Commonly known as ‘Gum Disease’, periodontal disease is the process of loss of support to your teeth. This eventually leads to the loss of your teeth if untreated. You only have one set of adult teeth so once they're gone, they're gone. The supporting tissues to your teeth are the gingivae (gums), bone and the ligaments which join your teeth to the bone.
Your body produces an immune response to the bacteria and the toxins they produce in your mouth. We all have bacteria in our mouth. If we do not clean our teeth the bacteria will adhere to areas of food debris, and multiply in numbers. This film of bacteria and food sugars is called plaque. This is the sticky colourless film which forms on our teeth. These bacteria feed on the food which remains on your teeth after you have eaten.
Gingivitis means inflammation of the gums. ‘Itis’ in Latin means inflammation. Periodontal disease is the subsequent loss of supporting tissues to your teeth, eventually resulting in the loss of your teeth. We will all suffer from gingivitis at some points during our lives. It means our oral hygiene is not optimal, plaque has accumulated around the gums and more effort is needed in certain areas to improve our oral health. You may notice that the gums bleed when you brush your teeth. If so, DONT STOP brushing in these areas. The only way for this to stop is to continue with a daily regime of cleaning your teeth. Your gums may bleed for a number of weeks before they stop so you must persevere. If gingivitis is not resolved, with time this can develop into periodontal disease.
Smoking causes the reduction in blood supply to your gums. Therefore those who smoke with gingivitis or gum disease often don't present with bleeding gums. Ask your Hygienist or Dentist for advice on quitting smoking
The contributing factors for periodontal disease are the following;
The most important factor which effects all those with periodontal disease is oral hygiene. It is absolutely necessary to maintain optimal oral health for periodontal disease to resolve. If oral hygiene cannot be maintained at an optimal level then the periodontal disease will progress. It is not worth spending lots of time and money on periodontal treatment if you are not going to look after your teeth at home.
Smoking increases the risk of getting periodontal disease and also greatly reduces the success of treatment for periodontal disease. Smoking cessation is an important part of treating periodontal disease successfully.
Poorly controlled diabetes mellitus has been linked to having gum disease, the progression of the disease and reducing the success of treating the disease. It is worth consulting your GP to see what can be done to help control your diabetes.
Some people are sadly more predisposed to suffering from periodontal disease than others. This means their immune system is much more sensitive to the bacteria and toxins than others. As a result they have to be extremely regimented with their brushing.
Patient often present complaining of bleeding, inflammation of the gums, bad breath and receding gums with occasionally wobbly teeth if the disease has progressed far enough. Bad breath is often a result of food debris collecting in-between teeth.
At every oral health assessment (check-up), we shall assess your periodontal health by taking simple measurements around your mouth and monitoring the degree of plaque and bleeding present. From this we will determine whether further clinical and radiographic investigations are required.
Our hygienists are specifically trained to help you improve your oral hygiene and treat gingivitis and periodontal disease. They will discuss with you what toothbrush would be appropriate for you, any interdental cleaning aids which you should be using and structure a personalised home oral hygiene regime for you.
As well as the oral hygiene advice, all patients seeing a hygienist will receive a gross scale of their teeth to remove any hard calculus (tartar) from their teeth so they can start to improve their oral hygiene. Dependent on the severity of the periodontal problem we will either review your periodontal health in 3 months to see if this has improved or begin with some deeper cleaning around your gums within 6 weeks. However we will not provide this deep cleaning of your gums unless your plaque and bleeding scores are below 15%. The reason for this is that clinical studies have shown that treatment is unsuccessful if your oral hygiene is not at this satisfactory level. It would therefore be a waste of your time and money if you were to pay for this treatment.
We recommend you see the hygienist every 3 months until your periodontal health has stabilised if you have gum disease. At this point we would recommend you come every 6 months unless we have any concerns or there is relapse.
If you require treatment such as root canal treatment, crowns, bridges and implants we are clinically justified not to offer these unless we can evidently see an improvement in your oral hygiene and it would not be of detriment to otherwise healthy teeth. This is for your benefit as you could waste time and money on treatment which is likely to be unsuccessful over a short period of time.
We shall reassess your oral health, areas of specific concern, and see if we can provided further treatment or whether it would be in your best interest to be seen by a periodontal specialist.
If your oral hygiene and gingival health is not optimal your treatment options can be limited both in the long and short term.