The roots of your teeth are, in good health, completely embedded in the jaw bones. The gum (or gingiva) overlies the bone and wraps around the root forming a collar around the neck of the teeth.
What is gum disease?
Gum disease is an infection that affects the gums and the underlying bone which supports the teeth. Bacteria are the cause of this infection. Bacteria are always present in the mouth and with time they form a soft mass called 'plaque'. Plaque is usually removed with tooth cleaning (brushing and cleaning between the teeth). However, if some plaque remains an inflammation of the gums may result.
This inflammation if not treated can lead to Periodontal disease. In Periodontal disease, the inflammation of the gums causes the loss of bone around the roots of teeth. A pocket is created as the gum detaches itself away from the root surface.
Are there other factors contributing to Periodontal (gum) disease?
Periodontal disease is primarily caused by plaque. It can however be more common and more severe in:
- Patients who smoke
- Patients with other medical conditions such as Diabetes.
There is an association between Periodontal disease and other systemic diseases (for example cardio-vascular diseases). This association may be bi-directional, this means that some systemic diseases may influence Periodontal disease and that Periodontal disease may influence other diseases. Treatment of Periodontal disease could be beneficial in this respect.
How is Periodontal (gum) disease diagnosed?
The patient and / or dentist can sometimes see that the gums are red, swollen and bleed easily. Often however the patient may only notice minor discomfort and the disease may remain 'silent' for many years. Often patients will only realize something is wrong when they notice that their teeth are becoming loose. At this stage often a lot of bone support has been lost around teeth and successful treatment is more difficult.
Diagnosis of the disease is made through detailed measurements of your gums and from x-ray images.
Can it be treated successfully?
Yes, if the disease is diagnosed early or significant bone support remains around teeth.
The success of treatment not only depends on completing the proposed course of therapy, but also on you carrying out good daily oral hygiene in order to keep away harmful bacteria. Reducing or stopping smoking will also have a large positive impact on the success of treatment. Following initial treatment it is important that you are regularly seen for maintenance appointments to make sure the good results achieved are maintained.
What does the treatment consist of?
The first phase of treatment will consist of deep cleaning of the root surface below the gum level (usually with local anesthetic), this will reduce the level of inflammation and the depth of the pockets. We will then evaluate the response to this initial therapy.
For most patients deep cleaning will be sufficient to control the disease, however in advanced cases of Periodontal disease, the improvements after deep cleaning alone may not be enough. A second phase of therapy may include minor surgery to gain access to deep areas for cleaning.
As soon as the condition is considered stable the patient will be advised to have maintenance appointments at 3 monthly intervals and a full Periodontal reassessment at yearly intervals.
Are there adverse effects of treatment?
The reduction in the depths of the pockets are likely to show in the form of some gum recession (root exposure), this is inevitable when the gums are initially very swollen. There may also be increased sensitivity to cold, however this is usually temporary and can be easily treated.
Will I be able to retain my teeth for life?
If you have completed a course of Periodontal therapy, you have been keeping up with good oral hygiene and regularly attending for maintenance appointments, you are likely to have a stable condition. All patients who have suffered from Periodontal disease are at risk of reinfection. However good home tooth cleaning and regular maintenance care will reduce this risk.