Correct oral hygiene (OH) habits are the cornerstone of a patient’s pathway to good oral health. Good OH ensures healthy teeth AND gums.
Too many patients however neglect the gum part as gum disease is an insidious process, with symptoms often only appearing in the later years of life, when the severity of the damage eventually forces the patient to seek dental help. For too many patients it is then a case of too little too late. The key to good gum health is prevention, and or at the very least early detection and implementation of a treatment plan whilst the infective process is still reversible and treatable without the necessity of gum surgery.
Gum disease, as with caries, is a bacterial infective process. Gum disease starts off as gingivitis (just superficial or marginal gum infection) which is visible as red, slightly swollen, tender gums that tend to bleed very easily with tooth brushing. If allowed to continue, the infection spreads deeper down alongside the tooth to involve and destroy the fibres which adhere the gum to the tooth. Deeper destruction results in pocketing, with the gradual loss of bone around the neck of the tooth. Gingivitis with bone loss is termed periodontal disease. Unchecked, this process will lead to such an amount of bone loss that the tooth becomes very mobile, gum abscesses occur deep within the pockets and between the roots of the molar teeth, often with pus or exudate drainage, bleeding, a bad taste and of course, pain.
Periodontitis is one of the most prevalent chronic diseases in the world, not far behind other chronic conditions such as hypertension and diabetes. People lose more of their teeth due to chronic periodontitis than caries or trauma. Apart from the signs and symptoms of periodontitis, such as pain, bleeding and bad breath, having to wear removable dentures to replace missing teeth can be extremely uncomfortable. A fairly high percentage of patients cannot tolerate or function (eat, speak, laugh) with removable dentures, and they then require the placement of dental implants in order to provide a stable base for crowns, bridges or fixed dentures.
A more serious medical risk to a periodontitis patient is that of the constant contamination of their own blood system, via the periodontal pocketing, with hordes of bacteria which are resident in their mouths. Human mouths are home to literally hundreds of different strains of bacteria, and these bacteria with their toxic byproducts are now known to cause or exaggerate systemic diseases such as heart disease, strokes and diabetes.
The aim of the practice’s oral hygiene programme is the following:
- Regular check-ups to monitor for gum disease
- To inform our patients of threatening periodontal conditions
- To educate the patient as to what periodontal disease is, and what needs to be done to prevent it
- Giving oral hygiene instructions – how to brush and floss correctly
- To literally nip periodontal problems in the bud whilst it is easy to reverse and easy to treat, and to prevent progression of the disease to the point where teeth are going to be lost, or for the necessity of gingival surgery by a specialist periodontist to preserve seriously affected teeth
- To do regular prophylaxis treatments such as scaling and polishing
- Scaling removes the calcified deposits of plaque which a tooth brush cannot remove
- Polishing removes plaque and unsightly stains
- We use Sirona’s SIROLaser to perform laser bacterial reductions (LBR) in the pockets around teeth in cases of gingivitis and where there are moderate pocket depths
- With deeper pocketing laser assisted periodontal therapy (LAPT) assists in reducing the bacterial count, and non-surgically removes the infected soft tissue inside of the pockets, to allow healthier periodontal fibrous attachment to the tooth to eliminate the deep pockets. Diode lasers also have a stimulatory effect on the bone with reversal of bone loss around teeth
- Placement of fissure sealants on newly erupted permanent teeth in younger children to prevent the formation of fissure caries
- Application of fluoride gels and varnishes to the tooth surface to enhance calcification of the outer layers of the tooth, for enhanced strength, greater ability to withstand caries, and to reduce hypersensitivity
- Referral to specialist periodontists when indicated for the more severe cases