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Periodontal (Gum) Treatment

Periodontal treatment is a dental procedure during which the teeth are cleaned above and below the gums. The intended benefits of the procedure include reducing/stopping active periodontal disease (also called gum disease) aiming to prevent the loss of teeth. Gingivitis and Periodontitis are the two most common forms of gum disease we see in practice.

What is periodontitis?

Periodontal (gum) disease is caused by bacterial toxins which damage the supporting structures around the teeth causing irreversible damage to the supporting bone and premature tooth loss. Periodontitis is when the supportive mechanisms of the teeth such as tooth bone, gum fibers which help support teeth in its place break down due to bacterial provoked inflammation. Gingivitis often is a precursor to this condition. If we clean our teeth better and see the dentist/hygienist at the stage of gingivitis, most of the damage to gum tissue and bone is preventable.

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What is gingivitis?

Within our mouths we have hundreds of thousands of bacteria and other microscopic organisms living in a community, this is called a ‘Biofilm/Plaque’. These are sticky, highly adherent and are all over our teeth, gums, lips, cheeks and tongue. Even people who brush and clean their mouths really well will still have these bacteria. As such biofilms are present in most natural places such as water lines, hulls of boats and even on the sea side!

By keeping the mouth clean with (electric) toothbrushes, interspace brushes and floss, we can keep biofilms to a minimum. However, if oral hygiene is lacking biofilm build up substantially. This thicker biofilm full of bacteria (plaque) will trigger the body’s inflammatory responses and lead to bleeding gums and irritation also known as gingivitis. This is a reversible gum condition.

Treatment of periodontal disease is often divided into stages. This varies from person to person.

  • Stage One: Hygiene Phase Therapy
    This stage of treatment will involve removing deposits of plaque and tartar (calculus) and will focus on improving your oral hygiene to the highest standards by self-care at home.
  • Stage two: Non-Surgical Periodontal Therapy Phase (Deep Cleaning)
    This may be carried out with/ without local anesthetic, using mechanical and/or hand instruments to flush out the gums and remove the tartar (calculus), bacterial plaque & toxins deep below the gum line. The proposed treatment may take anything between 1-4 appointments.
  • Stage three: Supportive Care Therapy
    Supportive care therapy is to support you during the healing phase of the treatment and to make sure that you are doing your best with plaque control at home. We also check if your gums are healing well, inflammation & bleeding is settling down and keep an eye on your progress.
    If we manage to get your disease under control, then you move to the “maintenance phase” which is outlined below.
  • Stage four: Maintenance Phase
    If all your gum pockets are within a range that you can sufficiently maintain at home and the gum disease looks stable, we will move you towards the “maintenance phase”.
    Maintaining a hygienic mouth at home is the most important part in keeping the disease at bay. Seeing your dentist/hygienist regularly will make sure any problems are picked up early enough.
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What causes periodontal disease?

Most patients who develop periodontitis have a certain degree of genetic predisposition. However, this alone will not lead to periodontitis and the patient’s environmental factors will have a substantial role to play. These environmental factors could be poor oral hygiene, smoking, stress, uncontrolled diabetes or other health related issues.

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Will I lose all my teeth?

If periodontitis is left untreated, this can potentially lead to loss of all supportive structure around the affected tooth/teeth. Due to lack of bone, the tooth can become mobile, sensitive and difficulty in chewing can be experienced. This process may eventually lead to failure or loss of tooth/ teeth.

Gingivitis is reversible if good oral hygiene is maintained at home.  Regular visits to the dentist or hygienist for a check-up, oral hygiene advice and picking up problems at an early stage will help.

Periodontitis can be managed with professional help. Periodontitis is a more advanced stage of gum disease. Bone loss and loss of supportive tissues is irreversible. However, with regular professional care and excellent self-performed oral hygiene this can potentially be stabilized, and future bone loss and teeth loss can potentially be prevented.

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What sort of treatment can I expect?

The treatment proposed is set out to ensure the condition is brought under control, stabilized and monitored closely to prevent recurrence and further deterioration to your periodontal (Gums & Bone) health, in order to prevent premature tooth loss and help in the retention of your natural teeth.

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Should I see a hygienist or periodontal specialist?

A periodontist (gum specialist) is a dentist who has specialized in diagnosing, treating and managing periodontal disease. They are able to treat complex periodontal disease surgically or non surgically as well as other gum related treatments such as gum grafts, crown lengthening and regenerative procedures.

A dental hygienist is a dental care professional who is highly skilled in managing gum care. They often work under the prescription of a dentist/specialist to carry out the treatments described above.

Your dentist will recommend whether you should see a periodontist or hygienist. Often the two will work in collaboration with each other.

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