GUM DISEASE

OVERVIEW

Basic Anatomy of Teeth and Implants

The periodontal tissues are the supporting structures around the natural teeth which are the bone, gum and periodontal ligaments surrounding the roots.

The peri-implant tissues are the gum and bone surrounding dental implants.

Periodontics deals with the diagnosis, prevention and control of periodontal diseases or gum diseases. Our periodontics services include

Treatment of periodontal and peri-implant disease

This is also known as gum disease which destroys the supporting structures around the natural teeth and implants. This is a quiet but progressive disease, hence the patient does not feel any pain at all. The most common complaints are their gums will bleed when they brush or their gums look swollen. As the disease progresses, their teeth will shift and become more shaky or loose. The final outcome is the loss of these teeth. Though dental implants or fixed bridges can be done, there may not be enough bone support and thus the implants or bridges do not last long.

For peri-implant disease, the implant will be firm until the bone loss reaches a certain level. The gums around it usually swell and might be painful and finally the implant is lost.

To determine the severity of the disease, the dentist will have to diagnose the disease by visually looking for swelling, recession, bleeding and etc. X-rays have to be taken to see the level of remaining bone. The periodontal charting where the disease gum pockets are measured to determine how complex the treatment will be is important too.

Non-surgical periodontal treatment

This is the first line of treatment when managing both periodontal and peri-implant disease. The aim of this treatment is to remove bacterial plaque and dental tartar which is the main cause of the disease. This has to be done together with personalized oral hygiene instructions for each patient. Normally the teeth are numbed and instruments such as the ultrasonic scalers, hand scalers and other tools are used to clean the roots of the teeth. Sometimes, fillings or crowns which are defective have to be changed to reduce the collection of bacteria plaque and hence allow the patient to maintain good oral hygiene. The patient is then reassessed about 6 weeks later to see how much healing has occurred.

Surgical periodontal treatment

Open flap debridement

In some cases, the disease is very severe such that surgery needs to be done to allow better cleaning of the roots. The process involves numbing the teeth and gums, and the gums are raised and moved aside from the teeth. This allows the dentist to clean the roots and gums. The gums are then repositioned and sutured. Pain is minimal, and mild to moderate painkillers are given to ease it. The gums would heal rather quickly.

Guided tissue regeneration

Sometimes, some teeth can have their bone regenerated. This surgery involves numbing the affected area and cleaning the roots. Bone taken from an external source would then be placed into the defect and this is known as the graft material. A resorbable membrane would then be placed over the graft to protect it. The gums are sutured firmly around it. For good success, the area has to be monitored closely and maintained well.

Aesthetic Crown Lengthening

Some patients have short front teeth and a "gummy smile". After it has been properly diagnosed as to why it is so, aesthetic crown lengthening can be done such that the excess gum and bone can be shaped and sculpted such that the teeth can appear longer and be in harmony with the gums and lips.

Root Coverage Surgery

In these group of patients, they will normally have gums which have receded or shrunk away due to harsh brushing. It can also be due to orthodontic treatment (braces). As such the teeth look longer and can be sensitive too. This surgery technique involves moving the gums back down to its original position and can be thickened with additional connective tissue from the patient’s own palate. This thickening allows the gum to better resist the harsh brushing and hence recession to occur again. Proper oral hygiene techniques have to be taught to the patients undergoing this treatment.

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