PERIODONTICS – THE TREATMENT OF GUM DISEASE
Dr Rob Crawford, our specialist periodontist, carries out treatment to help patients who have gum problems. He is concerned with the ‘soft tissues’ in the mouth.
His patients’ most frequent concerns are:
- bleeding from their gums
- teeth which are becoming slightly loose
- gum recession
The health of the gums is very important as it affects the health of the underlying bone which holds the tooth roots in place. Any bleeding from the gums is a sure sign that they are not healthy.
Poor gum health can lead to bone loss around the roots, which will then result in teeth becoming loose.
There is ongoing research regarding the role of periodontitis and its effects on general health, including diabetes, heart/ cardiovascular disease and adverse pregnancy outcomes. Maintaining a healthy mouth may have far greater benefits on a healthy body than previously thought.
THE GOOD NEWS
In the early stages of gum disease (gingivitis, see below) people can often achieve a great improvement by simply having treatment with one of our hygienists and up-grading their own home-care routine to include effective cleaning between the teeth with either interdental brushes or floss.
If it is clear that periodontitis (below) is present, treatment with a gum specialist will be needed to keep the condition under control and stop it deteriorating. It is usually not possible to ‘cure’ gum disease, but with the right treatment combined with excellent home-care it can be kept under control.
The first consultation will be a comprehensive one, with a detailed discussion.
He will measure the ‘pocketing’ around each tooth, record the areas of inflammation and bleeding as well as any recession and will take low dose digital x-rays as necessary. He will demonstrate the use of interdental brushes for effective cleaning between each tooth. Following the consultation he will send a report outlining the recommended treatment plan.
THE TYPES OF GUM PROBLEMS THAT WE TREAT
The first stage of gum disease is called gingivitis, which means that the gums become inflamed, and look redder and puffier than healthy gums. They are likely to bleed on brushing. Another unpleasant side-effect may be bad breath (halitosis).
If gingivitis is not treated it can in some circumstances progress to periodontal disease. ‘Pocketing’ of the gums will develop around the teeth and their roots, and some of the supporting bone around the teeth will gradually be lost. As the bone loss continues the teeth will be less firmly held in place, so they may become loose.
Gum recession is often an aesthetic concern but it may also involve sensitivity of the exposed teeth. If it is progressing in individual areas it is particularly important to assess the cause. The cause may be just an over-enthusiastic brushing method or something more complex
NON-SURGICAL PERIODONTAL TREATMENT (debridement)
After a detailed initial consultation Dr Crawford may recommend a deep cleaning treatment (‘debridement’). The purpose of this treatment is to remove any deposits from the root surfaces, which will encourage the gums to re-attach and the pocketing to reduce.
You will always be given detailed advice after treatment. In most cases some tenderness is likely for a few days, but patients are often surprised by how little discomfort they have.
You will be shown in detail how to maintain the improvements resulting from the deep cleaning, and we will give you the necessary brushes for the necessary meticulous daily cleaning routine. Your own efforts at home are essential to maintain the benefits of the treatment. Controlling periodontitis needs to be recognised as a life-long process.
POCKET DEPTH REDUCTION
Sometimes it is advisable to reduce the depth of individual deep pockets by localised surgical treatment, but this is rarely a treatment of first choice.
TREATMENT FOR GUM RECESSION
He will often recommend that impressions are taken so that models of the teeth showing an accurate record of the gum level can be kept for comparison in the future. In this way the specific areas of recession can be monitored precisely.
If the recession has reached the stage where treatment becomes necessary to replace it he will discuss possible ‘gum grafting’. This procedure involves taking some gum tissue from another part of the mouth and re-positioning it into the areas where it has been lost.
This is a minor surgical procedure carried out to slightly alter the position of the gum line. The main reasons for this treatment are
to show more of a tooth before crowning
for aesthetic reasons such as to correct an asymmetry if the gum line is higher on one side of the front teeth than on the other side
Gum disease and overall health
In recent years there has been much speculation regarding the role and connection of the inflammatory and infective processes related to periodontitis and its effects on general health including diabetes, heart/ cardiovascular disease and adverse pregnancy outcomes. So maintaining a healthy mouth can have far greater benefits on a healthy body than previously thought.