Periodontal Disease

Q. What is periodontal disease?

Periodontal disease is more commonly known as gum disease. It is caused by plaque, a thick and sticky film of bacteria that builds up on the teeth.

Plaque can harden to become calculus, also known as tartar. If your teeth have not been cleaned thoroughly by brushing or flossing (or often enough) the plaque and calculus accumulates and the bacteria infects not only your gums and teeth, but eventually the gum tissue and bone that support the teeth. This can cause them to become loose, fall out or have to be removed by a dentist.

periodontal-disease

Early stages of gum disease

Gingivitis is the earliest stage of gum disease and usually manifests as bleeding gums, which if treated early enough, can be reversible. It needs regular removal of the plaque and calculus by your dentist every six months or so, followed by thorough brushing and interdental cleaning aids like flossing every day at home.

Advanced stage of gum disease

Periodontitis is a more advanced stage of gum disease which can be irreversible and occurs when gingivitis is left untreated. At this stage, the supporting bone that holds your teeth in place is damaged. Your gums may begin to form a pocket below the gum line, which traps food and plaque.

Advanced periodontitis is the final stage of gum disease. At this stage, the gum inflammation and infection gets worse, gum pockets are formed, gums may recede from the teeth and the bone fibres are destroyed. As a result, the teeth can become loose, fall out due to painful gum abscesses or require extraction by a dentist. Periodontitis can result in the loss of many teeth in some people.

Q.How will I know if I have gum disease?

These are some of the symptoms to look out for-

  • Red, swollen, tender or painful gums
  • Gums that bleed during brushing or flossing
  • Gums that have shrunk away or receded from the teeth
  • Persistent bad breath or a bad taste in your mouth
  • Abscesses or pus between your teeth and gums
  • Changes in the way your teeth fit together when you bite
  • The fit of a denture has changed
  • Loose teeth; drifting apart of teeth, and gaps appearing between teeth

Even if you don’t notice any symptoms, you may still have some degree of gum disease. Gum disease may progress painlessly, producing few obvious signs, even in the late stages of the disease. Although some of the symptoms of gum disease are often subtle, the condition is not entirely without warning signs. Only a dentist can recognize and determine the progression of gum disease.

Q. How does the dentist diagnose gum disease?

Your dentist will check your oral health to find contributing factors to gum disease. Any change in size, shape, appearance and texture of the gums says a lot. A periodontal probe may be used to identify areas where gums bleed easily or have recessed, or where pockets have developed. An x-ray examination may also be needed to check whether the bony socket around each tooth is healthy.

Q. How Is Gum Disease Treated?

The aim of gum disease treatment is to promote the reattachment of healthy gums to teeth; reduce swelling, the depth of pockets, and the risk of infection; and to control disease progression. Treatment options depend on the stage of disease, how you may have responded to earlier treatments, and your overall health.

After examining your gums and teeth, your dentist may recommend periodontal treatment. Treatment may involve the following-

  • Removal of the plaque and calculus build up from above the gum line and in the shallow pockets below the gum line with a professional clean by your dentist. Scaling usually requires only one visit to the dentist
  • Root planing: deposits of plaque and calculus on tooth roots and in deeper pockets beneath the gum line are removed using instruments which helps to smooth irregularities on the roots of the teeth making it more difficult for plaque to deposit there. A local anaesthetic may be needed to numb the teeth and gums being treated
  • Replacement of fillings: if a filling is contributing to gum disease, it may need to be reshaped or replaced.
  • Instructions on how to improve your oral hygiene, including removal of plaque with a more effective technique of brushing and cleaning between the teeth.
  • Quit smoking: smoking increases the risk of gum disease and reduces the chances of successful treatment.
  • In severe cases, periodontal surgery may be required

Your dentist will evaluate the results once treatment is complete. Other factors like smoking or systemic diseases like Diabetes may interfere with healing. If your gums have responded well and oral hygiene is good, a program to maintain your oral health will be developed. Scaling and root planing may have to be repeated during the maintenance phase.

As gum disease tends to recur, maintenance therapy will follow periodontal treatment and is most important. The aim is for you and your dentist to work together to prevent, monitor and control your gum disease.

If you do not have treatment, the risk is that gum disease may get worse, leading to tooth loss.

Q. What are some of the side effects of periodontal treatment?

  • Sensitivity during scaling and root planing. (A local anaesthetic may be needed to help numb the area being cleaned)
  • Gum tenderness. (A soft toothbrush or a mouthwash containing chlorhexidine may be used if regular brushing causes discomfort)
  • Tooth sensitivity; within a few weeks of treatment, any tooth sensitivity usually diminishes. (Special toothpastes can reduce sensitivity, or your dentist or periodontist can apply a desensitising varnish)
  • Gum shrinkage. This is more likely to occur if gum tissues are swollen at the start of treatment.
  • Increased risk of decay around exposed root surfaces. Your dentist may recommend a daily fluoride toothpaste or mouth rinse to help decrease the risk of decay.

Q.How can I prevent gum disease?

By taking good care of your teeth every day through brushing and flossing, as well as having regular dental check-ups at least twice a year, early stage gum disease can be reversed in nearly all cases if diagnosed early enough. Effective tooth brushing will remove most of the plaque that builds up on the teeth, although brushing does not remove all the plaque from between teeth. Dental floss, tooth picks or special ‘’interdental brushes’’ should be used to reach surfaces of teeth touched by neighbouring teeth.

Remember when you JUST brush your teeth you can only clean 60% of your tooth and the rest is cleaned only when you brush and floss in between your teeth.

Note: The aim of this general information is to educate the reader about Periodontal Disease and may not essentially contain all aspects of the treatment. It would be beneficial to see us for a consultation to discuss the procedure and all of the associated complications.

Give us a call on (03) 5821 2388 to book an appointment and our dentist will be more than happy to answer all of your concerns.