Periodontal Treatment

Periodontal Disease is one of the main causes of tooth loss in adults. If caught in its early stages, however, it can be controlled with proper care. Periodontal Disease is an inflammatory disease which is caused by a bacterial infection that attacks the gums, bone and other supporting structures of the teeth. You may have Periodontal Disease and not realise it.

What causes gum disease (Periodontal Disease)?

Gum disease is caused by bacterial deposits (plaque) that form on the teeth. The plaque irritates the gums and causes them to become red, tender and swollen. It also causes the gums to bleed easily. If not removed daily, plaque hardens to form calculus around the necks of the teeth.

The tissue that attaches the gums to the teeth can be destroyed by the irritants in plaque. The gums pull away from the teeth and small pockets form between the teeth and gums. These pockets become filled with more plaque. As the pockets deepen, it becomes impossible for you to clean the plaque out. Eventually, the bone structure supporting the teeth can be destroyed. Depending on the severity, the teeth may start moving and in advanced stages the teeth can fall out.

Other factors that increase the risk of developing Periodontal Disease are:

  1. Smoking.
  2. Genetics (Family history).
  3. Physical and chemical irritants: Impacted food, alcohol.
  4. Abnormal oral conditions or habits: Badly aligned teeth, poorly fitting bridges or partial dentures, defective fillings and harmful habits (such as grinding).
  5. Certain diseases: Diabetes, anemia and leukemia are among the diseases that may affect the health of your gums.
  6. Certain medications: Oral contraceptives, anti-epilepsy drugs, steroids, may have a negative effect.
  7. Unbalanced diet: There is a link between nutritional deficiency and the body’s ability to fight off infection.
  8. Pregnancy: Due to fluctuations in hormone levels, a temporary condition referred to as “pregnancy gingivitis” may occur.

What are the signs?

One or more of the following are signs of Periodontal Disease:

Gums that bleed when you brush or floss your teeth

  1. Red, swollen and tender gums
  2. Bad breath or a chronic bad tastein your mouth
  3. Gums that have receded or shrunken away from your teeth
  4. Pus between your teeth when you press your gums with your finger
  5. Pain when chewing
  6. Calculus or tartar buildup
  7. Teeth that seem to be loose or that change position
  8. Changes in your bite
  9. Changes in the way your partial denture fits
  10. Teeth that are overly sensitive to hot and cold


A thorough oral examination is crucial to diagnosing periodontal disease. We use a special instrument called a “periodontal probe” to measure the depth of the pocket between the tooth and the gum tissue.

The pocket depth measurement, clinical examination and x-rays help us determine the precise location, extent and severity of gum disease.


The type of treatment you may require depends on how advanced your particular case is. Treatment may include any of the following:

  1. 1. More frequent cleanings.
  2. 2. Scaling, root planning and curettage of the periodontal pocket (Basic Periodontal Treatment). Scaling is removing the calculus deposits from your teeth. Root planning is the smoothing of the root surfaces so that the gum tissue can reattach to the tooth. Curettage is the removal of the soft tissue lining the periodontal pocket. This helps the gum tissue to heal.
  3. 3. Flap surgery (Advanced Periodontal Treatment) allows us to gain access to the root of the tooth for removal of calculus, plaque and diseased tissue.

The procedure in the practice:

To determine the severity of the disease in your case and to give you an individual prognosis of each tooth, you will have an Assessment Appointment. During this time, the dentist will perform a thorough examination of your teeth, including x-rays, clinical measurements and pictures. You will also be given effective oral hygienic instructions to follow during the treatment and in the future.

The next step will be the Basic Periodontal Treatment. The dentist, in 2 or 4 appointments (you will be told how many appointments you need after the assessment), will “eliminate” the periodontal inflammation through a technique known as “curettage plus scaling and root planning” (removal of bacteria and infected soft tissue underneath the gums).

Eight weeks later, you will come back to the practice for the First Review (all your gums will be Re-assessed)

Depending on your compliance and the outcome of the treatment, you will enroll on a Maintenance Program. This is the most important part of all, because we are treating a chronic disease. It involves regular gum examinations and reinforcement of cleaning every 3 months during the first year, and after, every 3 or 6 months. Some people, normally the ones whose periodontal disease is advanced, after the Basic Periodontal Treatment, may require Advanced Periodontal Treatment and/or some conservative treatment (such as the replacement of fillings in poor condition or other problems that can damage the periodontal condition).

We look forward to seeing you soon and we will be more than happy to answer any question that you have.