Gum Disease Treatment

Gum disease can be treated, but how we treat it depends on the type of gum disease and what stage it is in. One of the most important factors in the success of the treatment of gum disease is patient education and meticulous daily plaque control at home. This is because the bacteria and plaque which causes gum disease never stops growing and the gums can easily reinfect if it is not properly managed.

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Determining the Type of Gum Disease

Before treatment can commence, a diagnoses must first be made. We diagnose the type of gum disease through the appearance of the gums (whether they are red and swollen), if there is bleeding present and the levels of inflammation. We then determine whether there has been permanent damage to the supporting structures through something called a periodontal chart. The gum isn’t directly attached where you see it on the tooth; the gum can lift away from the tooth and this is called a sulcus. When there has been permanent damage to the supporting structures and the sulcus deepens, it is then called a periodontal pocket.

Gums and bone which have not had permanent damage typically have sulcus depths of 1-3mm. These depths can increase slightly if there is significant inflammation of the gum and this causes a false pocket. This resolves once the inflammation clears and measurements return to the normal range. This is called gingivitis and it can be mild, moderate or severe. Once the source of infection (plaque and calculus) is removed and controlled through daily oral hygiene, the gums return to a normal healthy state.

Gums and bone which have encountered permanent damage have pockets which are greater than 4mm. This results from the destruction of the supporting bone. In some cases the gums will stay at their normal level and the bone receeds. In other cases, the gum recedes along with the bone and patients may visually become aware that something isn’t right. This is called periodontal disease. Depending on the level of bone and gum loss, it can be mild, moderate or severe in nature. Bone loss is also assessed through x-rays. Any loss of the supporting tissues such as bone and gum is permanent.

Treatment of Gingivitis

One of the most important factors in treating gingivitis is education. In most cases gingivitis doesn’t cause pain and unless you are dentally trained, it can be hard for people to visually detect. This is why if there is an issue with your home care, we will show you where you are missing plaque and where you have calculus (hardened plaque). We will then educate you on what gingivitis is and how it progresses into periodontal disease. Once you understand how detrimental plaque is, we will demonstrate in your mouth how you should brush, clean in between the teeth and whether you should use any mouth rinses or specialised toothpastes. Every mouth is different, so home care is customised to the individual.

After educating our patients on gingivitis and providing a home care routine, we treat the gingivitis by removing the plaque and calculus from the teeth which is causing the infection. This is done will specialised equipment such as an ultrasonic scaler (uses vibration and water to blast off plaque and calculus), hand scalers and polishing. When the gums are infected and depending of the severity of the infection, this process can be uncomfortable. We don’t like inflicting suffering on our patients, so sometimes this treatment is done using local anaesthetic to numb the gums, so the process is painless.

Treatment of Gingivitis

One of the most important factors in treating periodontal disease is education. In most cases periodontal disease doesn’t cause pain and unless you are dentally trained, it can be hard for people to visually detect. This is why if there is an issue with your home care, we will show you where you are missing plaque and where you have calculus (hardened plaque). We will then educate you on what periodontal disease is. Once you understand how detrimental plaque is, we will demonstrate in your mouth how you should brush, clean in between the teeth and whether you should use any mouth rinses or specialised toothpastes. Every mouth is different, so home care is customised to the individual. When you have suffered permanent damage to the supporting structures of the teeth, meticulous plaque control is paramount. Unfortunately any bone and gum loss is permanent and the goal then becomes to stabilise the gums and bone and prevent further destruction and potential tooth loss. This is not possible if daily home care isn’t meticulous.

Periodontal disease is treated by removing the plaque and calculus from the teeth which is causing the infection. This is done will specialised equipment such as an ultrasonic scaler (uses vibration and water to blast off plaque and calculus), hand scalers and polishing. Because we are having to clean more than 4mm under the gums, this process is typically not comfortable – particularly if the periodontal disease is active and the gums are inflamed. We don’t like inflicting suffering on our patients, so this treatment is usually done over two appointments and using local anaesthetic to numb the gums, so the process is painless. Antibacterial agents are often recommended in conjunction with a customised home care routine. Once the periodontal disease is stable and inflammation is low to resolved, cleaning generally doesn’t require local anaesthetic – even if we are going more than 4mm under the gums as healthy gums typically don’t cause pain during professional cleaning.