The first appointment is aimed at information gathering, to come up with a tailored treatment plan, and to start to educate the patient about gum problems and why they have been referred for treatment. The clinical examination involves visual inspection of all oral tissues, some gentle probing to measure the depths of the gaps between the gums and the teeth, and any gum recession, and assessment of tooth mobility (increased looseness).
Tooth decay may be detected and your referring dentist notified for its management. There may be the requirement for additional investigations, in the form of x-rays or scans, impressions for study models, or photographic records.
Most treatment procedures (for periodontal therapy and dental implant therapy) are completed in our rooms. The area to be treated is anaesthetized, so that no pain is experienced by the patient. For patients anxious about treatment, we may employ some calmative measures, either pre-treatment or during the course of treatment. Following completion, any discomfort is usually minor, and should only last for a day or two.
Periodontal disease is a chronic disease, and its management is long-term. Following control of active disease, in many cases the damage caused may be improved with surgical procedures.
This may be reshaping of the gums and underlying bone, to reduce pockets, or combined with the application of regenerative materials and bone substitutes to try to regenerate lost attachment. In some cases, gum recession may be managed via gum grafts. In the long-term though, regular maintenance will be necessary to maintain the gums in a healthy stable state. If you have had gum disease, you can get recurrent disease without maintenance therapy.
As previously mentioned, periodontal treatment is divided into phases. Once the disease is brought under control (cause-related phase), we determine the requirement/benefit of a corrective/surgical phase.
Following this, long-term stability is achieved by two things: a high standard of home oral hygiene, and regular professional periodontal maintenance care. This is provided by our hygienist, and the period between these appointments varies from patient to patient, depending upon their individual clinical conditions.
Most patients who have had gum treatment require between three and six monthly maintenance. Maintenance appointments involve detailed re-cleaning of the teeth and areas beneath the gums, to get the patient back to the conditions achieved with active treatment. Plaque control is checked, and modifications recommended as necessary, and topical fluoride applied to try to prevent sensitivity and root decay.
Maintenance appointments are generally 60 minutes, and are more involved than a “routine polish” that most patients equate with tooth cleaning at the dentist.
Yes. Your general dentist is the person in charge of your overall dental management. Regular appointments for assessment of your teeth for decay etc. is important, and should occur.
In many cases, we can alternate with your general dentist, so that you may have the benefits of both aspects of dental care.