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Periodontists specialise in treating diseases that affect the gums and bones that support the teeth.

Periodontal disease (also known as gum disease) is a chronic inflammatory condition in which plaque bacteria accumulate below the gum line. Eventually, this inflammatory response to bacteria can lead to erosion of gum tissue and supporting bone. If left untreated, periodontal disease can lead to tooth loss.

Types of Gum Disease

Gingivitis

There are two main types of gum disease – the mildest is gingivitis (inflammation of the gums). The most common symptoms of gingivitis are:

  • Red or swollen gums.
  • Bleeding when brushing.

Gingivitis is reversible and is most often caused by inadequate oral hygiene. With the help of your dentist and/or hygienist you can adapt your cleaning regime to restore your gums to a healthy state.

Periodontitis

If left untreated, gingivitis can advance to periodontitis – this is irreversible. Over time bacteria, plaque, and tartar left on the tooth surfaces can spread below the gumline. This bacteria causes a chronic (long-term) inflammatory response. Without periodontal treatment, this inflammatory response leads to eventual tooth loss.

Inflammatory Response

Stage 1 – Healthy Gums – Light pink and firm.

Stage 2 – Gingivitis – Swollen and reddened gums that bleed easily.

Stage 3 – Mild Periodontitis – Some deeper pocketing with mild bone loss.

Stage 4 – Moderate Periodontitis – Loose gums and significant bone loss visible.

Stage 5 – Severe Periodontitis – Extensive bone loss and mobile (wobbly) teeth.

Symptoms of Periodontal Disease

Periodontal disease is often silent and symptoms may not appear until an advanced stage of the disease. Signs and symptoms of periodontal diseases are:

  • Red, swollen or tender gums.
  • Bleeding gums while brushing, flossing, or eating.
  • Receding gums.
  • Loose teeth.
  • Pus between gums and teeth.
  • Sores in the mouth.
  • Persistent bad breath.
  • Shifting teeth.
  • Gaps between teeth.

How can periodontal (gum) health be established?

Phase 1: Periodontal assessment and treatment planning.

Periodontal (gum) health will be examined thoroughly with measurements and x-rays to produce a bespoke treatment plan. Measurements are taken to determine the size of any gingival pockets. X-rays are taken to determine the extent of any bone loss. The clinical and radiographic findings will be explained and then treatment options will be discussed.

Phase 2: Non-surgical periodontal treatment.

Deep cleaning, also known as non-surgical periodontal therapy, is a non-invasive measure of preventing the progression of periodontal disease. A deep cleaning goes beneath the gum line to remove plaque, bacteria and other toxins from areas that brushing and flossing cannot reach, reducing the risk of disease advancement. Oral antibiotics, as well as antimicrobial mouth rinses, can be used short-term, if needed, to control bacteria and treat the periodontal infection.

Phase 3: Periodontal re-assessment.

At this stage, the response to the treatment will be assessed. Clinical examination is performed as it was performed during the initial consultation in order to determine if further treatment is necessary.

Phase 4: Surgical periodontal treatment.

If inflammation and deep pockets are present after non-surgical periodontal treatment (deep cleaning), regenerative procedures or bone grafting may be recommended to minimize the depth of the pockets and therefore reduce the risk of further disease progression and tooth loss.

Phase 5: Periodontal maintenance.

If non-surgical periodontal treatment (deep cleaning) has led to reduction of all deep pockets, a maintenance phase and thorough check-ups on your teeth and gums will occur every few months or so to ensure the stability of your periodontal (gum) health.

Advanced Periodontal Treatments

Gum Contouring

If your teeth appear short, you may have asked your periodontist about procedures to improve a “gummy” smile. There may be no problem with the length of your teeth, but they’re covered with too much gum tissue. This can be fixed by a dental crown lengthening procedure performed by your periodontist.
By reshaping excess gum tissue and bone tissue, the dental crown lengthening procedure reveals more of the natural tooth. This can be done to one tooth, to even out your gum line, or to several teeth to create a wide, natural-looking smile.

Gum grafts

Gum recession – from age or periodontal disease – leads to exposed tooth roots. Gum grafting surgery will repair the defect and help prevent further recession and bone loss.

Grafts can be used to cover roots or to restore gum tissue where it has been lost due to excessive gingival recession. A gum graft is a surgical procedure in which your periodontist uses gum tissue from your palate to cover an exposed root. It can be done for one tooth or several teeth to even your gum line and reduce sensitivity.

Benefits of gum graft surgery

Gum grafts can help prevent further bone loss and recession. In some cases, they can cover exposed roots to protect them from decay. This may also reduce tooth sensitivity and improve the appearance of your smile. If you have a gum graft to improve function or aesthetics, you will often gain two benefits: a beautiful new smile and better periodontal health – your keys to smiling, eating, and speaking with confidence.

Laser Therapy

Laser treatment does not replace traditional therapies but works alongside them. Periodontists use lasers for periodontal laser therapy to remove inflamed gum tissue from around the roots of teeth. Tartar and plaque are then removed from below and around your gums. An additional tool is used to smooth out any rough spots above and below the gumline. By eliminating these rough spots, you reduce the likelihood that your teeth and gums will attract bacteria and become infected in the future.

Benefits of Laser Therapy

The four main advantages of using laser therapy to treat gum disease are as follows:

  • Shorter recovery and healing times.
  • Laser therapy can be done under local anaesthetic.
  • Lasers can accurately and precisely target diseased areas.
  • Laser periodontal therapy is less invasive than regular surgery, so there is less bleeding, discomfort, and swelling.

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Dr Olga Argyros

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