Periodontal disease

Periodontal disease (periodontitis or gum disease) comprises a group of conditions resulting in inflammation of the gums. The inflammation leads to breakdown of the gum attachments to the teeth, and eventually the reduction of the bone levels supporting the teeth. This leads to loosening of the teeth and eventually their loss.

What is gum disease?
Gum disease describes swelling, soreness or infection of the tissues supporting the teeth. There are two main forms of gum disease: gingivitis and periodontal disease. Gingivitis means inflammation of the gums. This is when the gums around the teeth become very red and swollen. This is usually curable and reversible. Long-standing gingivitis can turn into periodontal disease. As the disease gets worse the bone anchoring the teeth in the jaw is lost, making the teeth loose. If this is not treated, the teeth may eventually fall out. In fact, more teeth are lost through periodontal disease than through tooth decay.

Am I likely to suffer from gum disease?
Probably. Most people suffer from some form of gum disease, and it is the major cause of tooth loss in adults. However, the disease develops very slowly in most people, and it can be slowed down to a rate that should allow you to keep most of your teeth for life.

How can I tell if I have gum disease?
The main sings of gum disease include bleeding gums (spontaneous, on brushing, or flossing etc), loose teeth, receding gums, spaces developing or teeth moving position, tenderness, swelling, redness, bad breath and taste, abscess (pus)

What is the cause of gum disease?
All gum disease is caused by plaque. Plaque is a film of bacteria which forms on the surfaceof the teeth and gums every day. Many of the bacteria in plaque are completely harmless, but there are some that have been shown to be the main cause of gum disease.

What happens if gum disease is not treated?
Unfortunately, gum disease progresses painlessly on the whole so that you do not notice the damage it is doing. However, the bacteria are sometimes more active and this makes your gums sore. This can lead to gum abscesses, and pus may ooze from around the teeth. Over a number of years, the bone supporting the teeth can be lost. If the disease is left untreated for a long time, treatment can become more difficult.

Can periodontal diseases be cured?
The periodontal diseases are never cured. But it can be controlled, as long as you keep up the home care you have been taught. Any further loss of bone will be very slow and it may stop altogether. However, you must make sure you remove plaque every day, and go for regular check ups by the dentist and hygienist.

Periodontal (gum) treatment
The aim of this information sheet is to help answer some of the questions you may have about having periodontal treatment. It explains the benefits, risks and alternatives of the procedure as well as what you can expect when you come to hospital. If you have any questions or concerns, please do not hesitate to speak to a dentist or dental nurse caring for you.

What is periodontal treatment?
Periodontal treatment is the specialist cleaning of your teeth and gums to help control the bacteria that cause gum disease. During treatment we will clean the ‘tartar’ (calculus) caused by bacteria from above the gum line by cleaning (scaling) the teeth. If the disease has already destroyed some of the support for your teeth we will also remove bacteria and calculus from under the gum by cleaning (scaling and instrumenting) your teeth. This involves the careful use of fine powered and hand operated cleaning instruments on the tooth surfaces. Periodontal treatment is given over several appointments and the number of appointments you will need depends on how severe and widespread your disease is. Patients with more aggressive forms of gum disease may be asked to take short courses of antibiotics after treatment. We will also teach you the best methods of cleaning your teeth and gums to remove the bacteria. Treatment will be most effective if you clean your teeth thoroughly on a daily basis.

What are the benefits – why should I have periodontal treatment?
After periodontal treatment your gums will become healthier, which will help you keep your teeth longer. The improvements will depend on how good your cleaning becomes and how severe your disease was to start with. If your gums bleed, are red or are swollen this will get better. If your gums are sore, treatment should help and if your teeth feel loose they may feel firmer after treatment. Your breath may become fresher.

What are the risks?
The gums occasionally feel sore after scaling but should feel better after a few days. Your teeth may become sensitive to hot, cold or sweet substances but usually this will decrease within a few weeks. Sometimes you may need to use special toothpaste or have other treatment.

Are there any alternatives?
No treatment: The result of not having treatment will depend on how severe your disease is. With no treatment the gum disease could get worse. Your teeth could become painful or you may lose your teeth sooner.

Extractions: Removal (extraction) of teeth may be an acceptable alternative treatment if your gum disease is severe. This may mean you need replacement teeth such as a denture or bridge. Such treatment would routinely be provided by your own dentist. Some people find it easier and more enjoyable to eat with natural teeth than a denture. Extractions would reduce the time spent treating your gums and an extraction would remove a painful tooth quickly. An extraction may also be a suitable option if teeth are loose. If your front teeth have a poor appearance a denture may look better.

How can I prepare for periodontal treatment?
Continue to take any medications as normal. Please make sure that you tell us about any problems with your health and about any tablets or medicines you are taking. Some medical conditions change the advice and information we need to give you. If you smoke tobacco we recommend that you stop smoking as gum treatment does not work as well in smokers as non- smokers. You can contact the free NHS smoking helpline on 0800 022 4 322.

Will I feel any pain?
You may experience a little discomfort when we are cleaning your teeth so we may give you an injection to make the gum numb.

What happens after the procedure?
As the gums become healthier they may shrink or recede and the teeth may appear longer. You may also notice spaces appearing between the teeth.

What do I need to do after I go home?
There are no special precautions that need to be taken when you return home. You will need to continue with tooth cleaning at home and stick to the special advice given to you by your dentist.

Will I have a follow-up appointment?
Your response to treatment will be monitored at a future appointment and further treatment may be needed. This appointment will either be organised before you leave hospital or sent to you by post.