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Periodontal treatment at Angle House Specialist Dentistry

Did you know that the enamel on our teeth is one of the hardest parts of our entire body? But to keep our teeth in position our gums need to be strong and healthy to anchor them in place.

At Angle House Specialist Dentistry, we know just how important it is to not only keep your teeth healthy but the surrounding tissues and gums healthy too. If you don’t, this could lead to periodontal disease and the need for specialist periodontal treatment.

What is periodontal disease?

Periodontal disease (gum disease) occurs when the bone and muscle supporting your teeth gets infected with bacteria and starts to deteriorate. If this happens it can lead to the teeth becoming loose and increases your chances of losing that tooth (or teeth) completely.

The bacteria that causes periodontal disease comes from plaque buildup on your teeth, which is why it’s important to maintain a regular oral hygiene routine, as instructed by your family dentist and your specialist orthodontist.

If you notice that your gums are bleeding when you brush your teeth or that they’re sore and swollen, this could be a sign of periodontal disease developing.

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How does periodontal treatment work?

At Angle House our specialist periodontist offers the following treatment for periodontal disease:

  • Non-surgical periodontal therapy: Early onset periodontal disease can be treated with non-surgical therapy. Our specialist periodontist will provide oral hygiene instructions and deep cleaning above and below the gums with local anaesthetic. This aims to reduce bacteria levels below the gums and reduce the extent in which the disease can progress.
  • Surgical periodontal therapy: If periodontal disease is diagnosed and requires surgery, our specialist periodontist can provide pocket reduction and regenerative surgery. These procedures are indicated for sites with residual disease following non-surgical therapy. They aim to reduce deep gum pockets and, where indicated, regenerate lost tissue support.

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  • Periodontal plastic surgery: If the gum has receded in areas where periodontal disease has affected the health of the teeth and gums, periodontal plastic surgery procedures aim to provide root coverage in those specific areas.
  • Crown lengthening procedures: When teeth break or decay spreads below the gum line, crown lengthening procedures aim to increase the height of the remaining tooth structure, allowing teeth to be restored.

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Gum disease FAQs

It’s normal to have questions about your dental care, especially when it comes to Periodontal treatment. Here are some of the most common ones we get from our patients here at Angle House Specialist Dentistry.

Periodontal (gum) disease involves inflammation of the supporting tissues of the teeth. In the early stages it is a reversible condition known as Gingivitis and affects the gum support around the teeth. If gingivitis is not treated, it can progress to a condition called Periodontitis, which irreversibly affects the gum and bone support of the teeth and can ultimately lead to tooth loss if left untreated.

Symptoms of periodontal disease can include swollen, red, and bleeding gums; gum recession and tooth sensitivity; loose teeth; and sometimes toothache, although periodontal disease is often non-painful unless it has progressed to a more advanced stage.

The main risk factor for periodontal disease is bacteria, which is present in plaque and calculus deposits around the teeth. Other risk factors include smoking, a family history of periodontal disease, and sub-optimally controlled diabetes.

Healthy gums should not bleed when you brush them. The most likely reason for gums to bleed is due to bacterial deposits (plaque and calculus) irritating the gums. In the early stages, this condition is called Gingivitis (inflammation of the gums) and is reversible. You may also notice that your gums appear a little redder and possibly swollen. If your oral hygiene technique is improved and these deposits are removed, the bleeding should subside.

Patients often think that if their gums bleed they are brushing too hard and so they avoid brushing these regions... in fact the opposite is true! If your gums are bleeding, you need to brush along the gum-line even more thoroughly (and ignore the bleeding) for it to improve!

If you have improved your brushing technique over a two-week period and have noticed no improvement, it is advisable for you to see your dentist in case of more advanced and irreversible periodontal (gum) problems (Periodontitis), which if left untreated may eventually lead to tooth loss.

Taking care to effectively brush and clean between your teeth twice a day to remove the daily build-up of plaque deposits around the teeth and gum-line is likely to make the biggest difference in the prevention and treatment of periodontal disease, since bacteria within these deposits is the main causative factor.

Seeing your dentist and hygienist regularly for check-ups should ensure that development of any periodontal disease is detected and managed at an early stage. It is often useful to work with your hygienist to ensure that your brushing technique is as effective as possible. Often a small change in brushing technique can make a really big difference!

Smoking is also a big risk factor and often masks the signs of gum disease, therefore quitting is generally strongly advised, but especially when managing and preventing the progression of gum disease.

If you have diabetes, it is important to work with your doctor to optimise your diabetic control as sub-optimal control of diabetes can affect the severity of periodontal disease.

If you have early stage (reversible) periodontal disease (gingivitis), you do not need any surgical intervention. This can generally be managed with a change in your toothbrushing technique and simple superficial scaling around the teeth. Following this, provided that you are able to keep the plaque deposits to a minimum with effective toothbrushing, it is unlikely to progress further and should resolve.

For more advanced periodontal disease (periodontitis), there are various treatment options depending on the extent and severity of the disease. Treatment will always commence with non-surgical periodontal treatment. This involves reinforcement of oral hygiene and toothbrushing advice, as well as deep scaling (debridement) of the teeth, which often requires administration of local anaesthetic to ensure adequate and effective debridement is carried out to remove as much of the bacterial deposits as possible and therefore maximize the success of the treatment. More than one course of non-surgical periodontal treatment may be required and the success of the treatment relies heavily on your ability to minimize the plaque build-up around the teeth through effective oral hygiene techniques.

Following non-surgical periodontal treatment, provided the oral hygiene regime is optimised, some patients may then benefit from periodontal surgery to help stabilise the disease further. The suitability for surgery will depend on the severity and pattern of bone loss around the teeth and is assessed on an individual patient basis. Surgical intervention can involve resective (pocket reduction) surgery or regenerative surgery.

Resective periodontal surgery involves removal of excess gum tissue to reduce the deep pockets that have developed around the teeth. Regenerative periodontal surgery involves attempting to regenerate the bone support around the teeth and usually involves the use of bone substitute materials.

Maintenance therapy is provided for patients who have undergone treatment for their periodontal disease but continue to have some periodontally affected teeth which are not amenable to further surgical intervention. Maintenance therapy involves seeing a Periodontist or Hygienist for regular maintenance visits, usually on a 3 – 4 monthly basis. They will reassess and reinforce oral hygiene advice and carry out debridement (scaling) around the teeth to prevent any deterioration and ensure the periodontal condition of the teeth remains as stable and possible long term.

There are multiple factors that can cause gums to recede and the teeth to appear “long”. For example, over-zealous toothbrushing coupled with thin quality gum tissue can lead to gum recession, and this can often be managed with gum grafting procedures which restore the gum architecture around the teeth.

However, in cases where gums have receded due to loss of bone support as a result of irreversible periodontal disease (periodontitis), unfortunately it is not possible to reverse the gum recession. Occasionally, in this situation where gum recession has resulted in larger gaps between the front teeth, it may be possible to consider the use of tooth coloured fillings to reduce the spacing and improve the appearance.

Teeth can only be restored if there is adequate tooth structure above the gum-line to support and retain the restoration that is placed. In situations where there is lack of adequate remaining tooth tissue, it is sometimes possible to consider a surgical “crown lengthening” procedure to increase the height of the tooth above the gum-line to facilitate the predictable restoration of a tooth.

Book your specialist consultation

If you are suffering from some of the symptoms associated with periodontal disease, book a consultation with our specialist periodontist. Our periodontal treatment is currently available at Whetstone and Ealing.

Book a consultation

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