Periodontics

Periodontitis – Gum Disease

Periodontitis or gingivitis is an infection of the tissues in your mouth: the gums and bone that support the teeth. If untreated, periodontitis causes progressive bone loss around teeth, loosening your teeth and in extreme cases your teeth may even fall out.

Periodontitis is a very common disease affecting approximately 90 per cent of adults over the age of 50. Severe forms of the disease though affect less than 10 per cent of the adult population.

What causes periodontitis?

The major cause of periodontits or gingivitis is the accumulation of bacteria at the gum line in the form of a sticky, yellowish film, which is called dental plaque. If left undisturbed, bacterial plaque calcifies to form dental calculus or tartar.

Periodontits can be caused by a number of factors:

• Particularly potent or virulent bacteria
• Smoking increases the rate of bone loss, compromises the healing and thus the response to the treatment
• Stress does not help as it compromises the immune or defence system
• Systemic diseases such as diabetes, Leukemias or HIV
• Family history is also a factor – some people are more susceptible than others

Symptoms

• Occasional redness or bleeding of gums while brushing teeth, using dental floss or biting into hard food (e.g. apples)
• Occasional gum swellings
• Pus coming from the gums and between the teeth
• Bad breath or persistent bad taste in the mouth
• Recession of gums resulting in longer teeth
• Pockets between the teeth and the gums - sites where the jawbone has been destroyed gradually or by repeated swellings
• Loose, shaky, drifting teeth
• Exfoliation of teeth in later stages

Gingival inflammation and bone loss are largely painless. So, painless bleeding after tooth-brushing could be a symptom of periodontitis that is progressing.

Treatment of established disease

It is possible to treat even well established cases of periodontitis as follows:

1. Good oral hygiene

Tooth-brushing twice a day and interdental cleaning using floss or interdental brushes once a day should be part of your normal dental hygiene routine.

2. Professional cleaning and scaling

At the London Day Surgery we offer use professional cleaning hand scalers and curettes to remove bacterial plaque and calculus or tartar from the tooth surfaces.

There are also devices called cavitrons that use a powerful ultra-sonic vibration and irrigation system to disrupt the bacterial plaque and calculus deposits around the teeth and below the gum-line. Local anaesthetic is commonly used to prevent discomfort during this process.

More than one course of deep scaling may be needed in order to combat gum disease. In the case of residual inflammation gingival-periodontal surgery could be the next step in the treatment cycle.

3. Gingival surgery

This type of oral surgery is performed to access the root surfaces close to the bone level and improve visibility to remove any deposits and inflammatory tissue. Moreover, surgery can be used for bone augmentation. This is achieved by using bone grafts, either animal or synthetic derivatives.

4. Maintenance

Once the gums become healthy again, frequent maintenance visits will be necessary to ensure that the disease doesn't establish itself again.

Dr Robin Ratcliffe BDS treats patients on Wednesdays and Fridays. To find out more about Dr Ratcliffe please see our Team page.