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Dr Ilja Sapiro MSc

Dr Ilja Sapiro MSc is the dental surgeon at Wanstead Dental. More »

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What is Periodontal Disease?

Periodontal or gum disease results from a bacterial infection that affects the tissues that support the attachment of the teeth to the jaw. The tissues involved are that of the gums, the ligaments, and the bone. The infection starts when a film of plaque or tartar forms on the surface of teeth, producing toxins that cause gum irritation and stimulating the immune system to fight the infection. If the film is not removed regularly and in the early stages, the bone will be damaged and bacteria will multiply in the space or pocket formed between the gums and the teeth.

Gingivitis is the mildest form of periodontal disease, and affects only the gums without harm done to the supporting bone tissue. If this mild infection is left untreated, it can progress to periodontitis, which is irreversible and affects the gums and the bone tissue underneath. Periodontitis can result to wobbly teeth, and may eventually lead to tooth loss.

What are the symptoms of periodontal or gum disease?

Since gum disease is not usually painful, it is easy to overlook its earliest signs until such time that the disease has progressed. Classic gum disease symptoms include:

  • Bleeding gums (triggered mostly by tooth brushing, or the use of dental floss)
  • Swollen or red gums
  • Wobbly or loose teeth
  • Gum recession
  • A bad taste in the mouth and/or bad breath

How does one get gum disease?

Mild gum disease or gingivitis is common and affects a lot of individuals, but periodontitis does not necessarily follow. Genetics plays a crucial role in the susceptibility of an individual to gum disease; if severe gum disease runs in your family, then you have a higher risk of having this problem as well. Smoking cigarettes or using tobacco products, uncontrolled diabetes, and stress also contribute to the development of gum disease problems.

Periodontal disease is also associated with systemic problems.

Gum Disease

What is involved in a Periodontal Consultation?

A periodontal consultation starts with a comprehensive assessment carried out by your dentist. This process can help you understand the risk factors involved in the development of the disease, as well as those factors that can prevent a positive outcome from the periodontal treatment.

You will undergo a thorough periodontal assessment, with the dentist undertaking the assessment of:

  • Tartar and plaque deposits
  • Factors that affect the retention of plaque
  • Probing depths (determining bleeding distributions and recessions with the use of a six-point pocket chart)

After the initial periodontal assessment, your dentist may find it necessary to do a radiographic examination. This diagnostic exam will help the dentist see the bone condition underneath the gums. The findings from the periodontal examination, as well as the results of the diagnostics, will be explained to you in detail by the dentist. A diagnosis, the overall prognosis for the affected teeth, and a treatment plan relating to your gum condition will be presented to you. The periodontal consultation will be completed with an outline of the available gum treatments and procedures to give you a clear idea on what to expect from the treatment.

Periodontal Disease Treatments and Procedures

Gum Treatment (Part 1)

Oral Hygiene Education – Good oral hygiene is considered as the most important part of your treatment, as your dedication to following proper oral hygiene habits will determine the long-term success of the gum disease treatment for your specific condition. You will be given instructions on how to properly brush your teeth, and how to use dental floss and/or interdental brushes.

Professional Deep Cleaning and Root Debridement – Professional dental cleaning can be limited to the cleaning just above the gum line for gingivitis or mild gum disease. A deep root cleaning procedure, which goes underneath the gum line, will be needed to treat chronic or aggressive periodontitis. Depending on how deep the pockets formed are, and the number of teeth affected, the deep root cleaning can be carried out in two (half-mouth) appointments, or four (quadrant) appointments.

Gum Surgical Treatment – A gum surgical treatment may be needed if a deep root cleaning procedure is not enough to solve the gum problem. With this surgical procedure, the gums will need to be lifted away from the teeth to expose the area underneath; this will enable the dentist to access the plaque and tartar deposits so that they can easily be removed. Gum tissue may be removed, and the bone tissue re-contoured, as part of gum surgery.

Gum Treatment (Part 2)

Soft Tissue Graft – Soft tissue grafts from the palate, or the use of synthetic grafts with a protein gel and special flap designs, can be used to solve gum recession. The soft tissue graft will work on covering the exposed roots that contribute to teeth sensitivity especially when the teeth are subjected to temperature changes.

Graft Surgery – A bone graft is used to address the damage to bone tissue resulting from severe gum disease. Bone that has been damaged generally will not grow back, but the use of specific materials for grafting can stimulate periodontal regeneration. Specific criteria should be fulfilled with regards to the graft site and the patient’s anatomy, as part of the careful selection of the graft material to be used.

Crown Lengthening – Lengthening the crown results to the improvement of the gum line’s appearance for aesthetic purposes. This procedure also exposes more of the healthy tooth structure to restore the tooth’s function, with respect to the surrounding gum tissue.

Supportive Periodontal Care and Maintenance – The periodontal treatment will be followed by a supportive periodontal care program, which aims to provide you with long-term periodontal health. This supportive phase can be conducted by the cooperation of a general dentist and a periodontist, with the appointment frequency to be determined by your specific periodontal needs.

Tooth Lengthening