Periodontal Treatment for gum disease

Periodontal Treatment- Specialised treatments are available for the treatment of mild to advanced gum disease.

Preventing dental disease is a fundamental part of our work here at Mulamoottil Dental Clinic. Our aim is to help you achieve and maintain optimal dental health through regular hygienist visits. We have a Preventative Dental Team consisting of two Dentists and a visiting Periodontist (expert in treatment of more complex gum problems).

Understanding gum disease

There are three main types of gum disease:

1. Gingivitis

   The main cause of gum disease is poor oral hygiene. When brushing and flossing techniques are not carried out effectively, this allows plaque to build up along the gum line. Plaque contains harmful bacteria resulting in the infection and inflammation of your gingivae or "gums". This condition is known as gingivitis and nearly all adults suffer from this to some degree. Bleeding on brushing or flossing your teeth is one of the earliest signs of gingivitis.

   Plaque left for any length of time will start to harden and form calculus or "tartar" on your teeth. This cannot be removed by tooth brushing alone, requiring specialist scaling by your hygienist or dentist. At this early stage gum disease is reversible. Regular visits to the hygienist will help you return to and maintain gingival health.

2. Periodontal Disease

   Left untreated, gum disease may progress to a more severe condition known as periodontitis.This is the primary cause of tooth loss in adults. Here the bacterial infection progresses to the deeper supporting tissues of the teeth known as the periodontal tissues which includes the bone. As the disease progresses, the bone supporting the teeth is lost. The teeth become loosened, abscesses can form and teeth may eventually be lost

3. Smoking and Oral Health

   Patients who smoke are far more likely to suffer with more severe gum problems. Smoking causes a lack of oxygen in the bloodstream. This has an adverse effect on the healing process, so infections in the gums are slow to heal. Our Hygienist will be happy to discuss the various methods now available to help patients give up smoking.

   Thoroughly clean your teeth removing plaque, tartar and stains, creating an environment for your gums to return to optimal health. Teach oral hygiene techniques, individually tailored to your particular needs, helping you maintain this environment and prevent gum disease and tooth decay.

   Educate children as to the importance of good brushing and diet, giving them the very best chance of staying decay free. Give dietary advice to prevent tooth decay.

The results:

Clean teeth and fresher breath
You maintain your optimal dental health status. With care and cooperation on your part this is very achievable.

What does the Periodontist do?

A Periodontist is an expert in all aspects of gum disease. The Dentist or Hygienist will refer you to see our periodontist if they have detected any signs of progressive gum disease.

The Periodontist will:

• Give you a thorough examination, taking all necessary x-rays and measurements.
• Draw up a treatment plan specifically for your requirements with the aim of improving your condition and maintaining your teeth in as healthy a state as possible for as long as possible.
• Where necessary, carry out further cleaning of the roots of the teeth to ensure the last pockets of bacteria are removed. This is all done in the surgery using a normal local anaesthetic to ensure you are as comfortable as possible
• If necessary, remove any diseased tissue and place specialist treatments and medications into the pockets surrounding the teeth to aid the healing. Again all this can be done in the surgery using a normal local anaesthetic
• Monitor and review your progress and draw up a maintenance programme with the hygienists

Rooy Planning & Scaling - Halitosis, Bleeding & Swollen Gums

There are three broad classes of periodontal (gum) therapy for treatment of gum disease:

1. Dental cleaning (prophylaxis or prophy)
2. Root planing & scaling (RP&S)
3. Periodontal (gum) surgery

A dental cleaning is what one typically receives at a six-month check-up. It is appropriate for those who maintain excellent home oral hygiene and have minimal gum pocket depths around their teeth. Patients should be aware that calling to schedule a 'check-up' doesn't necessarily mean that one desires a cleaning. A check-up could mean just x-rays and exam.

Root planing & scaling (RP&S) is usually recommended when one needs more work than a typical cleaning. This may be due to lack of adequate home oral hygiene, high sugar diet, deeper gum pocket depths around teeth or more extensive dental work that might inhibit access for a regular cleaning. Root planing & scaling is usually divided into two to four office visits. Novocain is frequently used since this cleaning will attempt to get to the full depth of the deeper gum pockets. This procedure usually involves minimal pain and one should expect to resume social and professional activities later that same night and certainly the next day. Most people feel a tremendous difference in how much cleaner their mouth feels and how much fresher is their breath. The benefit can be quite profound and immediate.

Three to six months after completing the RP&S the periodontist would perform a reevaluation examination and would usually recommend one of the following:

• Go back to regular cleanings but at a frequency of every three, not every six months
• Repeat the root planing & scaling
• Periodontal surgery is indicated for either the whole mouth or just refractory sections.

Gingivectomy is a relatively minor type of periodontal surgery that involves the removal of a small amount of gum tissue around a tooth or several teeth. A gingivectomy might be necessary to remove diseased tissue, allow a filling or crown to be placed below the gum line or to improve esthetics. The procedure, which is performed by a Periodontist in our office, is usually fairly quick and typically involves only a little postoperative pain.

Periodontal surgery is similar to that performed during root planing & scaling except that the periodontist actually cuts the gum and moves it out of the way during the procedure. This allows him or her direct vision to really see the problem and direct mechanical access to attempt to clean and repair the diseased tissue.

Osseous Surgery is a type of periodontal (gum) surgery that involves the removal and/or reshaping of the jawbone under the gum. The phrase 'gum disease' is not a technically accurate description because most of the damage occurs not in the gum but in the underlying bone; osseous means bone. Our Periodontist performs this procedure.

A simple analogy with carpeting may be used to describe the process of osseous surgery; the overlying gum is the carpet and the underlying soft matting is the bone. Bone is frequently irregularly destroyed by the infection associated with gum disease. This irregular bone will, like a bump in the soft matting under a carpet, prevent the gum, or carpet, from laying down flat. Reshaping the bone with osseous surgery by our Periodontist will allow the gum to lay down flat in the areas between the teeth.