Periodontal Disease

Gingivitis 

Almost 90% of the population will experience gingivitis at some stage of their life.  It is caused by an accumulation of plaque, which is mainly made up of bacteria.  If  left undisturbed for longer than a day (you know that furry feeling in your mouth!) the bacteria releases toxins which attack the gum (gingiva).  Our body's immune system reacts to these toxins and this results in the gums becoming inflamed (red and swollen), bleeding easily and the gums may become painful.

Gingivitis can easily be reversed, by a thorough scale and clean by the dental hygienist and thorough brushing and flossing at home. 

Periodontal disease 

Should gingivitis be allowed to progress, the fibres that attach the tooth to the jaw and the underlying supporting bone are affected.  This is called periodontal disease and unlike gingivitis it is not reversible.

As the plaque and bacteria slides further underneath the gum it hardens and calcifies to form calculus or tartar. Calculus adheres very strongly to the tooth root surface and harbours anaerobic bacteria (bacteria that don’t like oxygen) which produce toxins when left for extended periods of time. These toxins destroy the gingiva, periodontal ligaments and supporting bone. If left untreated, it can continue damaging the periodontal structures, resulting in the tooth having less and less bony support.   Eventually this may lead to a gum abscess and tooth loss.

How do we treat periodontal disease?

After the periodontal disease is first detected at the initial dental examination we need to perform a thorough gum examination. This establishes the extent of the disease and allows us to formulate a plan as to how we can work together to stabilise the disease and prevent it from progressing.

A series of gum depth measurements (pockets) are recorded, along with tooth mobility, gum shrinkage (recession), forking of the tooth roots (furcation involvement) and the extent of the inflammation (periodontitis).  We may request that X-Rays be taken to help map the bone levels in your mouth.

After this gum examination, a plan will be formulated, and a series of appointments scheduled. At these appointments the dentist / dental hygienist will root plane (very thorough below gum scaling) removing the calculus, plaque, bacteria and toxins.  This will allow the gums an opportunity to heal.

We may need between one to four appointments depending on how much time and effort is needed to thoroughly clean your teeth.  This treatment is sometimes performed with a local anaesthetic.

For the prevention and stabilization of periodontal disease we rely greatly on your home care.  Effective tooth brushing and flossing is very important for a successful outcome.  The hygienist will introduce techniques of home care that best suit each individual.

How do I prevent periodontal disease from returning?

Once diagnosed with periodontal disease you are always predisposed for the disease to return, even after we are able to stabilise the gums. It is important that in order to prevent the return of the disease meticulous, regular cleaning at home is undertaken. After the initial rootplaning sessions, we suggest a waiting period of no longer than three months before your next recall appointment.  At this appointment we will reassess the condition of the gums, thoroughly clean the teeth and provide any further support.  A suitable recall appointment will be decided, depending on each individual case.

For maintenance and prevention of gum disease we recommend the following:

• Using good quality toothpastes containing fluoride
• Soft bristled toothbrushes with a small sized head to assist in accessing the back teeth.
• Dental floss or tape to remove the plaque which forms between the teeth that the toothbrush is unable to access.
• Antibacterial Mouthwashes to reduce the amount of bacteria in your mouth, this helps to reduce the likelihood of disease re-activation. We recommend having several different mouth rinses and cycling through them one bottle at a time.  This helps to avoid bacteria becoming resistant to the rinse.
• Interdens or Piksters for cleaning the spaces between the teeth in areas where dental floss or tape is not effective.
• A Tongue Cleaner to remove the plaque that accumulates on the top of the tongue, this may help to prevent bad breath and tongue irritations.
• Regular three / four / six monthly preventative hygiene appointments – tailored to your specific needs.
• Cessation of smoking.

Specialist Periodontal referrals.

In certain circumstances the progression of periodontal disease may be aggressive and difficult to control.  In these circumstances we may advise you to consult a specialist periodontist to assess and treat your gums.