A very detailed gums assessment will be done for patients at risk of periodontal disease. We will also need to take x-rays to determine the amount of supporting bone that has become affected by gum disease. We may need to take a full mouth radiograph called an OPG (orthopantomagram), this will give us a comprehensive overview of your teeth, bone levels and jaw joint.
A small measuring tool, called a periodontal probe, allows us to identify what areas bleed easily or have receeded and to measure the depth of the gum pockets alongside the tooth. Pockets are usually shallow when the gums are healthy, but will deepen with gum disease.
When periodontitis is present:
- Pocket depth increases due to swelling and inflamation and destructive changes.
- The gums may bleed easily when touched, flossed and brushed.
- The bone level changes around the tooth.
- Your teeth may literally fall out.
1. Initial deep cleaning phase
This first step is to reduce the gingival inflammation and allow the tooth supporting tissues to recover. For an optimal result, the oral hygiene must be excellent. The initial treatment phase includes the following:
- Personalised oral hygiene instruction using techniques and tools adapted to your needs.
- Scaling and root planing (deep cleaning). Special instruments are used below the gum line to remove soft and hard deposits from the tooth surface; this is done mainly under local anaesthesia and usually requires 2 to 4 appointments.
2. Maintenance phase
Between 6 and 12 weeks after the initial cleaning phase is completed, we will re-examine your gums in order to evaluate the healing that has occurred and determine if additional treatment is recommended and plan the latter.
3. Surgery phase
Persistent gum disease may sometimes benefit from gum surgery with or without antibiotics.