Gum Disease
What is gum disease?
Gum disease occurs when your gums react to the presence of plaque in the mouth. There are 2 different stages of gum disease, an early stage called gingivitis and a later stage called periodontitis.
Gingivitis is a very mild form of gum disease. The gums can appear red, swollen and may bleed when brushed. Gingivitis is very common however the good news is that it can be effectively treated by a team effort involving a combination of treatments provided by our hygienist at the surgery and taking measures to improve plaque control at home.
Periodontitis is the more serious form of gum disease and although it is very similar to gingivitis, the damage it causes to bone and gums is irreversible and can ultimately lead to tooth loss. Once Periodontitis starts to occur the gums recede and ‘pockets’ (spaces between the gum and teeth) form and can allow infection. As the damage is irreversible periodontitis cannot be ‘cured’ in the way that gingivitis can be cured. The aim of treatment is to stabilise the condition and ideally stop the progress of the disease. Improved cleaning alone is not enough to prevent the progress of periodontitis – it is important to see your Dentist and Hygienist prevent tooth loss.
Who is at risk? (Risk Factors)
The factors that create an increased risk of harmful effects from plaque are:-
- Smoking – Smoking is the most significant risk factor associated with gum disease.
- Hormonal changes in girls/women can make gums more reactive and make it easier for gingivitis to develop.
- Diabetes – People with diabetes are at higher risk of developing gum disease.
- Certain illnesses like cancer and their treatments can affect the gums.
- Medications – There are many medications that reduce the flow of saliva. Normally saliva can have a protective effect on the mouth so less saliva can allow problems to occur with gums and teeth. Also, certain medications can cause an overgrowth of the gums causing pocketing to occur and making plaque control more difficult.
- Genetic susceptibility – Some people are more prone to severe gum disease than others.
Stage 1
Baseline scoring of the condition
Your hygienist or dentist will check the condition of the gums and produce a numerical score. These scores will relate to the amount of plaque and bleeding displayed within your mouth and also show the levels of destruction of your gums, including the bone and ligaments. A higher score indicates more severe gum disease. If you receive high scores, the hygienist will plan an effective course of treatment for you to control your gum disease…
Stage 2
Initial Hygienist treatment and Homecare
At this appointment your hygienist will provide an initial general scale and polish procedure, removing any visible plaque and tartar present on the teeth above the gum line. Most importantly the hygienist will also outline a series of effective plaque control techniques which should be used at home in order to maintain a healthy mouth.
The techniques we advise will vary between each patient according to the nature of the gum disease and the current level of oral hygiene. The effective application of these home techniques is critical to the overall success of the hygienists’ treatment.
The aim of this phase is to ensure that around 90% of the mouth is plaque free. Progression to the next phase of treatment depends upon how effective the homecare treatment is, and how well the surrounding gums respond to your homecare routine.
Stage 3
Deep cleaning
With the use of specialist instruments, your hygienist will deeply clean the areas of pockets, often under local anaesthetic, in order to remove any deposits from the pockets that surround the teeth below the gum line. This treatment is required to remove infection-causing bacteria and irritants beneath the gum line which can cause gum disease…
The deep cleaning will be carried out in the areas where pockets have formed – this may be much localized affecting just a few teeth or very widespread affecting the whole mouth… Antibacterial agents may be placed into the pockets to reduce the bacterial count in the pocket.
Stage 4
Reassessment and maintenance
After 3 months a reassessment will be carried out to check how well the gums have responded to treatment. If the gum condition has sufficiently improved we would advise maintenance appointments with the hygienist every 3-4 months until we are sure the improvement is stabilized at which point the interval between the maintenance appointments will be increased.
If the gum condition has not improved as expected we will discuss the likely reasons and advise upon repeating stage 2 and stage 3.
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