Gum disease is also known as periodontal disease and is a major cause of tooth loss if it remains untreated. Over time, plaque becomes mineralized into tarter, and bacteria make the plaque/tarter stick onto the tooth surface. The longer the tarter stays on the tooth, the harder it becomes. The problem begins with plaque bacteria causing inflammation in the region where the tooth is surrounded by the gums. This is called Gingivitis and usually occurs if the oral hygiene is not sufficient. If the problem persists and there is no improvement in the oral hygiene it can lead to progression of Periodontal Disease. The symptoms include bleeding gums during tooth brushing, red swollen gums, mobile teeth, drifting teeth and bad breath. Pain is not usually a feature of gum disease especially in the earlier stages until an acute episode. Note: with smokers, the adverse effect of the cigarettes on the gums / bone is hidden as the inflammation of the gums is masked and the gums bleed less. 2/10 people are susceptible to Periodontal disease.

The bacteria in gum disease which cause the problem produce “toxins” which attack and damage the ligaments and bone supporting the tooth, resulting in mobility of the tooth. Eventually this may lead to tooth loss.

Treatment given in a scale and polish appointment:

1. Removal of soft and hard deposits (plaque and tarter) at and under the gum line.
2. Removal of any plaque retention factors (eg. smoothing of overhung filling).
3. Education / Motivation in the maintenance of your oral hygiene through use of dental products (eg Floss, Super floss, Tepe brushes) to achieve and maintain a healthy mouth with fresh breath.

If the condition of your gums on initial presentation is poor, you may need a series of extended appointments until the gums are under control. If the gums are inflamed and/or your teeth sensitive, you may find the Scale and Polish a little uncomfortable for which reason we may offer you some Local Anesthetic. Once under the gums are under control, you should not find this process painful.

Note: external staining (ie those from the outside) such as tea, coffee, red wine, Corsodyl, cigarettes may be removed mostly with a Scale and Polish. However internal staining (eg form Tetracycline staining, long term smoking discolouration) may need to be managed with Whitening procedures.

For advanced, severe cases, or those with a rapidly deteriorating gum condition, those with particular medical conditions making them more susceptible to gum conditions, a Specialist referral may be suggested.

Instruments we may use:

• Hand and Ultrasonic cleaning instruments.
• Dedicated plastic scalers for implants.
• Polishing pastes.
• Important signs to look out for:
• Bleeding gums
• Swollen gums
• Bad breath / taste
• Loose teeth
• Gaps forming between teeth, ie drifting teeth
• Shrinking gums

Alert your dentist of your finding. On initial presentation, a number of gum measurements may be taken and X rays to assess the extent and severity of the gum condition and also to compare with future measurements and x rays. The aim of the treatments is to reduce plaque bacterial level and reduce the inflammation to allow the hard and soft tissue to resolve.

Unfortunately, the bone that has been lost does not readily grow back, however, if the plaque bacteria are suppressed through good home care and regular visits for Scale and Polishes the bone loss process may slow down and even stop.

1. Heavy tartar and tobacco stain

2. After scale and polish

1. Tartar build-up

2. After ultrasonic dental cleaning

It is very important to discuss any concerns you may have about your gums with your Dentist and the Dental Therapist.