Chronic periodontitis ('gum disease') represents a major health problem in the UK. Surveys show that more than 50% of the population currently experience some degree of damage to bone or the soft tissues supporting the teeth. Approximately 10-15% of the population will lose a significant number of teeth as a result of chronic periodontitis: the more susceptible the patient, the more rapidly the bone loss progresses. In addition, around 1% of the population is susceptible to the aggressive forms of periodontitis. These patients can present with advanced levels of attachment (bone) loss and pocketing in their twenties or thirties. Although many patients do not immediately link their symptoms with gum disease, other patients report concerns with bleeding gums, drifting or loose teeth, a lack of mouth freshness or discomfort when eating, all of which are associated with periodontitis. Early diagnosis is important for periodontitis in order both to simplify treatment and improve prognosis.
Treatment of chronic periodontitis
Treatment of chronic periodontitis is highly successful in keeping teeth and improving both comfort and confidence. Non-surgical therapy is the foundation of periodontal care and this can also be successful when the disease is thought to be unresponsive or refractory. Effective self-care oral hygiene is the main key to success and we can help by equipping patients with skills and building their motivation and confidence to achieve this. In addition, meticulous instrumentation of the root surface (deep scaling or root planing) will lead to substantial improvements in periodontal health. A recent audit of our non-surgical care at PerioLondon demonstrated that 68% of initially deep pockets responded well to just one course of treatment, healing to 4mm or less. As a result of this approach, antibiotics are seldom needed.
Supportive periodontal therapy (maintenance)
Supportive periodontal therapy (SPT) begins when active treatment is complete. SPT maintains the health improvements achieved by the patient and is the long-term continuation of care. Most patients with periodontitis benefit from regular SPT, typically every three months, although this recall is dependent on health status and risk factors. SPT involves helping patients to maintain an effective daily plaque control routine and to overcome barriers which prevent the routine being effective. Monitoring of periodontal health is also an integral aspect together with removal of bacterial deposits and re-instrumentation of developing pockets. Our hygienists are highly experienced at providing SPT for periodontally susceptible individuals.