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Gum Disease in Perth
(Periodontitis)
Gum Disease Explained
What is gum disease?
Gum disease is also known as periodontitis or gingivitis. It is inflammation affecting the supporting structures of the teeth: the gums.
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What causes gum disease?
The primary cause of gum disease is the plaque bacteria that lives in our mouths. We all run the risk of developing gum disease, however those who have a combination of risk factors (e.g. smoking, stress or poor oral hygiene) are at increased risk of developing it.
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Gum disease develops as the plaque bacteria under the gums begins to grow and stick to the root surfaces of the teeth forming a hard-mineralised layer known as calculus or tartar. This then has the ability to produce its own toxins, which attack the supporting structures of the tooth causing bone destruction, and soft tissue and/or gum destruction. This is typically known as recession or receding gums.
Dr Mahnaz Syed
Specialist Periodontist
Gum disease explained
Once this process starts, the gums, which are attached very firmly to the teeth, detach from the teeth and form gum pockets. Over time, the gums can shrink back from the teeth causing recession.
Once the process has started patients need to seek advice from a dentist or periodontist for treatment. Early detection and treatment is key for the best treatment and resolution for gum problems.
What is the difference between periodontitis and gingivitis?
Gingivitis is a superficial disease, which can be completely reversed and treated, leaving patients healthy and back to their normal gum health following treatment.
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Periodontitis is a deeper disease that affects the bone around the tooth, weakening the tooth’s support. Although it can be treated the bone loss cannot always be rebuilt.
What are the signs and symptoms of gum diseases?
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Bleeding while brushing, flossing or eating hard food.
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Blood stains on your pillow after sleeping.
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Gums that are receding or shrinking away from the teeth.
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Red, swollen or tender gums or other aches and pains in your mouth.
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Itching sensation from the gums.
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Changes in teeth position.
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Pus between your gums and teeth.
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Bad breath or a bad taste in your mouth.
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A change in the way your teeth fit together when you bite.
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A change in the fit of partial dentures.
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Who does gum disease affect?
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Most people suffer from some degree of gingivitis in their lives, but in certain cases this can progress to destructive periodontitis. Certain risk factors increase the chances of developing periodontitis. These include:
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Smoking.
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Poor oral hygiene.
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Diabetes.
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Immune suppression.
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Heavily restored dentition (e.g. having lots of fillings and crowns).
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Genetic factors (gum disease tends to run in families).
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Stress.
Prevention of Gum Disease in Perth
Preventing gum disease involves thorough brushing and flossing or use of small bottle or proxy brushes between the teeth.
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When toothbrush bristles are splayed, their efficiency is greatly reduced so the toothbrush needs to be replaced.
Electric toothbrushes are recommended as they provide a constant pressure and a two-minute timer, which is how long tooth brushing should take.
Treatment of Gum Disease in Perth
How is it treated?
A technique called periodontal probing is used to measure the extent and severity of your gum disease. This involves a small measuring instrument used to measure the spaces between the gums and the teeth (gum pockets) as well as measuring the amount by which the gums have receded (shrunk away from the teeth).
The periodontist will inspect the colour and firmness of your gums and test your teeth for looseness. They will also check the way your teeth fit together when you bite. X-rays may be taken to evaluate the bone supporting your teeth. Note: if you have already had x-rays taken previously by your dentist, bring them with you.
The periodontist will make a note of any risk factors, which may explain the level of gum disease that you have.
Baseline gum disease will be measured and an assessment of your response to treatment will be made.
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Treatment of Periodontitis
Gum treatment or periodontal therapy can be divided into two stages:
Stage 1
Elimination of the bacteria and encouraging healing of the gums non-surgically. This involves the use of specialist periodontal therapy equipment that physically removes the plaque bacteria calculus and infected soft tissue from the root surfaces inside the gum pockets. In deep pockets, the periodontist will use a local anaesthetic to make the procedure pain-free.
Areas of the mouth are usually treated in quadrants (quarters) to ensure the best response to treatment.
Once all the affected areas are treated a healing period of 8-12 weeks is observed to enable the gums to re-attach to the teeth and, in some circumstances, the bone to grow back in areas where it has been lost.
Stage 2
For some patients who don’t respond to the stage 1, some corrective or advanced treatment is needed.
This advanced treatment involves adjusting teeth, which may have physical or anatomical problems on the surfaces and sometimes overgrown soft tissue and irregular bone. The procedure is done under local anaesthesia with sedation or general anaesthesia options available too. The area is made fully numb and the gums gently pushed away to reveal the problematic root surface or bone problem. The bone may then be reconstructed to a proper shape and the gum is then replaced to its proper position and sutured.
Healing of these procedures takes from 7 to 21 days and is usually uneventful, although not without some expected post-operative discomfort.
In some cases regenerative materials can be used to re-grow the lost bone and strengthen affected areas.
Antibiotics are sometimes prescribed to treat gum inflammation.
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