Periodontal (Gum) Disease

What is Gum Disease

Gum disease is an inflammatory disease that damages the support around your teeth. The excessive inflammation can cause bone to be lost around the teeth, allowing the gums to shrink or recede, allowing teeth to become loose or move or in the worst cases teeth can just fall out.

Are there different types of gum disease?

Yes. They can be broadly splint into 2 groups:

Gingivitis - This is the type of gum inflammation that affects everyone from some time or another. Gums appear red and swollen and may bleed easily when cleaned or even spontaneously. If good cleaning is established, Gingivitis will resolve without any further intervention having done NO DAMAGE.

Periodontitis - Is similar in appearance to Gingivitis in the early stages. The big difference is that when good cleaning is resumed there will be underlying damage to the bone supporting the teeth. This damage is IRREVERSIBLE. Depending on the stage of the Periodontitis, cleaning alone may not be enough and you may require Professional help.

Within the Periodontitis group, there are further sub groups of the disease. We mainly see Chronic Periodontitis which is a relatively slowly progressing disease. Occasionally we see Aggressive Periodontitis where the speed of bone loss can be alarming and require rapid intervention. Getting the diagnosis right is crucial!

Who Gets Gum Disease?

We will probably all experience Gingivitis at some point in our lives and by the age of 60, around 80% of the population will exhibit some signs of Periodontitis, even though some in that group will on exhibit small signs of disease. What we do know is that around 10% of the population are highly resistant to Gum disease and that 10% are highly susceptible. Gum disease is not a disease of old age. Some of the more aggressive forms affect people in their 20’s or younger!

What are the signs of Gum Disease?

Signs that you may have gum disease are gums that bleed when you clean them, Teeth that look longer or have that have moved position, gums may also look red and swollen. Gum disease is usually not painful and as such many people overlook the other important signs.Bad breath may also be caused by gum disease.

Why not click on the “Do I have gum disease?” button to be taken to the American Academy of Periodontology’s web site and their on-line test? Try it, there are only 12 questions, it takes seconds!

How do I get gum disease?

The number one cause of gum disease is dental Plaque, the sticky film of bacteria that builds up on your teeth. Everybody reacts to Plaque differently. How you react is largely genetic i.e. runs in the family. So, if your one of your parents has or had gum disease or if a brother of sister has gum disease, you have a significantly higher risk of developing gum disease.

If you are susceptible to Periodontitis you need to do everything to prevent the disease becoming established. This means great oral hygiene and avoidance of the modifying factors that can make things worse.

What are these “modifying factors”?

Whilst we have said that genetics and Plaque are the causes of the disease the risk of being affected by Periodontitis or the severity of the Periodontitis you experience can be influenced by many things. These Risk Factors include:

SMOKING - is the number one risk factor. You are 3-5 times more likely to experience periodontal disease if you are a smoker. Also the more you smoke, the higher the risk. If you are serious about wanting to maintain you gum health, stopping smoking is one of the most important things that you can do. We can still treat patients with periodontitis who cannot give up smoking, but all of our treatment options are less successful in smokers due to their reduced healing capacity.

DIABETES - uncontrolled or undiagnosed diabetes can play a huge role in the development and progression of Periodontitis. When treating Periodontitis patients we will often screen for Diabetes and if we suspect anything, we will liaise with your GP. The good news is that if your Diabetes is stable, you are at no greater risk of Periodontitis than a non-Diabetic.

STRESS - chronic stress that is not managed in a healthy manner can have an impact on our immune systems. It is our immune systems that responds to the Plaque to produce the inflammation that causes the periodontal destruction. It is important for your general health and your periodontal health that stress is managed in a healthy way i.e. exercise, relaxation techniques, reading and unwinding rather than the unhealthy ways like drinking excessive alcohol or smoking.

Can Periodontal Disease be cured?

No. But it can be successfully treated and controlled so it is no longer causing any damage. The reason that we cannot cure periodontal disease is due to the fact that we cannot change an individuals genetic susceptibility to the disease.

Is it painful to treat?

No. Because of our treatment sequence, you should find that treatment is comfortable. The success of your treatment relies on your cleaning and the thorough nature of our cleaning. If for any reason we think that something may be uncomfortable, we will offer to numb the area using some local anaesthetic, it is important to us that you are comfortable and we can do our job properly to give you the best results.

Periodontal Disease Treatment

Oral Hygiene
The first step to achieving short and long term gum health improvements is to ensure that the patients oral hygiene regime is good. We will take time ensuring that you are doing all the right things and non of the wrong things to ensure that the efforts you put result in the maximum results. Periodontal patients need to accept that, due to their genetic susceptibility, their oral hygiene regime will need to be optimal and maintained daily for the rest of their lives.

We are simply talking about the correct use of toothbrushes, floss and interdental brushes.

Active Treatment
This involves the removal of the hard and soft deposits that are stuck to the teeth, namely Plaque and Calculus (calcified Plaque). Whilst similar to a “Scale and Polish” that you may have at your dentist, successful periodontal treatment relies on meticulous removal of deposits above and below the gum. Whilst the Calculus its self does not caused the disease, we remove it to aid long term Plaque removal and give the gum tissues a clean environment in which to heal. It also looks better when it is removed!

This treatment can take anything from one visit up to 5-6 visits depending on the severity disease at the start of treatment. Treatment should not be painful, but local anesthetic will be offered if you feel that something is uncomfortable.

Occasionally, it may be appropriate to consider the use of antibiotics during this phase of treatment. We do not give antibiotics to every patient, this is done on a case by case basis.

This Phase of treatment is called Non-Surgical Therapy. Occasionally, this phase of treatment may need to be repeated more than once.

In my experience approximately 80-90% of the cases that I treat with Non-Surgical Therapy will become stable periodontal patients and only require simple maintenance in the medium to long-term.

Advanced Treatment Options
Occasionally, despite everyone’s best efforts, certain areas of gum disease may not resolve with Non-Surgical Therapy. In this situation we may consider some advance treatment options such as Periodontal Surgery.

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