How did I get periodontal disease?
Periodontal disease is not contagious and is not a condition you can catch from another person. The condition also known as gum disease (loosening of teeth) is not even caused by decayed teeth, and even healthy teeth can be affected. The disease often starts between the teeth where cleaning is more difficult. Bacteria can multiply and spread between teeth and gums and eventually if left untreated can damage the root attachments and supporting structures of the teeth. Gum disease is progressive and will eventually develop into a chronic condition if not taken care of properly. You can see the diagnosis and images of gum disease by following this link. Fortunately if the periodontal disease is treated early enough then it can be cured and your gums returned to a healthy condition. Be warned that periodontal diseases are painless until it is almost too late to save teeth.
The goals of non surgical periodontal treatment
The overall aim of non-surgical treatment is to create an environment in the mouth that is healthy and can benefit the healing of periodontal tissues. The disease may have progressed into a number of distinct stages that can be diagnosed by a periodontist who uses various methods, one of which is the Florida Probe System. The periodontist will use a probe to measure the periodontal pockets between the teeth, and if the condition has not advanced too far then a non surgical treatment plan can be adopted. The patient has an important role to play, and must maintain good oral hygiene through the treatment. The main goal then is to eliminate biofilm and bacteria that are the cause of the periodontal infections. The patient can go some way towards removing the bacteria by regular brushing, flossing and rinsing with mouthwash. However in some cases when the periodontal pockets are too deep the patient cannot access the entire depth of the pocket during cleaning, this will leave undisturbed bacteria and biofilm that is likely to cause a re-infection. A dental hygienist is most likely to achieve full decontamination and remove toxins and calculus from the tooth root surfaces by employing skilled technique through various mechanical and chemical treatments. The patient’s response to non-surgical therapy is closely monitored and if periodontal problems persist further treatment may be required to avoid eventual tooth loss.
Taking care of your personal oral hygiene is the first step towards a cure
Patient homecare, plaque control programmes and hygiene phase therapy are all important components of non surgical periodontal treatments. The treatment plan will be individual to the patient’s needs and stage of the periodontal condition. As well as the treatment provided at the clinic, the patient must understand that they play a key role in the management or cure of their gum disease. This often means changes in attitude and cleaning techniques to achieve high standards of homecare oral hygiene. The primary consideration for patients is the general removal and control of plaque. Dental plaque is usually a pale yellow colour and develops naturally on the teeth, it is formed by colonizing bacteria trying to attach themselves to the smooth surfaces of the teeth.
How to manage dental plaque – Effective cleaning with your toothbrush
First of all make sure you have a good toothbrush, if you use a manual tooth brush do you remember the last time you replaced it? Generally after some usage toothbrushes so signs of wear and the bristles tend to flatten and spread out, commonly you should replace it every three months or so. Also it is a common misconception that stiff brushes clean your teeth better, people frequently “over-brush” their teeth causing damage to the gums. Softer bristles have greater flexibility and have been shown to reach further between your teeth and under your gum line, making cleaning more effective. (Also you are less likely to press too hard and cause trauma to your periodontal tissues)
You should brush your teeth twice a day for at least two minutes using toothpaste with fluoride. Your brushing technique is an important concept to grasp. The majority of patients use a “horizontal scrub” technique which does not effectively clean around your gum line and can lead to tooth wear. When brushing you should follow a set pattern and clean all accessible surfaces of the teeth. One method is to hold the toothbrush at 45° angle against both gum and teeth, clean gently with small circular movements. Repeat the procedure to the inner surface of your teeth. After brushing take some water in your mouth and swirl the foam between the teeth for 30 seconds. Spit out but do not rinse to make the best use of the fluoride´s preventative effect.
Clean between the teeth using interdental brushes or dental floss
It is very important to clean between the teeth as brushing alone does not remove dental plaque from these tooth surfaces. Because the humble toothbrush is an ineffective tool for this job it is recommended that interdental brushes or dental floss be used once a day to clean these areas as they are particularly susceptible to unwanted plaque accumulation. Floss is usually made from nylon and can be coated with wax to help it glide between the teeth and remove plaque.
Interdental brushes are especially useful for cleaning between your teeth. You should choose a brush size that will fit your interdental spaces. Very often more than one brush size is needed. If you are not sure, let your dentist or dental hygienist choose the right size for you. Don’t use smokers toothpaste, since it contains abrasives. Use the interdental brush once a day, preferably in the evening. Change brush when it is getting worn or the bristles become bent. For effective cleaning using a small interdental brush, use a straight brush for the front teeth, insert the brush gently between your teeth. Do not force the brush into a space; work it in gently or choose a smaller size. Move the brush full length back and forth a few times. Follow this link to see a short animation on how to use interdental brushes.
How the hygienist and periodontist provide non surgical treatment
Mechanical plaque control – Scaling and root surface debridement
The hygienist’s role is to provide support and guidance for the patient in their objective to maintain good oral hygiene during non surgical treatment. Often this treatment will include the need for professional intervention such as scaling and root planning (also called root surface debridement). You can find more about these about non surgical techniques by following this link.
Chemical plaque control, mouth rinses and medication
Following scaling and root surface debridement, and once much of the deposits have been removed, your periodontist may decide to administer a full mouth disinfection. This is usually achieved by taking a full mouth rinse or spray immediately after debridement. These chemical treatments are usually sufficient if your periodontal condition is in its early stages. If it is more advanced and you are diagnosed with periodontitis, then in addition to the non surgical treatments discussed here you may also receive a prescription for antibiotics to help cure and manage the periodontal infection.