We’re Here to Help Prevent and Treat Gum Disease
The first stage of treatment is almost always what is referred to as a non-surgical treatment. This involves three stages:
1. Oral hygiene instruction – it may sound simple, but cleaning your teeth and gums effectively is not an easy task to achieve. We need to teach you how to be able to carry out effective homecare in order to treat the disease and make sure that it remains stable once treated. Whatever treatment we carry out will not be effective unless you are able to achieve a high standard of oral hygiene, because you are battling against the cause of the disease, i.e. Plaque, every day.
2. Mechanical cleaning – this involves removal of all the plaque, bacteria, toxins, inflamed tissue and hard calculus deposits above and below the gumline, along with smoothing any restorations, such as fillings, which may be acting as plaque traps. The root surfaces are cleaned and smoothed with special instruments, and also in some case with a laser. The procedure is carried out using a local anaesthetic so that it is completely painless. The main side effects to expect once the anaesthetic wears off include some pain or soreness, which is easily relieved with over-the-counter painkillers and mouthwash, sensitivity to hot and cold, and some recession. All except the latter are transient and soon settle down.
3. Reassessment – this is carried out two months after the completion of active treatment. At this stage, the pockets are re-measured. The hope is that the gum “sticks” back to the tooth, thereby eliminating the pocket, and therefore the area around the tooth that can harbour infection. It may be that some pockets remain following initial therapy, and reassessment will help determine why this is the case and decisions can then be made about what can be done about it. This may involve further oral hygiene instruction, further scaling, use of antibiotics, or surgical management.
For mild and moderate periodontal disease, non-surgical treatment is often all that is required. However, for some cases of moderate and advanced periodontitis, surgical treatment may also be required following initial therapy. These procedures are also carried out using a local anaesthetic and allow us to move the gum out of the way so that we can visibly see and access the deposits that need to be removed.
Frequently, we also reshape the gum and bone, in order to achieve an end-point that allows you to be able to clean as best as possible, and therefore help to keep the area stable once treated.
Again, we use lasers for a lot of this process, making the side effects such as pain and bruising far less likely.
Other surgical procedures include bone regeneration, gum grafting to treat recession, preparation of soft and hard tissues for placement of dental implants, removing roots from teeth that have several roots in order to prolong the life of the tooth, lengthening the crown of teeth in order to facilitate placement of crowns or improve appearance, and placement of dental implants.
COMPLETION OF TREATMENT
Once active treatment is completed i.e. all pockets eliminated, and the disease stabilised, we usually enrol you into a maintenance program. This is to ensure that the disease remains stable so that you won’t need to go through such an intensive course of treatment again.
Once an individual is shown to be susceptible to the destructive effects of plaque, then that person is always susceptible in the future, and areas may be prone to sudden bursts of further destruction which are unpredictable in nature.
Maintenance visits, therefore, allow us to detect any new disease, or relapse, early enough to manage it simply i.e. nip it in the bud. Further scaling and reinforcement of oral hygiene are also carried out during these visits.
Initially, maintenance often starts off on a 3-4 monthly basis. However, they are prescriptive to you. Therefore the aim is to gradually increase the time between them, but with the knowledge that they can be carried out more intensively if for some reason you were undergoing a period of rapid destruction.
Eventually, maintenance can be carried out by your own dentist or hygienist with guidance from the periodontist.
Treating gum disease in this way is less costly and better for your health than replacing lost teeth. A very high standard of plaque control, along with regular check-ups with both your dentist and periodontist will significantly improve the chances of retaining your teeth for life.