PERIODONTAL ( ‘GUM’) DISEASE

PERIODONTAL  ( ‘GUM’) DISEASE

1. Q. What is periodontal disease?
2. A. Periodontal disease, or gum disease as it is often called, occurs in the gum and bone around the tooth. Gingivitis is the early stage of periodontal disease. The gum tissue becomes red and swollen and bleeds easily especially during brushing. There is little pain or discomfort at this stage.

If gum disease is left untreated, gaps called pockets can form between the gums and the teeth and become infected. This causes irreversible damage to the gums and bone surrounding the teeth. It can eventually progress to periodontitis.

Periodontitis is the more advanced stage of periodontal disease which causes teeth to become loose and may eventually fall out or require extraction.

1. Q. What causes periodontal disease?
2. A. The main cause is dental plaque, an almost invisible sticky film of bacteria which constantly forms on your teeth. The toxins produced by the bacteria irritate the gums , hence the redness and bleeding associated with it. If left undisturbed, a ‘pocket’ can form and this will permanently damage the bone supporting your teeth. Other signs to look for are an unpleasant taste in your mouth or bad breath.

If the plaque is not removed it can turn into a hard substance called calculus or tartar which builds up more plaque making it harder to clean. It is often apparent behind your lower front teeth. It should be removed by the dentist or the hygienist since it makes thorough plaque removal difficult.

By carefully cleaning your teeth each day, you can prevent periodontal disease or prevent it advancing to a more destructive stage. With practice, good oral hygiene takes less than 5 minutes ( about the same time as shaving or applying make-up). Your dentist or hygienist will discuss with you the various cleaning aids.

1. Q. What can I do?
2. A. First, you should learn about periodontal disease – what causes it, how can it be prevented and how it is treated. This leaflet can help.

Once you know the facts, you will realise that youplay the major role in preventing periodontal disease and its destructive complications. Your daily tooth cleaning makes the difference between control and active disease.

1. Q. Is there only one type of periodontal disease?
2. A. No, there are many types. These include: gingivitis, other types of aggressive periodontal disease which affect children and young adults, and adult periodontitis. The number of teeth affected by this disease can vary as does the extent of problem at each tooth. This will eventually determine if treatment is going to be simple or complex and on the likelihood of long term success of the treatment.

1. Q. Who gets periodontal disease?
2. Anyone can get periodontal disease, but some people have a greater than average risk. If you smoke or use tobacco, you are more likely to suffer from gum disease or to experience the more severe forms of it. Smokers have also been found to heal more slowly following treatment.

Diabetics and people under stress or with other medical conditions can also be at a higher risk of gum disease.

1. Q. Is periodontal disease inherited?
2. A. Some people can inherit a tendency to have breakdown of their gum structures. But this susceptibility does not always affect all members of the family. In most cases, early diagnosis, appropriate treatment and regular review of treated areas are much more important than the influence of heredity.

1. Q. Why treat periodontal disease?
2. To preserve the natural teeth in comfort and function. Treatment could be considered for other reasons, including bleeding or ‘puffy’ gums and bad breath. In the great majority of cases, removal of all or almost all of the plaque from the  junction of the gum and the tooth halts the disease process. But if plaque is allowed to reform to previous levels, the disease process may resume. Like any other disease, if treatment is started early, successful results can be expected.

1. Can loose teeth be tightened?
2. A. Loose teeth may become firmer after periodontal treatment. However, teeth which remain less than firm after treatment can continue to function adequately for many years. If the degree of looseness is a problem, stability may be achieved by splinting teeth together by various means.

1. Q. What treatment will I need?
2. A. Your specific treatment will depend on how advanced the periodontal disease is, but it will involve removal of plaque above and below the gum . Complications can arise from treatment, resulting in sensitivity, incomplete healing and, rarely, a gum abscess. Also part of the healing process of this treatment can be gum shrinkage or recession and this is quite normal after the teeth have been cleaned. This is the healthier state of the gums compared to the puffy inflamed bleeding gums of active periodontal disease.

1. Q. Can I use TePe brushes?
2. A. Yes, they are simple to use and excellent to use for cleaning in between the teeth to prevent plaque accumulation which causes periodontal disease.

They come in different sizes and are colour coded.  Generally patients will need different sizes as the gaps between their teeth are different sizes. For most patients three sizes are a minimum required.We would advise Red, Yellow and Green to start off with. If the red is too small for a gap then you may wish to try floss or an orange or pink size but they do tend to fray too quickly.

The brush just needs to go into each space once, before moving to the next one. If you have trouble getting the recommended size into the spaces, try the next size down ( i.e. slightly smaller)  until you are able to feel it brushing against the sides of the teeth and gum as it goes through. You need to give time and look in the mirror – it cannot be done while you are doing something else! If you cannot get the TePe brushes between some teeth, you may need to use normal dental floss to remove the plaque.

1. Q. Once I have periodontal disease, can I get it again?
2. Periodontal disease is never cured. However, following active treatment, periodontal maintenance therapy will be essential to monitor the tissues and to review your home-care. This will require appointments with the hygienst and regular check-ups by the dentist.