January 12, 2018 - Roland Chong

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Periodontal disease treatment.

Periodontal disease  affects the gums around the teeth. Periodontal disease treatment and management aim to control the volume of bacteria at the gum line accumulating on the tooth surface . Removal of the heavy plaque and calculus build up will resolve the disease.

Periodontal disease affects the jaw bone requiring cleaning the root surface of the tooth past the gum line. Removal of 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. Dental visits need to be 3 monthly for periodontitis and 6 monthly for gingivitis.

Medicated mouth rinses are a useful adjunct in treating gum disease. However, rinsing with an antiseptic mouth rinse should cease once gum disease is under control. 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 Periodontal disease is life long and not difficult. There is no particular diet or exercise you need to adhere to. Just brushing your teeth twice a day with fluoridated toothpaste and visiting your dentist when instructed is sufficient to maintain good gum health. At ProCare Family Dental the frequency of dental visits is tailored according to the severity of your condition.

Periodontal disease sufferers must be seen every 3 months in the first year. This interval can be increased if the disease responds to treatment after the first year . The disease is monitored by assessing the gum pocket depth, the degree of gum bleeding when probed, and oral hygiene of the individual. Removal of calcified plaque, calculus, is carried out using instruments as shown in figure 2 and 3. The extent of bone loss is gauged with dental x-rays. Evidence of significant bone loss requires frequent dental appointments.

Regular dental appointments are necessary for managing gingivitis. 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. These visits will ensure low levels of plaque build up. 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. Your dental professional will clean the areas you have missed.
  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.