March 12, 2013
Tags: dentist, london dentist, nhs, whitening, inman aligner, cosmetic dentist, checkup, dental, anish, anish dentist, london hygienist, dental hygiene.
Healthy gums are the foundations of all dental treament. We offer you cleans with our dentist and hygiensit to remove heavy staining from coffee, tea, wine and smoking. We aim to restore gum health on the NHS when there is tar-tar preventing you from accessing the gums for cleaning
During your checkup we would have spotted the signs of gum disease (gingivitis or periodontitis) and given you a score based on your gum health. These would have been bleeding of the gums when probed, a build-up of tar-tar above/and or below the gums, periodontal pockets of 3.5mm or greater. The basic score is what we use to evaluate further treatment for your gums:
Basic Periodontal Examination Score and relevance to treatment we prescribe
Poor oral hygiene (major cause),concurrent smoking, and diabeties( aggravating causes) are the main contributing factors to gum disease (periodontitis). Poor oral hygiene includes an in-effective brushing and infrequent professional cleans, allows tar-tar and plaque to build up around the gum level. This has shown to cause inflammation and destruction of the bone, ligaments, gums,and cementum (collectively known as the periodontium) if left untreated for long periods of time.
Smoking and diabeties alter the blood vessels and is thought to restrict blood flow to your gums, therefore with a lessened blood flow fighting off harmful bacteria in plaque is prevented, allowing the the destruction of the gums and bone.
Non-Surgical Supra-Gingival General Scale And Polish
1. Simply involves the ultra-sonic scaler to remove tar-tar from above the gums- At this point you may experience some sensitivity. This is completely normal.
2. We follow this with a polish of your teeth. This leaves them feeling smooth and prevents plaque adherinng to any rough surfaces left after the clean.
Non-Surgical Sub-Gingival Scale With Local Anaesthesia
1. If deep and extensive we start by placing a small amount of local anaesthetic. This removes all pain sensation in the area we are treating.
2. Once suitably numb, we start by removing all tar-tar above and below the gums with the ultra-sonic and hand scalers. It is areas below your gums that no toothbrush or mouthwash can get to, and will need to be mechanically removed by us.
3. We normally only do one quarter or half of your mouth at a time (2-4 appoitments), leave this to heal for 6 weeks and re-evaluate with our probe to check for healing. If we have a positive response we will often leave alone for another 6 weeks.
4. After 3 months we will do a general clean and check, check for oral hygiene adherence, and make a follow-up appointment depending on disease regression or progression.
After a routine hygiene appointment, you may expercience some sensitivity on cold or hold. This is due to parts o your tooth being exposed that previously we covered with tar-tar. The pain will only last a couple of days, and if particulary bad can be treated with parcetamol.
As a result of deep treatment you may have an aggrevated area of inflammation/infection. This area of infection is short-lived and easily treated with anti-biotics and good oral hygiene.
The risks of not having treatment far out-strip those of having. These include progressive gum disease leading to gum and bone shrinkage, which eventually leads to tooth loss.
To reduce sensitivty during a clean an alternative is to use hand scalers instead of ultra-sonic scalers. You could also have the above treatment done with a periodontitst on referral if you are particularly resisitant to general treatment measures.
Surgical periodontal treatment with a specialist
Occasionally, despite our best efforts we fail to stop gum disease from progressing. This could be due to a number of factors including: continued poor hygiene, smoking, diabeties, or anything contributing to a lowered immune response. In these cases we will often refer you to a specialist or ask you to see our visiting specilist.
They will often attempt the same as above, and supplement with antibiotics only avaliable on their expert prescription. Surgical treatment would also be considered as well as elective extractions (Sacrificing some teeth of very poor prognosis to allow cleaning of those teeth of better prognosis)
Often, we will work alongside he periodontist to stablise your gums before we carry out any further work
The repetitive cost of a routine check-up and hygiensit is far less that the one off treatment to have root canal treatment for example. It is in your interest both from a health and financial point of view to attend the dentist regularly. At this point you are at the first level of the "dental cycle", and with proper preventitive practice may never need to have complex expensive treatment done.
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