Patients Guide to Periodontal Gum Disease Eltham

What is Periodontal (gum) Disease?

Periodontal disease is a condition which effects the supporting structures of the teeth (gum and bone).
It happens when irreversible destruction has occurred to these structures (gum and bone), and if left untreated can eventually lead to tooth loss.

What causes Periodontal Disease?

The main cause of periodontal disease is dental plaque, hence the importance of the removal of plaque through brushing twice a day and by carrying out interdental cleaning of the teeth.
Dental plaque is the sticky invisible film which grows on our teeth every day, which if left, turns into calculus/tartar (hardened plaque). The plaque contains bacteria that release harmful toxins, which can cause irreversible damage of the supporting structures.
When the damage occurs a ‘pocket’ is formed, due to the loss of supporting structures around the tooth. As the gum disease continues, so does bone loss. When sufficient bone has been lost the tooth loosens and either falls out or is removed.
Other factors which can cause periodontal disease include smoking, diabetes, medications (blood pressure medications), pregnancy and plaque retentive factors such as crowns/bridges which no longer fit.

How is Periodontal Disease detected?

Your Dentist/Dental Hygienist will check the gum health by dividing your mouth into 6 areas, and gives each area a score between of 0-4.

SCORE	What does this mean?	Treatment required
0	No bleeding No plaque or calculus/tartar No pocket	No treatment needed
1	Bleeding Plaque No pocket	Oral hygiene advice
2	Bleeding Plaque and calculus/tartar No pocket	Oral hygiene advice Referral to hygienist for scaling
3	Bleeding Plaque and calculus/tartar Plaque retentive factor Pocket measured between 3.5-5.5mm	Oral hygiene advice Referral to hygienist for periodontal treatment
4	Bleeding Plaque and calculus/tartar Plaque retentive factor Pocket more than 5.5mm	Oral hygiene advice Referral to hygienist for periodontal treatment

Periodontal Treatment required for patients with scores 3 and 4:

The aim of the treatment discussed below is to stabilise and prevent any further progression of the periodontal disease.

Any current damage of supporting structures of teeth cannot be regrown.

Plaque is the main cause of periodontal disease, hence the importance of its removal through excellent brushing technique and interdental cleaning technique of the patient.

Please see below the treatment plan:

Session 1 (30 min)	Removal of plaque and calculus Intense oral hygiene advice – brushing technique and interdental cleaning tips
Session 2 (30 min)	Full mouth recording of pockets – baseline for ongoing treatment Any further oral hygiene advice required
Session 3 (1 hour)	For patients with scores of 3: Whole mouth deeper cleaning underneath the gums using ultrasonic scaler and hand instruments For patients with scores of 4: 1st half mouth deeper cleaning with local anaesthetic underneath the gums using ultrasonic scaler and hand instruments
Session 4 (1 hour)	For patients with scores of 4: 2nd half mouth deeper cleaning with local anaesthetic underneath gums using ultrasonic scaler and hand instruments
Session 5 (30 min)	3 months after deeper cleaning carried out Full mouth reassessment of pockets If treatment successful: placed onto maintenance phase – hygienist appointments every 3 months and full mouth pocket recordings once per year If little or no response to treatment: referral to a specialist discussed

Possible treatment side effects:

Gum recession
Sensitivity
Infection