Treatments

What is gum disease? And how do I know if I have it?

Gum disease is caused by the actions of bacteria found in dental plaque and tartar that build up around the teeth. As the bacteria build-up, they begin to irritate the gums, becoming more harmful the longer they stay around the teeth.

Most people suffer from a mild type of gum disease called gingivitis which is reversible. The gums may look red and swollen and bleed easily, but there’s no permanent damage. This can usually be reversed with an improvement in brushing, interdental cleaning and professional hygienist teeth cleaning.

A small proportion of people have a stronger reaction to the bacteria and become even more irritated by them, leading to permanent damage. This is called periodontitis. The gums pull away from the teeth and form spaces called “pockets” in which more plaque collects. As the pockets deepen, the supporting bone and tissues around the teeth are gradually lost, and the teeth may become loose and need to be removed. In most cases, periodontal disease can be managed to reduce further bone loss around the teeth, but lost bone can’t usually be replaced.

During the consultation appointment, a detailed discussion of your concerns and history is taken, followed by an in-depth examination of your gums. This is typically followed by x-rays of the affected areas to assess the bone levels.

Additional salivary microbial testing for oral bacteria and referrals for blood tests can be done to build up a better picture of your overall health. These are done upon request at an additional cost, please enquire for further details.

The rest of the appointment will be an in-depth discussion of your case, in which a treatment plan is formulated aimed at restoring your gum health. This will be followed by a detailed report and treatment plan. The consultation typically lasts between 45-60 minutes.

Deep cleaning involves gently removing the bacteria and build-up from below the gum line using specialised instruments designed to fit below the gums. This is usually done under local anaesthetic. Numbing gel and specialised techniques are employed to ensure the local anaesthetic is comfortable. Once these bacterial deposits are removed, your gums will tighten back up. How many appointments you require will depend on the severity of your condition, but most people typically need 2-4 sessions.

You will notice an improvement in any bleeding of your gums, an improvement in bad breath, and a reduction in swelling and inflammation of the gums. You may experience some temporary sensitivity in your teeth that usually settles down in the first few weeks following treatment. You may also notice some slight recession of the gums following treatment as your gums heal. If this is likely to be noticeable when you smile, then this will be discussed with you, as well as options to manage it.

Bone regeneration is the process of growing new bone around your teeth. In the majority of cases, we can’t usually regenerate lost bone, but sometimes we can, depending upon the pattern of bone loss. Minimally invasive techniques, such as the application of growth factors, can be used to try and regenerate new bone.

This could mean the difference between keeping or losing a tooth. A growth factor is a naturally occurring substance that’s capable of encouraging bone regeneration. By applying the growth factors to your teeth, we may be able to stimulate your own bone to regenerate. We use Emdogain Growth factors which is a material is of animal derivative (xenograft).

Deep cleaning is usually enough to get optimal results in the majority of cases, but there are occasions when, depending upon the severity of the gum disease, periodontal surgery may be recommended. This is a small procedure done under local anaesthetics where the gums are gently lifted from around the teeth to allow better access to the roots and the jawbone.

Inflamed and infected gum tissue is then removed, and the root surfaces are thoroughly cleaned. Bone irregularities may be reshaped, and bone regenerative grafting material may be placed in the areas of bone loss around teeth. The gums are then secured with sutures. Dr Anju offers a full range of periodontal surgical treatments.

Pinhole technique & gum grafting

Gums can recede for a number of reasons, and it’s important to identify the underlying cause and address it. Once identified, we can also help improve the appearance of recession using traditional gum grafting techniques, where we either use some of our own gum tissue to cover the receded area or xenografts (animal derivatives).

Additionally, we can also assess your suitability for the Pinhole Technique. This is a non-surgical alternative to gum grafting, where several small pinholes are made under the lip depending on the number of teeth that need to be treated. Specially designed instruments are placed in the pinholes to gently loosen the gums and reposition them over the areas of recession. Resorbable collagen (of porcine origin) is placed inside the pinholes to secure the gum tissue in place.