What is Periodontitis?

Periodontal disease, Periodontitis or more commonly described as sever ‘Gum Disease’, is a chronic inflammatory disease affecting the supporting structures of the teeth and if not promptly recognised and correctly managed it can ultimately lead to tooth loss (Milward & Chapple, 2013). This in tern will result in reduced chewing function and subsequently alteration in dietary intake and nutritional status (Nowjak-Raymer & Sheiham, 2003; Steele & et al, 1998; Sheiham & et al, 2001).

The importance of successful management has recently been supported by the large amount of press recognising that Periodontitis is a risk factor for a number of systemic diseases, including cardiovascular disease, diabetes and rheumatoid arthritis (Tonetti & VanDyke, 2013; dePablo, Chapple, Buckley, & et al, 2009; Chapple & Genco, 2013).At Tracey Bell we recognise and treat all types of gum disease.

Periodontitis affects approximately 43% of the population and this increase to 85% of those over the age of 65 (Milward & Chapple, 2013). Around 10% of the population is highly susceptible to periodontitis and this is accelerated by a number of risk factors (Perkins, 2014) please see below. Data suggests that periodontitis is on the increase reinforcing the need for a successful management program, a key public health priority (Milward & Chapple, 2013).

Why Me? Risk Factors!

Smoking

Research suggests smokers experience more periodontitis, diagnosed later than non-smokers and respond less well to treatment than non-smokers. This is caused by reduced blood flow to the surrounding tissues of the teeth and intern suppresses the immune response to bacteria present in dental plaque. Therefore, assessments of current and former smoking habits are essential (Perkins, 2014).

Diabetes

Poorly controlled diabetes has more periodontal complications. Diabetic patients will be made aware of the links and advised improving their diabetic control will benefit their oral health. There is also evidence to suggest that improving your periodontal health may make diabetic control better as well.

Family History

It has been documented that susceptibility to periodontitis can be hereditary. It will be documented if there is a history of early tooth loss within the family.

Stress

Long-term stress impacts hormonal and inflammatory markers. Patients undergoing major life events (such a bereavement, divorce etc.) may have an increased risk of periodontal problems as a result.

Osteoporosis and Rheumatoid Arthritis

If you have a positive response two one or more of these questions may have an increased risk of periodontitis. If appropriate the relevant risk factor should be modified to reduce its impact on the patient’s oral health.

Nutrition

It has been acknowledged that nutritional intake can impact upon the levels of inflammation seen in periodontitis. High consumption of refined sugars, carbohydrate and saturated fat accelerate the inflammatory response and increase what we call ‘oxidative stresses’ (Milward & Chapple, 2013). Foods rich in antioxidants such as leafy vegetables (broccoli, spinach etc.), berries, red beans, dark chocolate above 70% cocoa, may help to reduce oxidative stress. Calcium and vitamin D intake is also taken into consideration (Milward & Chapple, 2013).

How Does Gum Disease Present ?

What can I expect when I come for treatment?

Hygienic and information gathering phase 1

Initially we will start with completing a comprehensive periodontal examination. This is where we gather information listed above, start to reduce the inflammation by completing a superficial clean, complete a 6 point pocket chart logging pocket depths and active disease and implement a customised oral hygiene plan to be completed on a daily basis at home (the key to successful treatment!). The ‘6 point pocket chart’ will create a map for the treating clinician when completing the next phase of treatment and provide a starting point to compare results to at the end of treatment.

Non-surgical periodontal therapy – deep scaling phase 2

Initially your clinician will make sure you’re comfortable by applying local anaesthetic, which will completely anaesthetise the areas working on. Using site-specific very fine instruments, your clinician will remove any calculus, plaque, bacteria and toxins produced by the bacteria from the deep pockets developing around the teeth’s surrounding tissues. Again, home care will be reinforced and imperative instructions will be provided to help stabilise the condition. Depending on the patient’s individual needs, this phase will be completed over 2 or 4 visits with interval periods not in excess of more than 1 week.

Post Treatment support Therapy – periodontal review phase 3

This will happen 6-8 weeks post phase two, allowing the tissues to heal. At this appointment we repeat the 6 point pocket chart and compare our findings to the original chart created in phase 1. We will be assessing your oral hygiene and ability to keep plaque levels down. If the treatment is successful we will put you on a 3 months maintenance program and ensure close liaisons with your general dental practitioner looking after your overall oral health.

If you are worried about gum disease contact your dentist or dental hygienist for advice

www.traceybell.co.uk

Works Cited

Chapple, I. L., & Genco, R. (2013). Diabeties and Periodontal Disease. Consensus Report of Working Group 2 of the Joint European Federation of Periodontology Workshop on Periodontitis and Systemic Disease. Journal of Clinical Periodontology.

dePablo, P., Chapple, I. L., Buckley, C., & et al. (2009). Periodontitis and Systemic Rheumatic Disease. Nature Reviews Rheumatology, 5, pp. 218-224.

Milward, M. R., & Chapple, I. L. (2013, May). The Role Of Diet In Periodontal Disease. Dental Health The Journal of the British Society of Dental Hygiene and Therapy, 52(6), pp. 18-19.

Nowjak-Raymer, R. E., & Sheiham, A. (2003). Association of Edentulism and diet and nutrition in US Adults. Journel of Dental Research, 82, pp. 123-126.

Perkins, M. (2014, May). Risk Relating to Periodontitis – The furture Management. Dental Health The Journal of The British Society of Dental Hygiene and Dental Therapy, 53(3), pp. 28-29.

Sheiham, A., & et al. (2001). The Relationship among dental status, nutrient intake and nutritional status in older people. Journel of Dental Research, 2, pp. 408-413.

Steele, J., & et al. (1998). National Diet and Nutrition Survey: People Aged 65 Years and Over. London: The Sattionery Office.

Tonetti, M. S., & VanDyke, T. E. (2013). Periodontitis and Artherosclerotic Cardiovascular Disease. Consensus Report of Working Group 1 of Joint European Federation of Periodontology and American Academy of Periodontogy Workshop on Periodontology Workshop on Periodontitis and Systemic Diseases. Journal of Clinical Periodontology.