Gum disease treatment: what are the options?

Gum disease treatment options vary, and the best plan depends on the patient and the stage of the disease. Read on to find out about treating gum disease in each of its four stages.

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There’s no need to feel anxious about gum disease treatment

You may not like the idea of gum disease treatment, especially if you have sensitive teeth, have had a bad experience with dental treatment in the past, or if it's been a long time since you’ve visited the dentist. But it’s important to keep in mind that the sole aim of treating gum disease is to get you back to being healthy and feeling good. 

And the best part? People who control their gum disease also reduce their risk of needing more dental treatments - and it will improve your overall health.

Simply put, we need to get your teeth clean, and keep them clean. It’s just that this sounds easier than it really is, especially for people with more advanced gum disease.

There are different ways to do this, depending on the severity of the condition. 

The main thing you might be worrying about with gum disease treatment is that it will be painful. It’s not. Everything is done under general or local anaesthetic, so you’re comfortable the whole time. And of course the benefit is that treatment will take away all the stress and worry that you have about your teeth and leave you feeling much better than before.

Read on to understand the different treatment options for each stage of gum disease.

Treatment options for every stage of gum disease

Gum disease treatment can vary widely depending on:

  1. What stage of gum disease you have
  2. How well you’ve responded to any previous treatments you may have had
  3. Your overall health

There are two categories of treatment - non-surgical and surgical. Both can be performed under general or local anaesthetic, usually at your periodontist’s practice.

Here is an overview of recommended treatments for each stage of gum disease.

Treating Gingivitis, Stage 1 and Stage 2 Periodontitis

The approach to treating Gingivitis, as well as the early stages of periodontitis (gum disease) is pretty much the same. We have to get your teeth clean and keep them clean. It’s just a question of how long this will take and how difficult it will be. Your dentist or periodontist will likely use the following methods to treat these stages of gum disease.

Debridement of the teeth:

As we outlined in Causes of Gum disease, bacterial plaque is the cause of inflammation in gums. If there is no bacterial plaque on the teeth, there will be no inflammation. So the aim of gum disease treatment is to remove all the plaque from the teeth.

We also spoke about the hard calculus that builds up on the teeth when the gums are inflamed. This is a hardened build up that forms above and below the gum and is very hard to remove completely. Calculus is very rough and so plaque sticks to it, even if you have brushed your teeth really well. It would be like trying to clean coral or sandpaper - it just can’t be done. So debridement of the teeth also involves removal of calculus as well.

But it isn't just calculus that keeps plaque on teeth. Fillings that don't have smooth edges also make it nearly impossible to remove all the plaque from the teeth. So sometimes these need to be smoothed or reshaped as well.

If this step is done well, it will resolve all of the inflammation in the gums. The problem is that it is not as easy as it sounds, much of it is done by feel and so without experience, it is easy to leave plaque or calculus behind.

Your periodontist may do this manually with special instruments or with an ultrasonic scaling device. Usually, both methods are used.

Although these processes may sound painful, they are not.  Your dentist or periodontist should always make an assessment as to what kind of pain relief you require.

The other vitally important and often missed step in treating these earlier stages of gum disease is coaching and instructions on how to look after and clean your teeth daily. Make no mistake, this is not as easy as you might think. Even though you have been brushing your teeth your whole life, most people don’t do it very well. 

But when you think about it, it is easy to understand why. When you brush and floss your teeth, you are trying to clean something that you can’t see, in an area that is very difficult to access (this is why your back teeth are often more seriously affected). There is more information about gum disease maintenance here.

Treating Stage 3 - Severe Periodontal Disease with Potential for Tooth Loss

If you’re familiar with the stages of gum disease, you’ll know that by the time it reaches stage 3 there are now very deep pockets between the gums and the teeth. These are much more challenging to clean. So even though the goal is the same (get the teeth clean and keep them clean), sometimes it is impossible to achieve with ‘non-surgical debridement’ of the teeth alone.

Treatment almost always begins with debridement, just as for gingivitis, Stage 1 and Stage 2 Periodontitis. After a review period (usually three months), your periodontist may find some areas do not respond well enough to be easily maintained. In these cases, some more advanced surgical techniques are required.

You may also be missing some teeth by this stage, and so provided the gum disease is treated, you may elect to have those teeth replaced.

If this is the case for you, treatment options are as follows. 

Periodontal surgery:

When gum disease reaches stage 3, it can be impossible to access the roots of the teeth that need debridement. In these cases periodontal surgery allows your periodontist to see and access the root surfaces and therefore do a more complete treatment. The other advantage of this technique is that the pockets can be reduced, which makes it easier to keep the plaque off the teeth long term and therefore maintain the health of your gums.

Periodontal regenerative surgery:

The ultimate goal in periodontics is to regenerate the ligaments and supporting bone that has been lost due to gum disease. Fortunately, in many cases this is now possible. Different situations require different techniques and materials including bone grafts, membranes and enamel matrix derivative. When used successfully, these approaches improve the prognosis of the teeth and simplify long term maintenance as well.

If you have lost teeth, your dentist or periodontist will be able to recommend your tooth replacement options as outlined in the next section.

Treatment for Stage 4 - Severe with potential for loss of all the teeth

If your gum disease has reached Stage 4 - Severe with potential for loss of all the teeth, the teeth are often loose, drifting and moving out of position.

Your specialist is likely to employ all of the methods listed above but ultimate stabilisation of the teeth often requires other specialist disciplines as well such as orthodontists and prosthodontists after the inflammation in the gums has been treated and resolved.

Orthodontists are specialists at repositioning the teeth back into alignment when they have drifted and moved due to gum disease. 

Prosthodontists are specialists in restoring and replacing teeth and crowns. They are also experts in how your teeth bite together and function. When you’ve had advanced gum disease sometimes teeth become loose and need to be stabilised by joining them to the other adjacent, healthy teeth. Often the teeth need to be adjusted and modified to reduce the biting force on the more severely affected teeth. And this all needs to be done in a way that makes the teeth look good so that other people are never aware that there was a problem.

Tooth replacement:

Gum disease is the most common reason for adult tooth loss. But thankfully, there are excellent tooth replacement options that look and work like natural teeth. Your periodontist can replace any missing teeth using either dental implants or dentures so you can enjoy life again.

Conclusion

There are solutions that can help you cure or manage gum disease at any stage. If you believe you have gum disease, don’t feel nervous about treatment. The quicker you seek help, the easier it will be to reverse or stop progression. You will always feel better after treatment than you do with gum disease.

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What are the causes and risks for gum disease?

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