Periodontal Disease

As defined by the British Society of Periodontology, it commonly begins as gingivitis, which is the reversible inflammation of the gums. Early signs include red, swollen gums that may bleed during brushing or flossing.

While gingivitis is completely reversible, if not treated, it can progress to periodontitis. This is a more severe form of gum disease involving the breakdown of the gum attachment around the teeth, destruction of the supporting bone, and can eventually lead to tooth loss. Plaque, a biofilm of bacteria, is the key cause, but risk factors such as smoking, diabetes, stress, and genetic predisposition increase susceptibility and severity.

The British Society of Periodontology emphasises prevention through a strong oral hygiene routine: brushing twice daily with fluoride toothpaste, cleaning between the teeth (interdental brushes, toothpicks or floss), and regular dental check-ups and professional cleanings. Prompt intervention and ongoing maintenance are essential to arrest disease progression and maintain healthy gums and teeth.

It can be difficult to persuade patients that treatment is necessary to slow down disease progression when the disease is diagnosed early because unfortunately, most patients are unaware if they are suffering from periodontitis as it often has no symptoms.  It is rarely painful and there are few signs visible to patients until the disease is relatively well established. At that point, patients may become aware of swollen bleeding gums, a foul taste or smell (despite regular cleaning), loose teeth, or movement of the teeth causing them to become spaced or misaligned. 

The mainstay of the management of gum disease is to identify the main exacerbating factors. We are very keen to show patients how to clean their teeth in a way that is effective and tailored to the individual as this leads to the most consistent improvement. If you smoke, giving up is probably the single most effective thing you can do to slow down disease progression alongside a tailored oral hygiene programme. Alongside this, the effectiveness of home cleaning is the most influential factor in successful management of the disease.

Management in the Practice involves a thorough assessment of every tooth. Each tooth can then be given the individual treatment it needs. Treatment typically involves deep cleaning under the gum, usually under local anaesthetic. This is followed by reassessment at which time further treatment or maintenance recommendations are made.

It is important to remember that periodontal disease is a chronic condition that cannot be cured. With the correct care both at home and in the dental surgery, it is possible to slow the disease process right down but commitment to long-term maintenance is essential. If you have concerns about your gum health, or you have a close family member with periodontitis, please discuss this with your dentist so that you can be correctly assessed.