Gum Disease

What is Periodontal Disease?

There are a wide range of diseases affecting the gums, which are grouped under the general heading of periodontal disease. All of these conditions are treated by the BCPI team. They include:

• Gingivitis
• Chronic Periodontitis
• Aggressive Periodontitis
• Periodontitis as a Manifestation of Systemic Diseases
• Necrotizing Periodontal Diseases

What is Gingivitis?

Gingivitis is the mildest and most common form of periodontal disease. Less than optimal oral hygiene causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Bleeding gums are a sign of disease, healthy gums do not bleed. Gingivitis is reversible with professional treatment and good regular oral care at home.

What is Chronic Periodontitis?

This chronic inflammatory process results from one of the most common infections in humans. It is not usually painful and effects at least 20% of the adult population. When the inflammation of gingivitis is unable to be controlled the disease progresses to Periodontitis. The result is loss of the supporting structures around the teeth (gum and bone) which causes the formation of pockets and or recession of the gums. If untreated it may result in the loss of teeth. With appropriate professional and home care the condition can usually be stabilised.

What is Aggressive Periodontitis?

This is a rare but severe form of periodontitis which frequently (but not exclusively) begins in early adult life and untreated can result in the loss of many or all of the teeth. It occurs in patients who are otherwise clinically healthy. Common features include rapid loss of attachment for the teeth and bone destruction and it may occur in more than one member of a family. It is a very difficult condition to manage and such cases should be treated by periodontists. The Team at BCPI are experienced in treating this difficult form of periodontitis.

What is Periodontitis as a manifestation of Systemic Diseases?

A large number of systemic diseases can affect the gums including diabetes, leukaemias and HIV infection. In some conditions the gum condition may also play a role in the systemic condition. It is recommended that patients with these conditions should have specialist periodontal input into their management.

What are Necrotizing Periodontal Diseases?

This is a small group of painful conditions that may result in significant loss of gum tissue and sometimes the underlying bone. It may result in permanent loss of support for the teeth and compromised aesthetics. They are most often seen in young adult smokers particularly at times of stress but may also be associated with HIV infection and immunosuppression.

What causes periodontal disease?

The main cause of periodontal disease is bacterial plaque, a sticky colourless film that constantly forms on your teeth. It needs to be constantly removed to ensure the proper balance between the bacterial assault and the body’s response. In addition there are a number of factors which may also have detrimental effects on the health of your gums.

• Smoking/Tobacco Use
• Diabetes
• Genetics
• Medications
• Pregnancy and Puberty
• Poor Nutrition
• Stress
• Other Systemic Diseases

How does Gum Disease affect your health?

It has long been understood that a number of systemic health conditions can have detrimental effects on gum health. In recent times, there has been an increasing body of evidence suggesting an association between gum disease and poor general health. The nature of these associations is unclear. It may be that the systemic condition is caused (at least in part) by the gum disease or it may be that having gum disease is just a marker for increased risk of also having a systemic illness. Studies into these areas are ongoing. At this point there is insufficient evidence to suggest that, treatment of periodontal (gum) diseases will reduce the risk of systemic conditions. However, it is not unreasonable to expect that a large area of persistent inflammation (as often found in untreated gum disease) is likely to have some systemic consequences. There is no evidence that treatment of periodontal diseases results in any increased risk of developing systemic disease. Some of the systemic conditions associated with periodontal diseases include:

• Atherosclerosis (Heart Disease and some Strokes)
• Diabetes
• Preterm low-birth-weight babies
• Rheumatoid arthritis
• Respiratory Diseases

The BCPI team are always working to keep you up to date with the latest findings in this area.

How is Periodontal Disease treated?

There are a range of proven treatments for periodontal disease. All of these are available at BCPI and your periodontist will recommend the most appropriate treatment for your case. Not all treatments are applicable for every patient. Commonly non-surgical treatment involving thorough debridement (cleaning) of the tooth root surfaces will be undertaken often over a number of appointments. In some cases periodontal surgery may be required to gain adequate access to the root surfaces. Periodontal surgery is necessary when your periodontist determines that the tissue around your teeth is unhealthy and cannot be repaired with non-surgical treatment. A range of surgical treatments may be available to achieve a number of aims. Commonly surgery may be undertaken to:

• Gain access to the root surfaces
• Reduce the depth of periodontal pockets
• Regenerate lost periodontal attachment
• Increase the amount of tooth above the gum for restorative procedures
• Graft tissue into areas where disease has result in loss of gum tissue.

Systemic antibiotics may sometimes be indicated as a adjunctive treatment and dental implants may be an option when teeth have been lost.