk for periodontal diseases (risk assessment test).
- Have heart disease, diabetes, respiratory disease or osteoporosis, or are thinking of becoming pregnant.
- Have a family member with gum disease. Research suggests that the bacteria that cause periodontal disease can pass through saliva. This means the common contact of saliva in families puts children and couples at risk for contracting the periodontal disease of another family member.
- Have a sore or irritation in your mouth that does not get better within two weeks.
If you would like to see clinical cases of periodontal (gum) therapy, please view the gallery.