Prof Dr Christian Mehl
The classic progression of symptoms of periodontitis means that the gums swell, turn red and begin to bleed. Did you know that around 45% of people in the UK have periodontal disease? Did you also know that people within this group may also have it without knowing that they do so? Such an inconspicuous, painless disease is also known to have dire consequences. So, let us ask and answer this important question: just how can modern periodontal therapy treat this devastating condition?
Periodontal disease – posing a clear and present danger to the whole body
Please be aware that brushing teeth with a toothbrush only cleans around 60-70% of the surfaces of your teeth. For example, interdental spaces between the teeth or the molars in the back of the mouth are notoriously difficult to access easily and so clean effectively. Yet, these areas are exactly the places where bacteria accumulate and cause the metabolic products of plaque to attack teeth and gums over time. This process can lead to inflammation and the breakdown of the gums and the bones – the crucial initial defensive mechanisms of the body. If the bacteria get into the bloodstream, their presence increases the risk of strokes, heart attacks, and diabetes developing in the affected patient – and as most recent research suggests – can even bring on the onset of lung infections, too.
Is conventional or surgical therapy the best way forward?
To prevent this situation from happening, dentists will advise that their patients improve their current oral hygiene regime – both at home and by attending regular dental and hygienist appointments in clinic. Appointments with the dental hygienist for professional teeth cleaning means we can examine and clean every surface of the teeth and remove the plaque more effectively. As dentists, however, we know from our extensive professional experience that sometimes these measures are not enough to stop the bacteria from taking hold. Following a detailed diagnosis, the dentist can clarify whether conventional measures still promise a successful clinical outcome or whether the case has reached the point in its severity which means that surgical therapy is now necessary. As dentists, we need to satisfy ourselves that we know how severe the current level of bacteria accumulation now is within the mouth and just how loose the teeth have become, plus just how deep the gum pockets actually are. When we have this kind of accurate information to hand to answer clinical questions such as these, we will know if the periodontal disease is very advanced. If so, we will also know that at this point, conventional therapies will no longer help. It is now time to consider proceeding with periodontal surgery.
Just how does periodontal surgery work?
As dentists we know and appreciate that a periodontal surgery must be well planned and co-ordinated according to the exact needs of the individual patient case, as presented, on this occasion. We also know that sometimes, the therapy we propose need to be extended over several sessions in order to achieve the best possible clinical results in a particular situation.
Rest assured, that before such a periodontal surgery begins, and in order to ensure that the procedure is largely painless, the dentist will numb the affected areas which are to be treated with local anaesthetic. The micro-surgical operating techniques we deploy allows for the gentle opening of the gums and the complete cleaning of the tooth roots. Thanks to special laboratory tests which we have at our disposal, the bacteria can be identified and specifically treated with effective antibiotics.
Please note that there are occasions which arise when we find that not only the gums but also the bones are now affected by periodontitis. To counteract such bone loss, the dentist rebuilds tissue that has receded as a result with the use of bone replacement material (see also the article about Guided Tissue Regeneration). Please also note that, contrary to many hopeful opinions, it is unfortunately only possible to regain bone on periodontally damaged teeth on a very limited basis. Be reassured though, that on the completion of each periodontal surgery treatment session, most of the bacteria should have been removed with a view that, subsequently, the teeth should become more stable over time.
Periodontal plastic surgery may be the best way to achieve beautiful gums
For affected patients, the consequence of severe periodontal disease means that not only damage is caused to their general oral health but that it can also affect the aesthetics of their teeth and gums. So, for such patients who dislike the long exposed necks in between their teeth we can offer the option of proceeding with plastic periodontal surgery. This way, we can restore their personal comfort and confidence in the foundation of their renewed smile – their now beautiful gums.
Affected patients may be discomforted by the fact that the recession of the gums not only makes their teeth appear longer, but also ensures that their gum line runs irregularly. This impression of the current aesthetic situation is reinforced when the papillae (the gum tissue residing in the spaces between the teeth) itself disappears, leaving behind the so-called “black triangles”. To remedy this loss, the dentist can try to cover such irregularities with small pieces of tissue from other regions of the oral mucosa (or membrane), mostly obtained from the palate or use small fillings to reduce or eliminate the black triangle.
With periodontal plastic surgery, not only have the health risks associated with severe periodontal disease been reduced or eliminated, but also the aesthetic side effects of this condition have, too. As dentists we recommend that a commitment to practising a thorough oral hygiene regime at home, complemented by regular dental and hygienist appointments in clinic, ensures that no new infection develops and that the teeth stay healthy. We know that severe periodontitis is treatable in most cases and that there are a set of effective therapy steps as outlined above which can be taken by your expert dental team (with your consent) to remedy such as a serious oral health and indeed general health situation. If this is a concern for you, contact us today.
|Non-surgical deep scaling per jaw||from £600|
|Surgical deep scaling and root planing per jaw||from £900|
|Aesthetic periodontal surgery||from £1,200|
|Lateral repositioned flap to cover recessions||from £800|
|Vertical repositioned flap to cover recessions||from £1,200|
|Periodontal regeneration||from £1,200|
|Gingival graft (attached gingiva)||from £800|
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When the sensitivity and swelling finally subsides, you can feel confident and comfortable about your own smile again.