Good, stable gum health cannot be stressed enough and is perhaps the single most important aspect of dentistry. If active gum disease is present, not only will the natural bone of the teeth be compromised, but also potentially any dental work that has been carried out such as crowns, bridges, root fillings and most seriously, dental implants.
Our initial dental assessments will always include gum health and if we suspect the presence of underlying disease, we will always treat this and stabilise it before continuing with more advanced dental procedures.
So what is gum disease?
There are many types of gum disease but on the whole they can be divided into 2 categories; Gingivitis and Periodontitis . They are both inflammatory conditions affecting the gums and bone supporting our teeth. Although the cause of these diseases can be complicated by smoking and other factors, they are both instigated by a build up of plaque (a film of bacteria) and calculus (hardened plaque – also known as “tartar”).
Gingivitis is the early stage of gum disease and is completely reversible. It is characterised by red swollen gums and bleeding when you brush your gums.
Periodontitis is more advanced gum disease where the bone that is supporting the teeth gets destroyed. If its is caught early and treated, it may not result in tooth loss.
Bad breath and swollen and bleeding gums can be a sign of periodontitis, but the only reliable way to diagnose the problem is for a dentist to examine your gums with a gentle probe. If we can get the probe into an area under the gum, we call this a “pocket’. Once plaque and calculus gets into a pocket, it is impossible to clean away with normal brushing and flossing techniques. The bacteria in the plaque are then free to release the toxins that damage the bone and supporting tissues.
The only way for a pocket to be cleaned is by a dentist or dental hygienist using special instruments. The gum then re-attaches to the tooth/root and the pocket reduces in depth to a healthier range.
What does the treatment of periodontitis involve?
A detailed examination is required to assess the true extent of the disease. This is done by measuring the depth of the pocket that exists around each tooth. X-rays are also used to measure the remaining bone.
Treatment of periodontitis involves the removal of the bacterial plaque and calculus (tartar) from the tooth and root surfaces. The aim of treatment is to eliminate the pockets around the teeth so that your tooth brushing and regular visits to the hygienist can prevent them returning.
Smoking has been shown to be a significant risk factor for gum disease. Smokers have more severe disease and respond less well to healing.
With mild to moderate disease very thorough professional cleaning under local anesthetic (numbing of the teeth) can be successful, however in more severe cases, a surgical procedure may be necessary.
The effects of all treatment will be measured after a period of healing (usually 3 months). It will be at this stage that any further corrective therapy or a tailor-made maintenance programme will be formulated.
Can gum disease be treated with antibiotics?
Unfortunately, unlike many other conditions caused by bacteria, gum disease is not caused by a single bacteria, so antibiotics are rarely prescribed for gum disease.
What will happen if I refuse treatment?
If your gum disease is left untreated the pocketing around your teeth can deepen. The rate at which the disease progresses cannot be predicted, but will result in further attachment and bone loss and possibly even tooth loss.
How will I feel after my treatment?
The gums and teeth are routinely numbed for treatment. It is normal to have some discomfort following your appointment and you may require pain relief for at least 12 hours. There may even be increased tooth sensitivity for up to 3 months.
For patients who require a little help with longer appointments or more in-depth treatment, sedation is available.
Patients can experience gum recession following treatment of gum disease, the extent of the recession will depend on the initial severity of the disease. The dentist will advise you of the amount of recession you can expect.
For more information about gum health or to book a free consultation click here or call 01423 565432