Periodontology

Periodontal diseases are inflammatory conditions affecting the gums and other tissues supporting the teeth. The original clinic text attributes 70% of adult tooth loss to periodontal disease and describes the benefits of early diagnosis and treatment. Disease begins with gingivitis, which affects the gums and can cause bleeding, redness and swelling. Treatment can resolve the inflammation. Without treatment it may progress to periodontitis and cause irreversible damage to the gums and supporting tissues. As disease advances, teeth may become loose and require extraction.

Symptoms of gum disease:

• Bleeding gums during brushing or spontaneously
• Red, swollen and tender gums
• Bad breath
• Gum recession
• Gums that pull away from the teeth
• Discharge between the teeth and gums
• Teeth that become loose or progressively move apart, creating new gaps or widening existing gaps
• Changes in the way upper and lower teeth meet when biting
• Changes in the fit of an existing denture may also indicate a problem with gum health.

The first stage of gum treatment is initial periodontal therapy, including scaling. Tooth and root surfaces are cleaned, oral hygiene guidance is provided, the bite is assessed and areas retaining food and microorganisms, such as decay or wisdom tooth problems, are addressed. The aim is to reduce or eliminate gum inflammation and remove the microorganisms causing it.

If tissues do not heal as expected after initial therapy, inflamed tissue and deposits below the gums may be removed under local anaesthesia. Where disease is more advanced and non-surgical treatment is insufficient, periodontal surgery may be considered. Surgery aims to stop progression and create conditions that allow effective plaque control. Following local anaesthesia, the gum is lifted to expose the roots and bone; inflamed tissues are removed, roots are smoothed and necessary bone correction is performed. In suitable cases with bone loss, grafts, membranes or tissue-stimulating proteins may be used to support regeneration. Other procedures aim to provide adequate attached gum tissue, treat recession or deepen the vestibule, sometimes transferring tissue from the palate to the treatment area.