PERIODONTAL (GUM) DISEASE TREATMENT
What is periodontal disease?
Periodontitis or periodontal disease (also commonly referred to as 'gum disease') is an inflammatory-mediated disease affecting the gum and the supporting structures of the teeth.
Teeth are housed in place by the periodontal ligament to the underlying bone. The periodontal ligament can be viewed as the attachment apparatus of the teeth. Periodontitis is caused by certain bacteria and by local inflammation triggered by these bacteria. With progression, the periodontal ligament, along with the bone housing the teeth, is irreversibly destroyed.
Gingivitis vs periodontitis
You may have heard of gingivitis which is a mild-to-moderate inflammation of the gum without affecting the attachment apparatus of the teeth, namely the periodontal ligament and the bone. Gingivitis is a reversible condition, whereas periodontitis is not.
The aim of periodontal treatment is to arrest the disease progression, to maintain the health of the periodontium, and to prevent further bone loss around the teeth.
How is periodontal disease diagnosed?
During your routine dental examination, your dentist assesses the health of your gum. This is done by inserting a periodontal probe into the gum on all your teeth. This may cause some discomfort and bleeding, which is normal; most often this is mild gingivitis.
When the probe sinks much deeper than usual accompanied with bleeding, this is an indication of periodontal disease. Your dentist may initial a full periodontal assessment to determine the extent of the disease. Depending on the severity of the disease, you may be managed in general practice or referred to a periodontist, a specialist in gum diseases.
Management of periodontal disease
Active Periodontal Therapy
What does periodontal therapy involve? Simply put, it is akin to cleaning your teeth. Unlike regular scale and clean, periodontal therapy involves deeper cleaning, all the way to the base of gum pocket, in order to remove any deep calculus and, most importantly, disrupt the biofilm (the complex microbial ecosystem) inside the gum. Periodontal therapy in generally done under local anaesthetic for your comfort.
Any active therapy will not be successful without effective home measures, predominately your own oral hygiene measures. Throughout the management of periodontitis, your dentist will go through effective oral hygiene measures with you and reinforce them. It is important that you implement and maintain these measures as you are responsible on a daily basis to maintain your gum health.
Smoking is one of the strongest disease-modifying factors in periodontitis. The research on the effect of smoking to periodontal health is clear: smoking significantly increases your risk for developing periodontal disease, accelerates its progression, and reduces the chances of arresting the disease upon active therapy. You should seriously consider smoking cessation upon diagnosis of periodontitis.
Supportive Periodontal Therapy (SPT) - Maintenance Phase
This is arguably the most important phase in the overall management of periodontal disease. Unfortunately, once you are a periodontitis patient, you'll forever be susceptible to the disease relapse and progression. This involves reviewing your gum health and your oral hygiene measures, as well as further cleaning, if necessary. The interval for this is generally between three and six months.