Periodontal Treatment

What Is Gum Disease?

Also known as gingivitis, gum disease occurs when bacterial plaque colonises and invades the gum, causing inflammation of the gums around the tooth. The gums begin to pull away from the tooth, forming gum pockets of infection. As the infection progresses below the gumline, the body sends its natural defences to fight it, causing the breakdown of bone in the process.

Eventually, without treatment, gum disease will progress to bone disease, slowly breaking down bone to the point that the affected teeth become mobile and require extraction.

There are risk factors, such as smoking, genetic predisposition, poor brushing and the lack of flossing habits that can place you at higher risk. It can indiscriminately affect all age groups, but older generations suffer more, as gum disease does not always hurt in its early stages.

That is why early detection of gum disease is paramount. Common symptoms of gum disease include bad breath, loose and sensitive teeth, redness, swelling, and bleeding, etc.

What is Gum Brushing?

It is important to know that bacterial plaque accumulates and builds up around the lower part of our teeth just above the gum first before it spreads onto the teeth above and the bone below. It is, therefore, logical to target cleaning at the original sites where bacteria begin to establish, i.e., at the gumline.

At CFS Dental, Dr Ng always stresses the utmost importance to clean the gums around and between the teeth, and not the teeth alone. If this is done correctly, the plaque is removed before it has a chance to spread over the teeth. Conversely, if only the teeth are brushed, the plaque will be left behind, stuck to the gums and the lower part of the teeth. This is the basis of the concept of gum­ brushing.

What Is My Role in Treatment?

It’s important for patients to support their periodontal treatments at home by regular cleaning of the gums, and in­-between the teeth, with a fluoride toothpaste and proper flossing.

If deep cleaning and medication do not resolve the periodontal disease, your dentist may recommend surgical procedures. During this procedure, the dentist will pull back the gums to clean deep periodontal pockets and remove all traces of tartar. The gums are then tightly sutured around the tooth at a lower level to make the area easier to keep clean.

What Does Periodontic Treatment Entail?

Gum disease treatments work to eradicate infection, remove the bacterial deposits above and below the gum line and control damage done to gum and bone disease, i.e. periodontal disease. Once your dentist gives you a diagnosis of periodontal disease, most treatments begin with deep cleaning called scaling and root planing.

The scaling portion of the procedure removes the accumulated tartar from above and below the gum line through scraping with specialised scalers.

Root planing then smooths the affected root surfaces, making it more difficult for germs and bacteria to adhere. This promotes the repair of the gums and renders the teeth easier to keep clean.

After scaling and root planing, you may be prescribed medication to help fight the infection and reduce bacterial plaque and the size of the periodontal pockets around the tooth.

'Brushing teeth is, therefore, such a misnomer because it is all tooth­-centred and does not effectively remove plaque, which lives on tooth surfaces closest to the gumline. I prefer a more effective gum-centred approach i.e. brushing gums and teeth instead. Yes, we are a little cheeky and play on words, calling the ubiquitous tooth­-brush a gum-­brush. It is a challenging concept, but I hope it makes sense. That is why flossing is such an integral and essential part of good oral hygiene maintenance, as it removes plaque hidden in the gum spaces between the teeth.'- Dr Ng