Dental Hygienist / Periodontal Therapy

Gum disease (periodontal disease) is primarily caused by the build-up of plaque—a sticky, invisible film of bacteria that constantly forms on your teeth and along the gum line. If this plaque is not removed daily through brushing and flossing, it causes inflammation and can harden into tartar, which requires professional cleaning. 

While bacterial plaque is the root cause, several underlying factors and health habits can significantly accelerate or increase your risk of developing gum disease: 

• Poor Oral Hygiene: Infrequent brushing or failing to clean between teeth allows harmful bacteria to multiply and cause gingivitis (early gum disease). 
• Smoking or Tobacco Use: Considered one of the most significant risk factors, smoking weakens your immune response, making it much harder for your gums to heal or fight off infection. 
• Hormonal Fluctuations: Changes occurring during puberty, pregnancy, or menopause can make gum tissues more sensitive and susceptible to inflammation. 
• Underlying Illnesses: Chronic conditions like diabetes, immune-compromising diseases (like HIV), and inflammatory disorders (like Crohn's disease) lower your body's ability to fight off bacterial infections. 
• Genetics: Some individuals are genetically predisposed to developing aggressive forms of gum disease. 
• Medications: Certain prescription drugs cause dry mouth or induce abnormal tissue changes that encourage plaque accumulation. 
• Poor Nutrition: Deficiencies, particularly in Vitamin C, can compromise gum health and healing.

Approximately 50% of the population experience some degree of damage to the bone and surrounding tissues from gum disease. 10-15% present with more advanced forms, which can result in the loss of teeth.

Some medical conditions, such as diabetes, can influence the extent of the disease. Other factors that also can aggravate existing periodontal disease include smoking and stress.

The main signs of gum disease include bleeding gums, loose teeth, receding gums, teeth moving position, tenderness, swelling, redness, abscess (pus), bad breath and/or taste.

In many cases, there may be no signs or symptoms. Gum disease can only be detected by a comprehensive clinical examination

Treating gum disease depends on its severity, ranging from early-stage gingivitis (which is reversible) to advanced periodontitis. The primary goals are to eliminate bacterial infection, reduce inflammation, and prevent bone loss. 

1. Daily At-Home Care

Effective home hygiene is the most crucial step to prevent and reverse early stages of gum disease: 

• Brush twice daily: Use fluoride toothpaste and a soft-bristled manual or electric toothbrush for at least two minutes, ensuring you clean along the gum line. 
• Clean between teeth: Use dental floss or interdental brushes at least once a day to remove plaque where a toothbrush cannot reach. 
• Mouthwash: An antibacterial or chlorhexidine mouthwash (often recommended or prescribed by dentists) can help control bacteria and reduce plaque. 

2. Professional Dental Treatments

If gum disease has progressed or does not improve with at-home care, professional intervention is necessary: 

• Scale and Polish: Routine professional cleaning to scale (scrape) and remove hardened plaque (tartar) and bacteria above and below the gumline. 
• Scaling and Root Planing (Deep Cleaning): A deeper cleaning procedure for mild-to-moderate periodontitis. It cleans deep into the gum pockets and smooths the tooth roots, preventing bacteria from reattaching. 
• Antibiotics: In severe cases, your dentist may prescribe oral antibiotics or apply antibiotic gels/chips directly to the gum pockets to fight persistent infections. 

3. Surgical & Advanced Treatments

For advanced periodontitis where pockets have deepened and bone structure is compromised, your dentist may refer you to a periodontist: 

• Flap/Pocket Reduction Surgery: Gums are lifted back to allow deep tartar removal, then sutured snugly into place to reduce the spaces between teeth and gums.
• Bone and Tissue Grafts: Procedures to regenerate bone or gum tissue lost to disease, preventing tooth loss. 

4. Lifestyle Adjustments

Quitting smoking is highly recommended, as smoking is one of the most significant risk factors for developing severe gum disease and interferes with the healing process. 

Good oral hygiene reduces the number of bacteria in the mouth and therefore reduces the amount of gum inflammation. The causes of your gum disease are discussed at this appointment and we explain exactly how to keep your teeth and gums clean. Individual tailored advice will be given to show you how to best use the various cleaning aids most effectively.

Non-surgical periodontal therapy is the gold-standard, conservative approach to halting gum disease. It primarily involves scaling and root planing (deep cleaning) to remove bacterial plaque, tartar, and toxins from below the gumline, allowing the gums to heal and reducing deep pocket depths. 

How It Works

• Scaling: Dental professionals use manual tools or ultrasonic scalers to meticulously remove hardened plaque (tartar) and bacterial toxins both above and below the gumline.
• Root Planing: This step smooths the rough areas of the tooth roots, preventing future bacteria from accumulating and helping the gum tissue naturally reattach to the tooth.
• Local Anaesthetic: The procedure is typically done under local anaesthesia (like numbing gels or injections) to ensure comfort. 

The Process

Treating periodontitis is a multi-stage commitment that requires collaboration between your clinical team and at-home habits: 

4. Initial Therapy: Usually carried out in 1 to 4 sessions, where the mouth is treated in sections (quadrants) over several appointments. 
5. Reassessment: A follow-up appointment (typically 6 to 8 weeks later) evaluates how well the gums are healing. A final periodontal assessment is often done 3 months post-treatment to re-measure pocket depths.
6. Maintenance: Diligent at-home oral hygiene (brushing and interdental cleaning) is critical, alongside lifelong periodontal maintenance check-ups 3 to 4 times a year. 

Expected Outcomes & Aftermath

• Results: The therapy aims to shrink deep gum pockets, stop bleeding, and prevent bone loss. It is highly successful for managing pockets up to 7mm. 
• Side Effects: Temporary bleeding, increased tooth sensitivity, and minor gum recession (which may make the teeth look slightly longer) are normal and to be expected during the healing process.

The healing response of your gums to treatment will be evaluated by measuring the depths of the pockets and the amount of bleeding found, eight to twelve weeks later. At this stage we can determine whether you may require any other form of treatment (surgical therapy) or whether we can move you on to the maintenance stage.

Sometimes, a localised surgical procedure is carried out to clean away plaque bacteria and calculus (tartar) on the root surfaces under the gum.

Under local anaesthesia, the gum is lifted and the root surfaces are cleaned under direct sight to ensure that all the deposits are removed. In some cases, it is even possible to treat bone loss at the same time using a special regenerative treatment. At the end of the procedure, the gums are sutured back into place around the teeth.

It is essential that all periodontal patients receive regular maintenance treatment and careful monitoring, once some stability has been achieved. This is usually done at 3 monthly intervals, either by a periodontist or by a dental hygienist under prescription, depending on individual needs.

Regular follow-up appointments are vitally important to ensure that the disease process does not reoccur. If there are signs of continuing disease, at your maintenance visits we will be able to identify new or recurring sites of inflammation and treat them at an early stage. You will also be given advice on how to modify your oral hygiene practices to tackle the inflammation.

Successful periodontal treatment requires your full co-operation with regards to daily oral hygiene practices and dental attendance.