gum disease What is Periodontal (gum) Disease?

  • Periodontal disease is a condition which effects the supporting structures of the teeth (gum and bone).

 

  • It happens when irreversible destruction has occurred to these structures (gum and bone), and if left untreated can eventually lead to tooth loss.

 

 

What causes Periodontal Disease?

  • The main cause of periodontal disease is dental plaque, hence the importance of the removal of plaque through brushing twice a day and by carrying out interdental cleaning of the teeth.

 

  • Dental plaque is the sticky invisible film which grows on our teeth every day, which if left, turns into calculus/tartar (hardened plaque). The plaque contains bacteria that release harmful toxins, which can cause irreversible damage of the supporting structures.

 

  • When the damage occurs a ‘pocket’ is formed, due to the loss of supporting structures around the tooth. As the gum disease continues, so does bone loss. When sufficient bone has been lost the tooth loosens and either falls out or is removed.

 

  • Other factors which can cause periodontal disease include smoking, diabetes, medications (blood pressure medications), pregnancy and plaque retentive factors such as crowns/bridges which no longer fit.

 

How is Periodontal Disease detected?

  • Your Dentist/Dental Hygienist will check the gum health by dividing your mouth into 6 areas, and gives each area a score between of 0-4.

 

SCORE What does this mean? Treatment required
0 No bleeding

No plaque or calculus/tartar

No pocket

No treatment needed
1 Bleeding

Plaque

No pocket

Oral hygiene advice
2 Bleeding

Plaque and calculus/tartar

No pocket

Oral hygiene advice

Referral to hygienist for scaling

3 Bleeding

Plaque and calculus/tartar

Plaque retentive factor

Pocket measured between 3.5-5.5mm

Oral hygiene advice

Referral to hygienist for periodontal treatment

4 Bleeding

Plaque and calculus/tartar

Plaque retentive factor

Pocket more than 5.5mm

Oral hygiene advice

Referral to hygienist for periodontal treatment

 

Periodontal Treatment required for patients with scores 3 and 4:

The aim of the treatment discussed below is to stabilise and prevent any further progression of the periodontal disease.

Any current damage of supporting structures of teeth cannot be regrown.

Plaque is the main cause of periodontal disease, hence the importance of its removal through excellent brushing technique and interdental cleaning technique of the patient.

Please see below the treatment plan:

 

Session 1(£55- 30 min appointment):

Removal of plaque and calculus

Intense oral hygiene advice – brushing technique and interdental cleaning tips

Session 2 (£55- 30 min appointment):

Full mouth recording of pockets – this will act as a baseline for ongoing treatment and allows the hygienist to compare results at the end of treatment

Any further oral hygiene advice required

Session 3 (£110- 1 hour appointment):

For patients with scores of 3 – Whole mouth deeper cleaning underneath the gums using ultrasonic scaler and hand instruments

For patients with scores of 4 – 1st half mouth deeper cleaning with local anaesthetic underneath the gums using ultrasonic scaler and hand instruments

Session 4 (£110-1 hour appointment):

For patients with scores of 4 – 2nd half mouth deeper cleaning with local anaesthetic underneath gums using ultrasonic scaler and hand instruments

Session 5 (£55-30 min appointment):

3 months after deeper cleaning carried out

Full mouth reassessment of pockets

If treatment has been successful, the patient will be placed onto the maintenance phase – hygienist appointments every 3 months and full mouth pocket recordings once per year

If little or no response to treatment, referral to a specialist will be discussed

Possible treatment side effects:

  • Gum recession
  • Sensitivity
  • Infection