Periodontitis – Gum disease and deep cleaning with root debridement

Periodontitis is a chronic inflammatory disease of the gums, which affects the gum, periodontal ligaments and bone support of your teeth. As this gets damaged over time, your teeth can become loose and painful. Sometimes they can end up needing to be removed. Gum disease is usually painless until the later stages, so regular dental visits and excellent oral hygiene are the best ways to prevent this gum problem. Gingivitis is a milder form of gum disease. This is inflammation in the gum tissues, but where damage is not occurring. There is a spectrum of severity and symptoms caused by all types of gum disease.

What causes gum disease?

Gum disease is caused by plaque and tartar on your teeth. More specifically, it is caused by your body’s response to the biofilm, the mircro-organism rich layer coating tartar and teeth. It depends on how your immune system works as to whether you are at risk. Keeping the plaque and tartar at bay is the best way to prevent gum disease. This can be achieved with excellent oral hygiene and regular dentist check ups. Depending on your risk, you will be advised to attend from every 3 months to every 2 years. A family history of gum disease means you are more likely to get gum disease. Diabetes is also a risk, particularly if you have diabetes yourself, but also can be a risk factor if there is a family history of diabetes. Smokers are at particular risk as they are more likely to get gum disease and less likely to show symptoms or respond to treatment.

How do I know if I have gum disease?

Due to the painless nature of gum disease, many people suffer from it and do not even know that they have it. Slowly, over time, they lose bone support and only become aware of the problem when it is too late. This is why regular dental visits are crucial to find problems early. The dentist will measure your gums and inspect the bone levels on your xrays. One of the main symptoms of gum disease is bleeding from the gum. This can occur when eating or when brushing the teeth. This can be something that occurs all throughout life. Some people with gum disease consider the bleeding to be normal, as they have always had it. Other symptoms can include bad breath or taste. Bad breath, or halitosis, can occur at any time with active gum disease. Recession of the gums is also a sign, making the teeth appear longer and making cleaning even more difficult, with more food and plaque trapping between the teeth. In later stages or in acute exacerpations of periodontits teeth can become painful and there can be swelling in the gum.

How can I treat gingivitis?

Gingivitis is normally treated with routine cleaning and improvement in oral hygiene. If it is not resolving, sometimes investigation of underlying conditions is warranted with blood tests.

How can I treat periodontitis or more advanced gum disease?

A deep cleaning is usually the intitial treatment for periodontitis. This may be done with a dentist, hygienist or with a perioddontist (gum specialist). The teeth and gums are made numb and a deep clean is carried out. Deep cleaning is more correctly called root debridement. Debridement of the roots is removal of the substrate on them. This is often done one corner of the mouth at a time, called a quadrant. The deep clean aims to remove plaque and tartar, and also to disturb the biofilm below the gum line. By then keeping this clean, it allows the body to heal and reduce the inflammation. The treatment aims to halt the damage process, rather than reverse it. In most cases, generalised damage cannot be reversed, but in certain cases, further surgery can repair the damaged bone support.

Changes in lifestyle, such as smoking cessation, will have a profound effect on treatment. Excellent oral hygiene is needed, to allow the inflammation to stop and for the healing to occur. Returning for a regular cleaning every three months then prevents the plaque and tartar extending below the gum again. The maintenance at home and regular recall is the most important part of treatment. There is no cure for gum disease, only management. This does not mean treatment is not worth doing, but more to emphasise the long term nature of the disease, similar to other chronic conditions like asthma or diabetes. If managed correctly, it should not impinge greatly on day to day life. If left untreated it can have a profound effect on your health, both oral health and general health.

How much does treatment cost?

Treatment cost depends on severity and how many sessions you will need. Each session for root debridement can cost $300. You may need 1-4 sessions. Your dentist will discuss the cost with you and you will get a quote prior to treatment. If specialist treatment is needed, we will make a referral for you and they will quote you for any treatment.

Can gum disease cause health problems?

Gum disease increases the amount of pathogenic (disease causing) bacteria in your mouth. This can act as a reservoir for the rest of your body. They can get into the blood stream affecting the heart and circulatory system. Those who have a heart attack with untreated gum disease are more likely for that to be fatal. The bacteria can be inhaled, so that you are at greater risk of respiratory disease. There are studies demonstrating improved control for diabetics who control their oral health. Pregnant women are more likely to have pre-term low weight births with active gum disease. With all these risks, it is clear to see why healthy gums are important not just for your mouth, but for your general health.