What is Periodontal
Commonly referred to as gum disease, it is the main
cause of tooth loss in this country. In its early
stages, gingivitis, the gum around the neck of the
teeth is inflamed and bleeds. If gingivitis is left
untreated it may progress to periodontitis, in which
not only the gum, but also the underlying bone,
which supports the teeth in the jaws, is affected.
The teeth are attached to bone by microscopic fibres,
and as the disease process progresses these fibres are
destroyed, resulting in a cuff of loose gum around the
teeth, called a pocket. This pocket is an indication of
the severity of disease. The deeper the pocket, the greater
the severity of disease.
Mr Zang, a lecturer, attended
from Manchester complaining of the appearance
and looseness of his teeth. We completed the following
He was overwhelmed
with the results. His self esteem has improved
tremendously and he can look forward to fixed
teeth for many years.
Thank-you for giving me my smile back. I am
able to eat and talk with confidence. I love
my new teeth. Your professional and caring
approach has helped me overcome many fears
I had about dentistry…..”
Mrs X complained of the following:
Difficulty with eating
Lack of confidence
General low self esteem
We reassured Mrs X and immediately
started with a 'gum programme'. We provided sedation
for her initial visits to combat her phobia, but
eventually she was able to be treated with simple
local anaesthesia. The loose teeth were splinted
together with a fibre-reinforced ribbon. Mrs X was
thrilled with the resultsand continues her maintenance
with routine hygiene appointments.
She has fresher breath, no loose teeth and better eating
ability. Also, she has a much greater self esteem and
self confidence. Mrs X has been stable for 5 years!
"...My life has dramatically
changed. My husband was the first to notice he is
thrilled with the results. Thank you so much…..”
Cause Bacteria cause periodontal disease. In a healthy
mouth various types of bacteria co-exist in balance
and cause no harm. However, if the teeth are not
brushed adequately, bacteria will work on the
food left in the mouth to form plaque. This is
a ‘bacterial jam’, which sticks to
the teeth. Bacteria use this food to nourish themselves
and produce acids, which decay teeth and also
cause gum disease. This is a chronic (slow) process,
which usually occurs over a period of years. The
timescale however varies with each individual.
Effect The effect of the acids is to destroy the
fibres around the teeth forming pockets. As deep
pockets are extremely difficult to keep clean,
a downward spiral of destruction is set-up. Apart
from forming pockets the following may also occur:
Bleeding swollen gums, painful gums
Shrinkage of gum down the tooth
Loss of bone supporting the teeth
Foul taste in the mouth
Foul smell in the mouth
Bad breath and stale breath
Loose teeth. Typically front teeth have a
gappy splayed appearance.
Treatment Treatment is designed to stabilise the situation.
Unfortunately it is largely true that bone, gum
and attachment can never be returned to original
levels, thus severely compromised teeth can be
lost even with treatment.
Life expectancy on average: the UK is ~ 75-80
years of age. It is therefore very important to
look after the gums from a very early age to avoid
damage to the supporting structures of the teeth.
Healthy gums mean a healthy dentition for life.
There is no substitute to your own healthy tooth.
Treatment Aims are to obtain:
Clean healthy mouth
No tartar, or plaque deposits
Pink firm healthy gums which do not bleed
No foul breath
No foul taste
Teeth which feel and look good
Teeth which last for life
The above are achieved to varying degrees, depending
upon the individual person and situation. In this practice
the periodontal programme aims to achieve the above.
The Periodontal Programme The Periodontal Program is not a passive process
of the patient receiving treatment. It is a partnership
between the dental team and the patient. To gain the
maximum benefit both partners must co-operate with each
other fully. You +Us = Health.
Objectives We Wish to Fulfil
Treat the periodontal disease and gain the benefits
Improve the patient’s knowledge of their
own dental situation and improve their ability to
maintain a healthy oral environment
Increase the patient’s motivation
to co-operate with the treatment
to co-operate with and carry out long-term home
to attend for regular recalls for professional
care to help maintain a healthy mouth.
The objectives are achieved specifically in the
An appointment with the dentist at which an examination
is carried out, the Periodontal Program diagnosed
and a treatment plan drawn up.
A planned series of appointments with the hygienist
tailored to the patient’s individual needs.
Intensive deep scaling, gingival curretage and
root planning( where necessary under anaesthetic).
Measurement of pockets, bleeding, recession, mobility,
plaque etc. at the start and end of treatment and
Sometimes the use of powerful antibiotics, which
are acting specifically against bacteria causing gum
Intensive individual Oral hygiene instructions ((OHI)
and toothbrushing instructions (TBI) etc.
The above will involve a varying number of visits
depending upon need. After a review with the hygienist
a final review with the dentist is arranged. A recommendation
will be made as to the frequency of recalls, i.e.,
3 or 6 monthly. An assessment will be made to need
for future treatment, emergency or specialist referral.
We have successfully treated many patients with the
above methods. The treatment has greatly improved their
general well-being, restored their confidence and many
have been able to eat at a much higher and more comfortable
We would like to re-emphasise that that this treatment
will only achieve its best results with proper home-care
and regular maintenance visits.