Periodontics is a branch of treatment more commonly known as Gum Treatment.
Periodontics, or Periodontology, is the dental specialty dealing with periodontal (gum) disease. Periodontal disease is caused by bacteria in dental plaque – the sticky white gelatinous material that continually builds up on the teeth. The bacteria cause inflammation of the surrounding tissues, which can have two consequences:
All ages can be affected by periodontal disease but chronic periodontitis normally only affects adults. The most common cause, though not the whole story, is inadequate oral hygiene. This results is the accumulation of plaque around teeth and allows the initiation or progression of periodontal disease. If plaque is left on the surface of the tooth for some time, it can start to mineralise and form calculus (‘tartar’) – this is a hard material and cannot be easily brushed off, but bacteria are still present within it and can cause continued inflammation. There would appear to be some genetic susceptibility to periodontal disease – some people seem much more prone to the condition whereas others are very resistant. Other factors which can increase the risk of disease include:
Diagnosis of the problem is an important first step and early diagnosis can lead to the best treatment outcome. Clinical examination can reveal whether the gums are healthy or diseased by their appearance, whether they bleed easily on gentle probing and if there are any periodontal pockets, indicating that the gums have become detached from their normal position against the tooth and bone had been lost. X-rays are a useful adjunct and can show more clearly the amount and pattern of bone loss around a tooth or teeth.
If the gums are inflamed but there has been no loss of the supporting bone i.e. the condition is gingivitis only, this can usually be easily treated by careful removal of plaque and calculus by the dentist or dental hygienist, followed by regular and thorough plaque removal at home by brushing and flossing. The gums would then normally be expected to be back to good health after a couple of weeks. Thereafter it is important that good oral hygiene is maintained together with regular visits to the dental hygienist (the frequency tailored to suit your individual requirements) to maintain the health of the gums and prevent future problems.
If there has been loss of the supporting bone around teeth, a careful record should be made of the extent of this – usually by measuring the depths of pockets with a measuring probe. This will help determine the extent of the problem and hence the treatment needed, and give a baseline record for later comparison to check the response to treatment. Treatment is again aimed at thorough removal of plaque and calculus, though this may be more difficult where pockets are present as the deposits will be on the root surface underneath the gum. A local anaesthetic is sometimes needed for this procedure. If there is generalised periodontitis throughout the mouth, a number of treatment sessions may be required to make sure treatment is thorough and the best conditions are in place for good healing. For advanced forms of periodontitis, gum surgery may be needed to obtain sufficient access to clean the roots of the teeth. The goals of treatment are to arrest the progression of the disease and create a stable gum situation which is easily maintained, though it is unusual for new bone to grow back around teeth. Maintenance of good health of the gums is again of great importance following treatment to prevent relapse.
If you have been asked to see our Specialist in Periodontics, this is because it is felt your particular gum problem needs the attention of an expert. The specialist is the best person to make an accurate assessment of the level of disease in your mouth, discuss the most appropriate treatment and either carry out the treatment herself or make a treatment plan for the dental hygienist to follow.