Non-surgical treatment of Periodontitis

Periodontics is the specific aspect of dentistry that studies the supporting structures of the teeth and the diseases that affect them.

The supporting structures or tissues are collectively known as the periodontium which comprises of the gums (or gingiva), cementum (a thin layer of cells covering the tooth root), alveolar bone and periodontal ligament (this binds the tooth root to the bone).

Chronic periodontitis (‘gum disease’) represents a major health problem. Surveys show that more than 50% of the population currently experiences some degree of damage to bone or the soft tissues supporting the teeth. Approximately 10-15% of the population will lose a significant number of teeth as a result of chronic periodontitis: the more susceptible the patient, the more rapidly the bone loss progresses. Genetics, diabetes, smoking, stress, obesity and harmful oral bacteria make patients more susceptible for developing gum disease. In addition, around 1% of the population is susceptible to the more aggressive forms of periodontitis. These patients can present with advanced levels of attachment (bone) loss and pocketing at a young age. Although many patients do not immediately link their symptoms with gum disease, patients will eventually report concerns with bleeding gums, spaces opening between teeth,  loose teeth,  halitosis (bad breath) or discomfort when eating, all of which are associated with periodontitis. Early diagnosis is essential  for periodontitis in order both to simplify treatment and improve the long term prognosis and prevent tooth loss. Untreated gum disease can also increase your risk of serious health problems such as heart attack, stroke, poorly controlled diabetes  low birthweight babies and preterm labor. There are also links reported to health problems like Alzheimers, Parkinsons, erectile dysfunction, liver disease and kidney diseases.

Treatment of chronic periodontitis is highly successful in keeping teeth and improving both comfort and confidence. The treatment of periodontitis also lowers the risk of developing health problems related to periodontitis. Non-surgical therapy is the foundation of periodontal care. This entails thorough cleaning of the teeth and tooth roots affected by disease by removing bacteria and disrupting the biofilm. Effective self-care oral hygiene is the main key to success and we can help by equipping patients with skills and building their motivation and confidence to achieve this. Meticulous professional cleaning of the root surface (deep cleanings and root planing) will lead to improvements in periodontal health. A recent audit of non-surgical care done in the UK demonstrated that 68% of initially deep pockets responded well to just one course of treatment. For severe periodontitis antibiotics is often used together with deep cleanings and root planning.