Gum Disease Care (Periodontics).
Periodontics is the mono-specialty which is involved in the assessment and management of diseases and disorders of the structures which support and retain the teeth. Commonly, this is known as gum disease, which is characterised by swelling, inflammation and bleeding of the gums, with the teeth becoming mobile and on occasion painful as disease progresses. Commonly, periodontal treatment includes a supportive continuum comprising of patient education to optimise plaque control and through cleaning of the tooth surfaces both above and below the gum. In some cases a surgical approach can be beneficial. Some recent cases can be found below.
Case 1.
This gentleman attended complaining of significant discomfort from his gums, which bled readily. He was becoming increasingly aware of the mobility of his teeth, especially his front ones, and was concerned that once lost, he would struggle to smile and eat. As can be seen in the photographs, the gums were very red and swollen, with generalised deposits on and around the teeth. The care of patients with gum disease can only be successful when a synergistic team approach is embraced. This gentleman was given intensive and highly customised oral hygiene education as well as brushes which could be used to target the most difficult to reach sites. Once we had supported his oral hygiene efforts and there was a good standard of plaque control, the teeth and their roots were debrided to remove any hard deposits and reduce the localised irritation and inflammation. Due to the extensive nature of his gum disease, a number of root canal treatments became necessary, and one tooth was lost. It is important to emphasise that gum disease can not be cured, but can be controlled thereby reducing, and in some cases mitigating the chances of losing teeth.
Case 2.
This lady attended having previously suffered from gum disease. Due to the destructive nature of gum disease, the attachment of the teeth to the jaw bone becomes compromised. When gum disease is successfully treated, the two commonest outcomes, apart from the bleeding reducing or stopping, is recession and sensitivity. While the sensitivity can often be controlled, management of the recession can be addressed surgically or prosthetically. The lady above attended having suffered considerable recession around her crowns when her gum disease was treated. Due to the extensive number of crowns which she had, and the severity of her recession, a periodontal veneer was provided which could be inserted and removed by the lady to improve the appearance of her teeth. She was delighted with the outcome, not least as she avoided replacement of all of her crowns and potentially complex surgery.