January 12, 2018 - Roland Chong

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Gum disease treatment.

Gum disease  affects the gums around the teeth. Aim of treatment for gum disease is to control the volume of bacteria accumulating on the tooth surface at the gum line. Once the heavy build up of plaque on the tooth is removed the disease will resolve.

However if the disease has worsened into periodontal disease affecting the jaw bone, treatment will require cleaning of the tooth surface past the gum line. The removal of the calcified plaque or calculus is carried out using ultrasonic instruments and hand instruments. This reduces the bacterial load at the tooth surface adjacent to the gum. Frequent agitation of the plaque mass reduces bad bacteria increasing in number.

Oral antibiotics is sometimes prescribed to kill the bad bacteria in conjunction with mechanical cleaning of each tooth in the mouth. Professional cleaning needs to be carried out at least once every 3 months for periodontal disease or at least bi-annually for gingivitis.

Medicated mouth rinses are also a useful adjunct in treating gum disease. The use of mouth rinses can cease once the disease is controlled and the mouth is healthier. Regular tooth brushing and professional cleaning by a hygienist or dentist is sufficient to maintain the gums.

Figure 1. This diagram shows periodontitis with the gum pocket deepening in response to the presence of calculus. Picture courtesy of National Library of medicine.

Management of gum disease.

Managing gum disease is life long and not difficult. There is no particular diet or exercise you need to adhere to. Brushing your teeth regularly, at least twice a day with fluoridated toothpaste, and seeing your dentist at least twice a year is all that is required. At ProCare Family Dental the frequency of dental visits is tailored according to the severity of your condition.

Periodontal disease sufferers should be seen every 3 months in the first year. After the first year of treatment the regularity of visits can be reduced. The state of disease is monitored by assessing the depth of the gum pockets, the degree of bleeding when the gums are probed, and the oral hygiene of the individual. Removal of the calcified plaque, calculus, is carried out using instruments as shown in figure 2 and 3. Dental X-rays  are also taken to gauge the level of bone around the teeth. Evidence of significant bone loss requires frequent dental appointments.

Gingivitis sufferers are managed with regular dental hygiene appointments. Level of home care dictates the regularity of dental appointments in gingivitis management. Individuals with poor oral hygiene need more frequent visits and over shorter intervals. This ensures the plaque levels around the teeth are kept to a minimum. In some cases regular mouth rinse use is recommended. Individuals who cannot maintain adequate oral hygiene independently benefit from regular use of mouth rinses.

Figure 2. Hand scalers used to clean teeth. Courtesy of How Stuff works.

Figure 3. A Zeta ultrasonic scaler. Courtesy of Zeta Dental.

Simple steps to manage gum disease.

  1. Brush, brush , brush. Tooth brushing is the only way to maintain healthy gums.
  2. Regular dental visits. This will ensure areas which are missed with tooth brushing is cleaned by your dental professional.
  3. Floss, floss and floss. The areas between your teeth at the gum line cannot be cleaned with the tooth brush. Flossing is necessary.
  4. Avoid smoking.

Figure 4 Flossing correctly.

Figure 5. Tooth brushing technique.

Gum disease is treatable and manageable. All it takes is some effort at good oral hygiene and regular dental visits.

Roland Chong

Roland has over 18 years experience as a general dentist. Roland does all aspects of general dentistry with a special interest in prosthodontics (crown and bridge work) and cosmetic dentistry. A member of the International Team of Implantology, Roland is constantly developing his skills by collaborating with international experts.