My gums are in a state!

Periodontal (gum) disease occurs in the gum and bone around the teeth. It is caused by the bacteria (plaque), that form on and around teeth. Everyone is different, so some people are more susceptible to periodontal disease than others. If untreated, it can even lead to the loss of teeth and other dental and general medical problems (for example, well known is link with heart disease, diabetes).

What are the symptoms of periodontal disease?

Periodontal disease is usually painless, and can be long standing. For an extended period of  time you may be unaware that you have been suffering from this condition. 

Take a look at these questions. If you answered ‘yes’ to more than 1 question below, you may suffer from periodontitis:

Do your gums bleed on brushing or overnight?

Are any of your teeth loose?

Can you chew everything you want to?

Do you have a bad taste or smell from your mouth?

Do you suffer from pain, swelling, gumboils or blisters?

Do you smoke?

Why is periodontal treatment needed?

It is a disease with very upsetting results if left untreated.

It is easy to ignore the disease and forget about it when you don’t suffer much. It often happens that patients underestimate the damage that this disease can cause… Left untreated, the condition of your gums will worsen. Gaps between your teeth, gum pockets and the teeth can get infected in the later stages of the disease. As the periodontal disease progresses, more bone is lost, the pockets deepen and more gum tissue is involved. Eventually the teeth become loose and may have to be removed.

Even with today’s impressive technology available to dentists, we remain unable to completely cure advanced periodontitis. However, with successful dentist/ hygienist – patient cooperation we can slow down the damaging process and extend the life of patients’ teeth for many many years.

What is the cause of periodontal disease?

The main cause of periodontal disease is the reaction of your gums to a build-up of bacterial plaque (bacterial mouth infection), which is constantly forming on teeth and colonize in the gum pockets surrounding the teeth and getting attached to the toot surfaces.

If plaque is not removed it turns into a hard substance called calculus or tartar, which can only be removed by the dentist, hygienist or a dental therapist.

Calculus harbours bacteria and acts as an irritant to help promote further destruction of bone and progression of periodontal pockets.

Root planning, or deep cleaning, removes plaque (live bacteria) and calculus from the pocket and allows the gum to heal back to the root surface. Root planning may eliminate the need for gum surgery, though surgical therapy may still be required due to the severity of the bone loss and gum disease.

What are the risk factors?

These include smoking and tobacco use. People who smoke are more likely to suffer from periodontal disease and to suffer from the more severe forms of it. Smokers also have been found to heal more slowly after treatment.

Other risk factors include diabetes, stress, and some medical conditions. The signs may not be visible to you (“silent gum and teeth killer”), but can be detected by a regular dental examination by the dentist, dental hygienist or a therapist.

What is the treatment?

Your dentist or hygienist will assess the condition of your gums and discuss this with you. Treatment varies depending on the severity of the periodontal disease. Usually it involves thorough removal of plaque and calculus above and below the gum.

The hygienist meticulously deep cleans your gums, removing all the bacteria that eats away at your bone. If you don’t do this, you will loose your teeth. This disease is called a ‘silent killer of teeth’. But don’t worry, this procedure is undertaken using local numbing agents, so you can relax and undergo the treatment free of pain. Your teeth will look much cleaner and stains will be removed.

What is the outcome of periodontal treatment ?

Your gums will appear healthier as there will be a reduction in bleeding, bad taste, bad breath, pockets, pus/swelling and discomfort.

Many times puffy, swollen gums will shrink in the absence of this infection process. As a result, roots may become exposed worsening temporary sensitivity. In rare cases, sensitivity persists. Because of bone loss, spaces between the teeth may appear once the swelling of the gums reduces. Patients typically become accustomed to this. Exposure of crowns (caps) metal margins from restorations may occur and cause an aesthetic concern.  Loose or damaged fillings and/or crowns may be loosened more, fall out or require replacement by your dentist.

However, as with any other treatment, a small number of patients do not respond successfully to non-surgical therapy despite our best efforts. The treatment may not be successful in saving teeth, function or appearance. Each patient’s condition is unique, long-term success may not occur.

What are the potential complications of periodontal treatment ?

Complications may result from non- surgical therapy, drugs or anaesthetics, and these include but are not limited to post-surgical infection, bleeding, swelling and pain, facial discolouration, transient but rarely permanent numbness of the jaw, lip, tongue, teeth, chin or gum, jaw joint injuries or associated muscle spasm, transient but rarely permanent increased tooth looseness, tooth sensitivity to hot, cold, sweet or acidic foods, shrinkage of the gum upon healing resulting in elongation of some teeth and greater spaces between some teeth, tooth mobility, infection, bleeding, cracking or bruising of the corners of the mouth for several days, impact on speech, allergic reactions and accidental swallowing of foreign matter.

The exact duration of any complications cannot be determined, may require further treatment and may be irreversible.

What alternatives are there to periodontal treatment ?

Alternates to non-surgical periodontal therapy with or without medications include:

1) no treatment (with the expectation of advancement of the condition which may result in premature loss of teeth) and

2) extraction of teeth involved with periodontal disease (with the understanding that extractions reduce function and aesthetics and may contribute to further bone loss and soft tissue loss in the extraction site or adjacent teeth).

Periodontal treatment – Follow up and aftercare

To successfully tackle periodontal disease, follow-up care and self-care are an absolute necessity.

The second part of non-surgical therapy is always oral hygiene instructions followed by a thorough evaluation of the results from non-surgical care. The dentist or hygienist will evaluate your pockets and gum condition. If inflammation or deep pockets persists, further treatment will be recommended. This could include further non-surgical care, periodontal surgery, antibiotics, or other adjunctive procedures.

Periodontal maintenance (cleaning) visits are vital to the success of any periodontal treatment plan – typically every three months. Failure to do so could result in failure or recurrence of your disease process and possible tooth loss.

Failed or failing fillings and/or crowns must be treated by your dentist. If tooth infection or break down is not treated, it could lead to pain, further infection and/or bone and tooth loss.

Enlightened Dentistry

Dentistry is a complex art requiring expertise and experience to fulfill our patients’ expectations. At PJS Dental, we aim to deliver an exceptional customer experience that focuses on making our patients feel good about every interaction they have with us. We improve lives by giving our patients confidence in everything that they do.

If you you need advice about periodonal treatment, get in touch to find out more.