What is periodontal (gum) disease?
Periodontal Disease is stated to be the sixth most prevalent condition in the world, affecting 743 million people globally. It is a condition that can affect people of any age and one which typically progresses silently due to its initially painless nature. If allowed to progress undetected and untreated, bone which supports your teeth is gradually destroyed, reducing their overall support. This ultimately leads to teeth drifting, becoming wobbly and finally, tooth loss. Dental implants can also be affected by gum disease.
Who should treat gum disease?
Initial treatment for gum disease can be provided by general dental practitioners and dental hygienists. However, more complex conditions may require input from practitioners with enhanced skill-sets or specialist expertise, known as Periodontists. The British Society of Periodontology outlines instances where referral of patients may be indicated.
- Patients with severe (> 50% horizontal bone loss) periodontitis, aggressive periodontitis and true pocketing of 6mm or more
- Patients requiring periodontal surgery
- Patients who present with furcation defects and other complex root morphologies
- Patients who have not responded to initial treatment with their dentist/hygienist.
- Patients who present with non-plaque induced periodontal diseases including periodontal manifestations of systemic diseases
- Patients with a medical history that significantly affects treatment
- Patients who require co-ordinated multi-specialist medical and/or dental care.
Who provides complex periodontal care at Wayside?
Dr Mitul Shah is currently a Specialist Registrar at Guy’s Hospital in the department of Periodontology. Additionally, he is the current Monospeciality Representative of the British Society of Periodontology Early Career Group. He is due to complete his training in the summer of 2019 and to then enter the GDC Specialist Register.
Do I have to be a registered patient of the practice to have gum therapy?
No, we are happy to accept all patients for an extensive consultation. You may contact the practice directly or ask your normal dental practitioner to refer you to Dr Shah.
What would happen at your first appointment?
The consultation begins with a thorough examination of your teeth and gums. This includes the measurement of “pockets” which allow us to quantify the severity of disease as well as to serve as a baseline recording, so we can assess future changes. Following this, digital x-rays are taken to examine the level of bone around your teeth, as well as any other dental issues such as infections or decay.
We then have an extensive discussion about the current status of your teeth and gums as well as which treatment option is the best for you. A detailed clinical report is written and sent to you via email or in the post. This outlines a personalised treatment plan which takes into consideration your priorities and concerns. Your referring dentist will also be sent a copy of this report. The costs of the recommended treatment are outlined in the report and reflect the high-quality and bespoke treatment that we can offer. We are happy to discuss any aspects of the report with you and answer any questions that you may have.
What causes gum disease?
Approximately 10-15% of the population are highly susceptible to suffering from gum disease. Conversely 10-15% of the population may be somewhat resistant to gum disease. The remainder of the population have the potential to develop gum disease. The main factors that are associated with the development of gum disease are listed below;
- Genetic Susceptibility
- Certain medications
- Poorly controlled Diabetes
- Poor nutrition
- Poor oral hygiene
- Other systemic diseases
What is unique about Wayside Dental Practice?
Wayside dental practice offers the latest advancements in dentistry which allow us to do all we can to treat even the most complex gum conditions. This includes the use of micro-surgical equipment, which allows us to provide minimally invasive surgical procedures, reducing pain and healing time after surgery. We additionally utilise lasers to clean teeth and when performing certain surgical procedures. Lasers can help us to clean hard to reach areas that conventional equipment may be unable to manage effectively. Lasers may also promote favourable wound healing and clinical improvements over conventional techniques.
What can treatment offer me?
- A renewed confidence in your smile
- Fresher breath
- Avoiding tooth loss
- Improved ability to chew food
With the right expertise periodontal disease is a treatable condition. You do not need to resign yourself to tooth loss as an inevitability or simply as a consequence of aging. Treating periodontal disease is an investment in your own health and the benefits of treating gum disease outweigh the costs of replacing lost teeth.
What does the treatment entail?
Treatment is usually split into three systematic phases:
1. Hygienic Phase
This initial phase is aimed at arresting the progression of gum disease, as well as controlling and modifying any risk factors that may be contributing to the gum disease. You will be given small recommendations of how to alter your day to day cleaning habits to improve the effectiveness of your oral hygiene. Teeth will be meticulously cleaned to remove bacterial deposits that may have formed beneath your gums. This is typically performed under local anaesthetic by either a dental hygienist or Dr Shah. We can utilise the latest technologies such as dental lasers to thoroughly clean the toughest areas that the usual equipment may struggle to deal with.
You may experience a small amount of discomfort lasting a few days which may require the use of pain-killers. There is often a short-term increase in tooth sensitivity which can be managed with special toothpastes or varnishes that the dentist can apply. You can experience slight shrinkage of the tissues which is known as recession. This is a normal side-effect of gum treatment and a sign that the gums are returning to health. In the event the recession is anticipated to have an impact on your smile you will be informed of this as well as different means of managing your personal circumstances.
For many people this initial phase and long-term ‘maintenance’ therapy may be sufficient in controlling the disease. However, for many with advanced gum disease and persistent deep pockets a second phase of treatment may be required.
2. Corrective (Surgical) Phase
This phase of treatment aims at treating the areas which have not resolved following the initial therapy. The exact decision on the type of treatment that may be required to manage these areas will be discussed in detail with you during a review appointment. The time between the hygienic phase and the surgical phase can vary from 2-6 months depending on your personal circumstances.
The aim of any gum surgery is to reduce any residual deep pockets and to improve your ability to clean your teeth. We aim to make all surgery minimally invasive- adapting treatment to your own needs with a view to promoting a quick recovery.
Upon completion of periodontal therapy, we can consider cosmetic improvements to your smile and the definitive replacement of missing teeth. This may even include the provision of dental implants.
3. Maintenance phase
This phase serves to ensure there is no deterioration or relapse in your gum condition and that health is maintained. It typically involves the periodic checking of the pockets and thorough cleaning and polishing of your teeth. This is typically carried out by one of our dental hygienists. It may be recommended that you continue to see Dr Shah for regular review appointments.
If you would like to book a consultation, or have any further questions, please contact our reception staff who will be happy to arrange this.
Mr Mitul Shah
Speciality Registrar in Periodontology
National Training Number – THS/068/607/D
Great Maze Pond