The treatment of gum disease typically begins with a detailed examination of the gums during which the periodontist can assess the extent and severity of the disease and recommend a specific treatment plan.
The dentist will provide advice and support for the patient to learn how to perform detailed daily tooth cleaning aimed at efficient and complete removal of the plaque from all accessible surfaces of the teeth. The patient will also receive advice and support to give up smoking, if this is applicable.
Remember that treatment will only work well if you clean your teeth as we ask you to! Generally this will involve a combination of a manual or electric toothbrush and either floss or interdental brushes to clean in between the teeth.
The next step is the removal of any teeth which are beyond treatment
This is followed by complete and thorough professional removal of the bacterial plaque and calculus deposits from the teeth, both above and below the gum line.
To accomplish this painlessly it is usually necessary for the teeth and gums to be anaesthetised by means of injections, and the treatment may need 2-6 sessions to complete. The procedure may be called root planing or root surface debridement or deep scaling.
Removal of the plaque and calculus is usually performed with ultrasonic powered instruments and manual instruments.
Occasionally it may also be necessary to smooth down any rough edges on restorations such as fillings or crowns, or the periodontist may recommend their replacement. After the procedure, the gums may feel a bit sore for 1 or 2 days.
This is followed by a healing period of 6 to 12 weeks
During this time, the typical response is for the general level of inflammation of the gums to reduce. As this happens, the gums will appear to shrink and the teeth will look a little longer. The exposed root surfaces may be initially quite sensitive to cold. To reduce this sensitivity, you may wish to apply fluoride toothpaste to the teeth and reduce the intake of acidic food or drink.
There are other treatments we can suggest if the sensitivity is not getting better. The benefits of the initial treatment may also include fresher breath and sometimes teeth that were feeling loose may feel somewhat firmer. The improvement will depend on how good you are at cleaning your teeth and how severe the disease was to start with.
After the six to twelve week healing period, a second examination needs to be performed. The condition of the gums is assessed again and is compared to the initial examination. In this way it is possible to evaluate the response to the initial treatment and make further plans.
If with the treatment so far, all the periodontal pockets around the teeth have reduced to a level which we consider possible for you and the professional team to keep healthy, then a programme of supportive periodontal therapy otherwise known as periodontal maintenance is started.
Typically this involves three-monthly visits for detailed cleaning and an annual or bi-annual visit to the periodontist for examination to ensure that there is no further deterioration. Depending on the individual circumstances, the periodontal maintenance treatment may be done by a hygienist, the general dentist or periodontist.
If there are still some deep pockets after initial treatment, there are various ways in which they can be managed. We may recommend pocket reduction surgery to surgically reduce the pocket depths or may suggest re-cleaning the pockets from time to time. Some defects allow us the exciting opportunity to attempt periodontal regeneration where we try to regenerate the missing bone and gum attachment. After periodontal surgery to treat pockets or regenerate tissue, you will start a programme of maintenance as described already.
In the long term, it is not unusual for patients with periodontitis to need re-treatment or to eventually lose some of the teeth which had initially severe disease. The important thing to remember is that without treatment, the lifespan of the teeth would be greatly reduced and treatment is nearly always successful in prolonging the life of teeth affected by periodontitis.
Is this treatment expensive?
An initial gum disease assessment costs from €95 and includes consultation, a detailed examination, and intra-oral (small) x-ray images, if required. We will also write a report to your dentist if you have been referred to see us. The treatment cost will depend on the extent of the work needed and we will inform you with a written estimate of the treatment costs before we start. When compared to the replacement of teeth with dental implants, we believe periodontal treatment offers excellent value for money.