Sonria Dental is a periodontal surgery London and gum disease specialist Central London. A healthy mouth is colonised by 200 to 300 bacterial species. Most of this bacteria are completely harmless and live in harmony in your mouth. However, when tooth cleaning is not thorough enough, the bacterial deposits build up next to the gums, forming a plaque. The conditions, therefore, gradually, become suitable for more dangerous bacteria to flourish, ultimately, compromising the body’s defences.
What is Periodontitis?
Periodontitis, often known as ‘gum disease’, is one of the most common human diseases. Gum disease is a very common condition in which the gums and deeper periodontal supporting structures become inflamed. This inflammation of the gums, which usually takes the form of redness, swelling and a tendency to bleed during tooth brushing, is the body’s response to periodontal bacteria that have been allowed to accumulate on the teeth.
The inflammation of the gums and supporting structures is the body’s defence system. However, this inflammatory response can eventually cause serious damage. If left unchecked, the inflammation can spread down below the gums and along the roots of the teeth, causing destruction of the periodontal ligament and the supporting bone. This ultimately leads to the loosening and potential loss of the teeth.
How does periodontal bacteria build up?
Although periodontal bacteria is naturally present in the mouth, they are only harmful when the conditions are right for them to increase in numbers. This bacteria, however, will build up in numbers when layers of bacteria and food debris, known as plaque, is left undisturbed on the teeth, commonly in hard-to-reach areas such as between the teeth. Here, the more dangerous bacteria are able to thrive, producing harmful by-products that cause inflammation of the gums. This inflammation is referred to as gingivitis.
Symptoms of Periodontitis:
Periodontitis begins with gingivitis (inflammation of the gums);
Gums that feel tender when touched;
Bleeding from the gums when you brush your teeth, eat, or even spontaneously;
Discoloured layer of bacterial plaque on the teeth;
Changes in the positioning of the teeth;
Pus between your teeth and gums;
Gum recession; and
Pain in the mouth, teeth, and/or jaw.
Please note – bleeding from the gums may be less noticeable in smokers!
What happens if bacterial plaque is not removed?
As a gum disease specialist Central London we are of the view that if the bacterial plaque is not removed from the gums and surfaces of your teeth while it is still soft, overtime, minerals are deposited and it can become a harder substance called tartar.
The more tartar is present, and for longer periods of time, the growth of bacterial plaque towards the root of the tooth is encouraged, This, then, causes an inflammatory reaction deeper into the gums, causing a disruption in the attachment of the gum to the root, causing a gap, known as periodontal pocket. This pocket then become an ideal habitat for further harmful bacteria to colonise and multiply, therefore driving the disease process forward. As the bacteria continues to invade, they release toxins as products of their metabolism, which further trigger the body’s defence mechanisms.
If periodontal inflammation is not treated, the supporting structures of the teeth, including the surrounding bone, can be destroy. Therefore, with no supporting structure, teeth can become loose overtime, and eventually fall out. If not lost, you may require an extraction of the affected teeth, as well as the above described symptoms.
Factors that increase the severity and speed of progression of periodontitis:
Number and type of bacteria present
Periodontal infections are usually mixed, most often involving anaerobes such as Treponema denticola and Porphyromonas gingivalis. The microaerophile Actinobacillus actinomycetemcomitans causes a rare form known as localised juvenile periodontitis.
Walter J. Loesche (1996) Chapter 99: Microbiology of Dental Decay and Periodontal Disease
The presence or absence of certain risk factors
Poor oral health habits
Smoking or chewing tobacco
Hormonal changes, such as those related to pregnancy or menopause
Inadequate nutrition, including vitamin C deficiency
Certain medications that cause dry mouth or gum changes
Conditions that cause decreased immunity, such as leukemia, HIV/AIDS and cancer treatment
Certain diseases, such as diabetes, rheumatoid arthritis and Crohn’s disease
Treating periodontal disease:
The key to success is to eliminate the bacterial plaque that triggers the periodontal disease process and to establish excellent oral hygiene practices. However, when a patient is suffering from periodontitis, there are a few options for treatment:
All soft deposits will be removed from accessible areas of the teeth and the teeth polished and treated with fluoride. Depending on the severity of the case, further oral hygiene instructions and cleaning may be carried out in subsequent visits. Additionally, your dentists will need to remove all bacterial deposits and tartar from the root surfaces and gingival pockets.
In some cases, with or without microbiological evaluation, antibiotics are prescribed to deal with active or persistent gum infections, which have not responded to oral hygiene measures.
After several weeks, your dentist or periodontist will make a full assessment of your gums to check the progress of your treatment. A special instrument called a periodontal probe is used to record the depth of any periodontal pockets and check for bleeding from the gums. If periodontal pockets are still present, further treatment options may be suggested, including surgical corrective therapy.
Corrective (surgical) treatment
Sometimes, a surgical procedure is carried out to clean away plaque bacteria and deposits that are under the gum within periodontal pockets and on the root surfaces at the furcations (where the roots diverge). Under local anaesthesia, the gum is lifted away and the root surfaces are cleaned under direct vision to ensure that all bacteria are removed. Sometimes, it is possible to treat bone loss at the same time using a special regenerative treatment. At the end of the procedure, the gums are sutured back into place around the teeth.
After the first phase of treatment has been completed, your dentist will need to review the condition of your gums at regular intervals to check that the inflammation has been halted. The frequency of your follow-up appointments will depend on the severity of disease and your individual risk of disease progression. Usually, follow-up visits are scheduled for every three to six months.
We can also advise on periodontal scaling and root planing cost, periodontist cost from the pov of a London periodontist. There is no such thing as an average cost of periodontal treatment. We are a periodontist Harley Street and would be happy to discuss with and advise you on periodontal disease treatment options.
We do have gum surgery before and after photos which we are happy to show you.
For more information regarding the topic of periodontitis, please visit the following websites: