What is specialist periodontal treatment?

Periodontal (gum) disease is a condition which affects the gums, surrounding bone and other supporting tissues of the teeth. Although most individuals suffer gum inflammation from time to time, around 10% of the population appear to suffer from the more severe forms of the disease which causes loss of supporting bone. This group appears to be at greatest risk of losing teeth through periodontal disease. It is caused by the bacteria which regularly collect on the teeth. Here at The Lytham Dental Clinic, we take gum disease very seriously. So much so, that it is the first thing we assess with all our new and existing patients.

If you have periodontal disease, we can provide a variety of different treatment options depending on the severity of the problem. This can include instruction in specific oral hygiene methods to help you control the bacteria (plaque) that collects on your teeth, professional cleaning of your teeth or treatment such as subgingival debridement (see below). Most cases of periodontal disease can be successfully treated by our dental therapist using methods such as these.

Occasionally, more complex treatments are required such as gum surgery, and here at The Lytham Dental Clinic our periodontal specialist Dr Jose Zurdo is on hand to help.

Dr Zurdo has a wealth of experience in the diagnosis and treatment of gum disease. Indeed his main areas of clinical interest are the treatment of periodontal disease, hard and soft tissue regeneration, implant dentistry and cosmetic soft tissue manipulation. The General Dental Council recognised Dr Zurdo as a specialist in Periodontics in 2002, and since then he has gained an international reputation as a leader in his field.

Dr Zurdo is currently the course principal of the MSc in Clinical Periodontology and senior lecturer in the MSc in Dental Implantology at the Institute for Postgraduate Dental Education, University of Central Lancashire. 

Why would specialist periodontal treatment be suitable for me?

Periodontal disease cannot get better by itself, so treatment is necessary if you want to try to save your teeth. It can only be diagnosed by a dentist and so a visit to The Lytham Dental Clinic will help you to understand your condition and what we can do to help you. After a thorough examination, we will discuss the various options and provide you with a comprehensive treatment plan.



Q. Why do some people suffer from this problem and not others?

A. Around 10% of the population is susceptible. Our knowledge of why this is, is improving all the time, although 3 major factors are thought to be responsible. Family history (genetics), stress and smoking are all important risk factors. Stopping smoking is an important part of reducing the risk of developing the disease. Certain general diseases such as diabetes may also make an individual more susceptible.

Q. How do I know if I have the disease?

A. Periodontal disease is often silent, meaning symptoms may not appear until an advanced stage of the disease. However, warning signs of periodontal disease include the following:

  • Red, swollen or tender gums or other pain in your mouth
  • Bleeding while brushing, flossing or eating hard food
  • Gums that are receding or pulling away from the teeth, causing the teeth to look longer than before
  • Loose or separating teeth
  • Pus between your gums and teeth
  • Sores in your mouth
  • Persistent bad breath
  • A change in the way your teeth fit together when you bite.
Q. I am pregnant, will I get gum disease?

A. Women may experience increased gingivitis (gum inflammation and bleeding) or pregnancy induced gingivitis beginning in the second or third month of pregnancy, that increases in severity through to the eighth month. During this time, some women may notice swelling, bleeding, redness or tenderness in the gum tissue.

Studies have shown a relationship between periodontal disease and pre-term, low-birth-weight babies. Any infection, including periodontal infection, is cause for concern during pregnancy. In fact, pregnant women who have periodontal disease may be seven times more likely to have a baby that is born too early and too small. If you are planning to become pregnant, be sure to include a periodontal evaluation as part of your prenatal care.

Q. What should I do if I think I might have the disease?

Regular dental examinations at The Lytham Dental Clinic will ensure that a correct diagnosis is made. We will then be able to advise you on any necessary treatment. This will often include instruction in specific oral hygiene methods to help you control the bacteria (plaque) that collects on your teeth. There may also be a need to carry out some professional cleaning of your teeth or provide treatment called subgingival debridement (see below). Most cases of periodontal disease can be successfully treated by our dental therapist using methods such as these.

Occasionally, more complex treatments are required, and here at The Lytham Dental Clinic our periodontal specialist Dr Jose Zurdo is on hand to help.

Q. What is subgingival debridement?

A. Sometimes, gum health maintenance or gum disease cannot be treated with routine hygiene treatment and so it may be necessary to be prescribed a treatment called subgingival debridement. This is a deeper clean under the gums that removes bacteria and tartar from the roots of your teeth. To make you comfortable during the procedure, we will offer you a local anaesthetic to numb the area.

Q. Why would I need specialist gum surgery?

A. Occasionally, when gum disease is very severe or has been present for a prolonged period, gum surgery may be necessary. In some cases, it may be necessary to remove (extract) the affected tooth. In the event that gum surgery is recommended, we will tell you about the procedure needed and how it is carried out. This will be provided by our in-house periodontal specialist, Dr Jose Zurdo.

Q. What is acute necrotising ulcerative gingivitis?

A. Acute necrotising ulcerative gingivitis (ANUG) is a severe and aggressive form of gum disease. It should always be treated by a dentist. However, if you see your GP before visiting a dentist, they may provide you with some treatment while you wait to see your dentist.

As well as the oral hygiene advice and dental treatments mentioned above, treatments for ANUG may also include antibiotics, painkillers and different types of mouthwash. These are described below:

  • Antibiotics - treatment with antibiotics, such as metronidazole or amoxicillin, may be recommended if you have ANUG. You will usually have to take these for 3 to 5 days.
  • Painkillers - paracetamol and ibuprofen are the most commonly prescribed painkillers. They are also available over the counter from pharmacies. They may help reduce pain and discomfort caused by ulcers.
  • Mouthwash - mouthwash that contains chlorhexidine or hydrogen peroxide may be prescribed to treat ANUG. Some chlorhexidine mouthwashes are also available over the counter, though they may not be as effective as a hydrogen peroxide mouthwash.

Facts and fallacies surrounding gum disease

FALLACY: Tooth loss is a natural part of aging.

FACT: With good oral hygiene and regular professional care, your teeth are meant to last a lifetime. However, if left untreated, periodontal (gum) disease can lead to tooth loss. It is the primary cause of tooth loss in adults 35 and over.

FALLACY: People who have gum disease don't brush their teeth.

FACT: Research proves that up to 30% of the population may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be six times more likely to develop periodontal disease.

FALLACY: Gum disease doesn't affect overall health.

FACT: Emerging research links periodontal disease to other health problems including heart and respiratory diseases; preterm, low birth weight babies; stroke; osteoporosis and diabetes.

FALLACY: Gum disease is a minor infection.

FACT: The mass of tissue in the oral cavity is equivalent to the skin on your arm that extends from the wrist to the elbow. If this area was red, swollen and infected, you would visit the doctor. Gum disease is not a small infection. Its result, tooth loss, leads to a very different lifestyle - dentures. The changes in your appearance, breath and ability to chew food are dramatic.

FALLACY: Bleeding gums are normal.

FACT: Bleeding gums are one of nine warning signs of gum disease. Think of gum tissue as the skin on your hand. If your hands bled every time you washed them, you would know something is wrong. Other signs of gum disease include: red, angry looking gums; swollen or tender gums; sores in your mouth; gums that have pulled away from the teeth (recession); persistent bad breath; pus between the teeth and gums (leaving bad breath); loose or separating teeth and a change in the way the teeth fit together.

FALLACY: Treatment for gum disease is painful.

FACT: New periodontal procedures including local anaesthesia and over-the-counter medications have made patients' treatment experiences pleasant and comfortable. Many patients find they are back to normal routines on the same day or by the next day.

FALLACY: Gum disease is easy to identify, even in its early stages, so my dentist would tell me if I had it.

FACT: Millions of people don't know they have this serious infection that can lead to tooth loss if not treated. You should always get involved in your dental care, so that problems are detected in the early stages. You should inform your dentist if any signs of gum disease are present or if any changes in your overall health or medications occurred in between visits. Most importantly, you should ask your dentist about your periodontal health and what method was used to evaluate its condition. This level of participation enables you to work in a team approach with your dentist to identify subtle changes that may occur in the oral cavity.

FALLACY: Once teeth are lost, the only treatment options are bridges or dentures.

FACT: Dental implants are a permanent tooth-replacement option for teeth lost to trauma, injury or periodontal disease. Dental implants are so natural-looking and feeling that many patients forget they ever lost a tooth.

FALLACY: Cavities are the number one cause of tooth loss.

FACT: Periodontal disease is the number one cause of tooth loss in adults.

FALLACY: Because gum disease is a bacterial infection, antibiotics can be used to treat it.

FACT: Research demonstrates that antibiotics can be a helpful adjunct to treating periodontal disease. However, medical and dental communities are concerned about the overuse of these medications in treating infections because of the possibility of the development of antibiotic resistant strains of bacteria. This overuse would be detrimental to patients if they develop a life-threatening illness for which antibiotics would no longer be helpful.

FALLACY: Pregnant women should skip professional dental checkups.

FACT: Teeth and gums are affected during pregnancy like other tissues in the body. In order to decrease the risk of damaging the gums and tissues surrounding the teeth, pregnant women should schedule an appointment for a periodontal evaluation.


Source: British Society of Periodontology/American Academy of Periodontology 

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