Have you ever wondered why so many people are struggling with gum disease and have been for so many years?
Why years after having treatments and going to see the hygienist every 3 or 4 months those pocket are still there, this disease is not stopped and we still loose bone and eventually teeth?
Is it possible to stop it, is it possible to defeat it once and for all?
The answer is easy: of course it is if you know how to do it.
As remarked in previous article http://www.traceybell.co.uk/no-longer-shoud-we-be-long-in-the-tooth/, periodontal disease is a multifactorial disease, so genetic predisposition, other medical conditions, social habits (smoke) and host response are involved in the pathogenesis of this disease.
As we have seen, in most cases advanced periodontal disease results in the permanent damage to the gums with what we call pockets (see previous article) and different kinds and severity of bone loss. As explained the first approach to this disease is to understand individual causes and factors, make the right diagnosis and therefore treatment plan.
In most cases gum disease will be then stopped by your dentist or hygienist, pockets will get smaller, bone loss will be halted and everything will finally get better.
The next big question is: is this it? Can I consider myself safe after all these treatments?
The answer varies for every patient and each situation is different but in general, if we catch the disease in early stages, these non-surgical treatments might be enough however, if the situation was severe at the beginning, you’ll end up in a mixed situation with some healthy areas and some areas with what we call remaining pockets.
What does it mean? What are they?
Well they are still gaps between your gum and the teeth, the same pockets we had at the beginning have basically reduced but they are in fact still there!!
These pockets are making the situation still unstable, plaque will keep getting there, patient and hygienist/dentist will still struggle to clean in there and slowly the situation might relapse.
This phenomenon has been proved by an impressive amount of studies where the progression of these pockets has been observed. In these studies every patient has been treated with non-surgical treatments to stop the disease, as explained before some of them ended up with some remaining pockets. All of those patients have then been put on a maintenance program with 3 or 4 monthly hygiene recalls.
After 10 years almost every one of these remaining pockets relapsed.
Are we doomed then? No, absolutely not! But most of the time after a first phase when the gum disease has been stopped, most dental professionals and patients believe to have resolved the problem, they are then trying to maintain the situation usually by having 3 monthly hygiene recalls, sometimes pushing it to 1 monthly recall, fighting against the inevitable.
It is really hard to make general statements about this disease because each patient and case is different but in most cases these pockets can still be sorted and fixed with some surgical procedures. The surgical procedures are not always needed or possible, but for the patients that will benefit from having them, the choices are many.
About the bone loss, in some cases the bone loss can be adjusted and in some other lucky patients the bone can even be regenerated!!
Of course it is crucial to evaluate when surgery is possible, which is the correct one for the specific situation, how to do it and a number of other things. The wrong approach to the case can make the situation worse or make the treatment unsuccessful.
So as usual it is always really important to make the correct diagnosis and treatment plan, customised to patient’s needs and possibilities.
Have you been struggling for years with keeping your periodontal disease under control? Would you like a consultation?
Ask your dentist, hygienist, therapist about your situation, about the possibility of accessing these treatments, it is always better to have an open collaboration between different clinicians treating the same patient or if you want a consultation just visit our website www.traceybell.co.uk or call directly on 805230.
Article by Dr. Giovanni Marras (Tracey Bell Castletown)
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