A periodontist is a dentist who has
completed a university post-graduate specialty program in
periodontics.
Periodontics is a specialty of
dentistry that deals with the maintenance of health and the
diagnosis and treatment of gum disease, as well as the placement of
dental implants.
Periodontal specialty programs are an
additional two to three years in duration following graduation from
the four year dental school program.
What is Gingivitis?
Gingivitis is a response by the gum
tissue to plaque building up around the necks of the teeth. If your
cleaning (brushing and flossing) technique is not correct, plaque
will build up at the delicate junction where the teeth come through
the gums. This irritates the gums and causes them to become inflamed
(gingivitis).
You may notice that they bleed when
you brush your teeth; they may appear redder than pink healthy gums.
In some cases they also swell up. Gingivitis is a reversible
condition and effective cleaning will lead to health in a couple of
weeks. Where the plaque has hardened into calculus (‘tartar’) this
has to be removed by a dentist or hygienist to allow proper
cleaning.
What is Periodontal Disease (gum
disease)?
Periodontal disease is a disease of
the gum tissue and underlying bone. Unlike gingivitis, periodontitis
is associated with irreversible loss of the underlying bone that
holds the teeth in.
Gum pockets usually open up between
the tooth and gum and act as reservoirs for bacteria unless treated.
The rate of bone loss varies very much from individual to
individual, but if untreated may well lead to tooth loss.
Up to 80% of the population will
probably get some periodontal disease, and 15-20% of people will
lose a significant number of teeth if they do not receive treatment.
Like gingivitis, periodontitis is
usually painless, and by the time people become aware of problems,
usually teeth becoming loose or drifting out of alignment, serious
damage has been done. If caught early enough, most periodontal
disease can be treated.
Why Do I Have Bleeding Gums?
Bleeding gums are a sign that the gum
tissues are unhealthy. It is extremely difficult to make healthy
gums bleed.
Bleeding gums are a sign of
gingivitis, usually as a result of ineffective tooth
cleaning in the area that bleeds.
Bleeding gums may also be a sign of
periodontal disease, which affects the bone holding
the teeth in. If this is not treated it can lead to early tooth
loss.
Why Do I Have Receding Gums?
Receding gums are a sign that there
has been some loss of the tooth-supporting tissue. It is not an
inevitable consequence of age.
Gum recession around one or two teeth
may be a sign that you are not cleaning properly. People who are
prone to this sort of gum recession will get it if they don’t clean
well enough (leading to gingivitis) or if they
clean too hard and scrub their gums away. Careful instruction in the
right way to clean by a dental hygienist is important. This sort of
gum recession can be often be treated by minor gum surgery if it is
unsightly.
More extensive gum recession may well
be an indication of underlying periodontal disease. Not everybody
with periodontal disease will get gum recession, it is more usual
for people’s gums not to recede and look superficially fine, whilst
losing important attachment under the surface.
What Is Gum (periodontal) Treatment?
The most common type of gum treatment
brings together two components;
1. Oral hygiene (home care plaque
control)
2. Meticulous removal of plaque
and calculus (tartar) from the gum pockets (debridement).
In this way, treatment targets the
causes and effects of gum disease, namely the bacteria initiating
disease at the edge of the gum and the bacteria progressing the
disease within the gum pockets.
Home Care Plaque Control.
Your susceptibility to gum disease means that your gums tolerate
very little plaque without inflammation (irritation) developing.
Therefore successful long-term control of your gum problems depends
on a high level of daily oral hygiene. To help you achieve this, we
will offer you advice and coaching to help you to remove plaque
bacteria from the gum line.
Debridement. In the
deeper areas that you cannot reach, we will meticulously clean out
the gum pockets. This is also called root planing
or deep scaling. You may need a local anesthetic
for this procedure. With deeper pockets or those that are not
responding to this treatment, surgery may be valuable to improve the
effectiveness of the debridement.
