Periodontics

Gum disease – periodontal disease

Gum disease is one of the leading causes of tooth loss. Gum disease occurs when the bacteria in plaque causes inflammation in the gums. Plaque is a sticky, colourless film that is formed on teeth by the bacteria in the mouth, mucus and food particles.

Gingivitis

The mildest form of the disease is called gingivitis. In gingivitis, the gums become red, swell and bleed easily. There is usually no, or little discomfort. Gingivitis is usually caused by inadequate dental care and easily reversed with professional care and good oral care at home. If left untreated it can lead to periodontitis.

Periodontitis

With poor oral care, plaque can spread and grow below the gum line. The bacteria in the plaque release toxins that irritate the gums. These toxins cause an inflammation which if left untreated causes an auto-immune response in the body, This means that the body turns on itself and starts to break down the tissues and bone that support the teeth. The gums are separated from the teeth and these spaces or pockets become infected. Without treatment the pockets become bigger and more gum tissue and bone is destroyed. There is usually little discomfort. 

The symptoms are:

  • Swollen gums
  • Bright red of purplish gums
  • Gums that are tender to touch
  • Gums that recede, that means when it pulls away from the teeth and teeth appear longer.
  • New spaces that appear between teeth.
  • Puss between teeth and gums.
  • Bad breath
  • Bad taste in the mouth

These symptoms are very mild and can go unnoticed. If left untreated the teeth can loosen and have to be removed.

Risk factors include:

  • Smoking. Smoking is one of the leading causes of gum disease. Smoking also lowers the chances of successful treatment.
  • Hormonal changes in girls/woman. These changes can make gums more sensitive and increases the risk of development of gingivitis
  • Diabetes. People with diabetes has a higher risk of developing infections and heals more slowly.
  • Treatments for disease like cancer can negatively affect the health of gums.
  • Medication. Hundreds of prescription and over the counter medications can reduce the flow of saliva. Saliva protects the mouth and a decrease in saliva leaves the mouth vulnerable to infections like gum disease. Some medication can even cause an abnormal overgrowth of gum tissue and make it difficult to keep the teeth and gums clean.
  • Genetics. Some people are genetically more prone to gum disease than other


Professional treatment is the only option at this stage of the disease. If too much bone is lost the teeth will need to be extracted. Your dentist/dental hygienist will measure the depth of these pockets. A scaling and root-planing treatment will have to be performed as the pockets are too deep for an at-home cleaning.

A local anaesthetic will be administered to the area. The dentist will deep scale and clean below the gum line to remove stubborn, crusty deposits called tartar or calculus, and dead tissue around the pocket near the tooth. This is done to prevent further damage and stabilize the tooth.

The pocket will then be irrigated with anti-bacterial. If the pocket is deeper a PerioChip will be inserted. This is a small orange-brown rectangular chip that contains 2.5 mg chlorhexidrine gluconate that kills the bacteria. This chip dissolves naturally so there is no need to remove it. A follow-up visit is recommended after 3 months to see if any further treatment is necessary.

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