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The casues of periodontitis

To understand this we must look at what causes gum disease in the first place. The cause of gum disease (gingivitis and periodontitis) is bacteria (bacterial plaque) inside your mouth which has overgrown. This is known as the indigenous bacteria i.e. it comes from own body. Just like the bacteria which we have inside our gut. The treatment for plaque induced gum diseases is all aimed at reducing the bacteria above and below the gum. However, we cannot get rid of indigenous bacteria, as this resides in our own body. That’s why antibiotics have only a limited effect in reducing the symptoms and the effect does not last more than a few weeks.

periodontitis cure before treatment

Treatment for periodontitis : Surgery and non-surgical management

All of periodontal treatments are aimed at reducing plaque bacteria to such a level that it does not become harmful and cause any further problems. First line of periodontal therapy is called non surgical treatment. Firstly we need to reduce the plaque build up above the gum by improving brushing & flossing techniques. Then any hardened deposits of plaque bacteria (called calculus or tartar) are removed both above and below the gum line by the use of both hand and ultrasonic instruments. Finally any fine deposits of bacteria and calculus are removed from the root surface with the use of specialised hand instruments called gracey curettes. In addition any teeth/tooth which have moved out of position and cause any problems with the bite may be adjusted (occlusal adjustment).

Management of periodontitis

Reducing periodontal pocket depths and bleeding

A reassessment is carried out approximately two months later to check the success of the treatment. The vast majority of cases we have treated at the Birmingham Periodontal & Implant Centre show at least 90% improvement in reduction of pocket depths. Almost all of the bleeding gums should be eliminated and in most mild to moderate cases this should be all the treatment that is needed. At this visit if we still find problems, then there is the option to have gum surgery. Gum surgery enables the periodontist to see the actual roots and bone surrounding the roots and also to remove any plaque/calculus deposits and any infection. Secondly the gum could be lowered to completely reduce the periodontal pockets also.

The final phase of any periodontal treatment is called maintenance therapy. Here 3 monthly hygiene appointments are arranged and professional cleaning above and below the gum line is carried out. Periodontitis needs to be treated like other chronic diseases such as diabetes and high blood pressure which cannot be cured but can be controlled by medication. The medication for periodontitis is good home care and regular professional hygiene visits. With this regime one can expect to keep their teeth for hopefully rest of their life.

aggressive periodontitis before treatment

Severe Chronic Periodontitis together with drug induced gingival hyperplasia (Nefidipine). After liasing with the General Medical Practitioner to change medication, the patient underwent a full course of non-surgical therapy.
After treatment the periodontal condition has been stabilised with just non-surgical therapy and has been maintained by excellent plaque control by the patient.

What are the differences between the signs and symptoms of gingivitis

Gingivitis is an infection caused by bacteria. In approximately 24 hours the natural bacteria in the mouth will multiply and form a sticky, almost invisible, film on the teeth called plaque. If this plaque (biofilm) is not removed by brushing and an effective oral hygiene regime at home then it will develop into calculus (tartar). As the disease progresses various signs and symptoms will begin to become obvious, however some indicators are not so evident to the patient. For this reason it is important to distinguish the difference between signs and symptoms. Periodontal disease that is left untreated can result in the loss of teeth and often the symptoms are painless until the disease has progressed so far and little can be done to save the affected teeth. If you have missing teeth already you can get affordable dental implants in birmingham

Altered gingival appearanceGums bleeding while brushing
Gums pulling away from the teeth Red and swollen gums
Exposed roots and recessionsRed and swollen gums
Periodontal pocketsTender and sore gums
Pus between teeth and gums.Loose teeth, spaces appearing between teeth
Change in the way teeth fit together / a different bite
Halitosis – Bad breath
table showing the signs and symptoms of gingivitis

Both signs and symptoms are actually something that is abnormal to a healthy person and usually indicate that there is a medical condition developing. The difference between a sign and a symptom however is that a symptom is usually something that a patient experiences and can describe, for example; my gums bleed when I brush my teeth. A sign on the other hand is an observation a periodontist makes upon an examination, a clinical discovery that proves that there is indeed gum disease present. For example a periodontist would notice gingival recession or periodontal pockets.

Do you have gingivitis? This is what you should look for!

It is important to note you may have periodontal disease and not experience any of these symptoms. Periodontal disease is silent and chronic, rarely giving an advanced warning that tissue destruction is taking place. That is why it is important to have regular dental checkups.

SIGN – 1 – Altered gingival appearance

Changes in appearance are usually described according to colour, shape, size, consistency and surface characteristics. Healthy gingivae are pale pink and the edges of the gum line tightly hug the shape of the tooth. Gingival inflammation usually starts between the teeth and gradually spreads around the tooth margin. The infection causes the tissues to become red and swollen and the fine definition and tone of the gingivae is lost, they eventually become smooth and glossy.

SIGN – 2 – Gingival bleeding

Gingival bleeding is probably the most frequent patient complaint. Unfortunately, bleeding is so common that some people may not take it seriously and even believe it to be normal. Bleeding is usually evidence that bacteria is present and an infection has begun. It occurs most frequently while brushing the teeth. Bleeding may also be provoked on eating certain hard foods such as apples. Patients can taste blood and it may even be smelt on the patients breath.

SIGN – 3 – Halitosis – Bad breath and an unpleasant taste

Halitosis is a word that describes bad breath, and it often accompanies gingival disease. Halitosis is a common reason people visit the dentist. The smell originates from blood and poor oral hygiene, and should be distinguished from odours from other sources. Halitosis has a number of causes:

    • Residual food deposits especially such things as garlic, curry, onion etc….represent the most common cause of halitosis. For example garlic that is absorbed in the intestines is then taken into the bloodstream and finally exhaled by the lungs, so the odour can be smelt long after the food has been consumed.


    • Bacterial infections in the respiratory tract, nose, sinuses, tonsils and lungs can cause an embarrassing smell as can diseases of the digestive tract.


    • Mouth odour is common upon waking up and between meals and is associated with food stagnation and reduced salivary slow.


  • Metabolic diseases such as uraemia and diabetes give characteristic smells, such as the odour as acetone in the case of diabetics with an increase in blood sugar levels.