Periodontitis and Gingivitis Blog

8 September 2016

Periodontitis and Gingivitis

If you have been diagnosed with gingivitis or periodontitis by your dentist, you may have some questions. What caused it? Is there a solution? What can I do to correct the situation? It is perfectly normal to have questions about these things. Gum disease can be broken into two categories; gingivitis and periodontitis. Continue reading for more information on periodontitis and gingivitis and their differences.

Gingivitis

Gingivitis is essentially an infection of the gums. It is the first and most common stage of gum disease, and is found in patients that do not practice good home care. It is caused by bacteria that is allowed to harbor in the mouth through plaque and tartar, things that are usually removed with both proper home care, as well as professional cleanings done by your dental hygienist.

The symptoms of Gingivitis include:

  • Red gums
  • Swollen gums
  • Bleeding in the gums when flossing or brushing
  • A slight odor
  • Possible pain in the gums

The causes of Gingivitis:

  • Improper home care (not flossing, not brushing)
  • Failure to return for professional cleanings

The good news is that gingivitis is completely reversible, and with proper oral maintenance and care, people who experience gingivitis will soon have a healthy, happy mouth. Your dental hygienist will have you return a few times for a deeper cleaning than usual, and when your mouth returns to its healthy state, you can go back to planning to return every six months for your routine checkup and cleaning.

Periodontitis

Periodontitis is an advanced form of gingivitis. When gingivitis is not taken care of and is allowed to advance, patients develop periodontitis. This is a much more serious condition, and is unfortunately irreversible; once a patient is diagnosed with periodontitis, they cannot reverse it. They can only come back for regular maintenance visits with their dentists to prevent the condition’s progression. The causes of periodontitis are essentially the same as the causes of gingivitis. Plaque and tartar are hardened forms of bacteria, and when they are able to get under the gums, the bacteria eats away at the bone. This causes the teeth to become loose, and it promotes a very unpleasant odor, as well as an unpleasant feeling for the patient.

The symptoms of periodontitis include:

  • Red, swollen gums
  • Recession of gums (More tooth visible)
  • Looseness of teeth
  • Teeth falling out
  • A very unpleasant odor
  • Bleeding, even simply to the touch
  • Pain and signs of infection
  • Deep pockets between the tooth and gum
  • Large amounts of tartar and plaque

To treat periodontitis, patients are required to come for regular deep cleanings, otherwise known as “scalings”. This is a procedure performed by the dental hygienist in which the tartar and plaque is completely removed from the teeth and from under the gums. An antibiotic is then placed underneath the gums to halt the growth of bacteria. This prevents the condition from worsening. As long as the patient returns for their scalings, usually every three months, it can be relatively simple to manage and control periodontitis.

Covid-19 and your care

We have now received clear guidance as to what dental procedures we can safely carry out and at what stages during the pandemic.

Below is a summary of the guidance as we understand it, although this may modify over the next few days as some small inconsistencies are clarified.

The government has set five different risk levels for the pandemic 1-5 (low to high), although this changes on a daily basis.

The treatments that we can carry out safely in dental practice will change with the risk level.

Treatments are significantly limited at level 4.

During the next few weeks, we will attempt to contact each patient that has contacted us with a significant dental problem during lockdown, and we hope to book an assessment appointment for those patients in the week commencing 8th June.

Practice doors will be locked at level 3, 4 and 5. Entry to the practice will be limited to pre-booked appointments.

There will be very clear criteria provided in due course as what is required before arriving at the practice, and what the procedure will be upon arrival. We will endeavour to ensure that each person knows exactly what to expect at their visit as this will be quite different to what you have been used to.

The appointment diary will be structured to take into consideration those patients who are shielding, may have underlying medical issues and so on.

The first week is expected to be a slow start as we ensure that the new protocols are working effectively for everyone’s safety. These protocols will be audited and modified until required.

At level 4 we should be able to carry out the following:

Dental assessment (initially restricted to patients who have current urgent need, or did and contacted us during lockdown).

X rays but only for patients who tolerate them well.

TEMPORARY re cementation of crowns. (We cannot dry the tooth effectively enough to cement a crown permanently with the restrictions we face).

Fabrication or repair of removable dentures.

Simple dental extractions. If a tooth breaks, it is probable we will have to leave the roots in place until we are at a lower level of risk. Naturally, we will assess the risk very carefully prior to treatment.

Tightening of loose dental implants if possible, without using a high-speed handpiece (drill).

Temporary fillings.

Draining of a swelling/abscess.

Provision of antibiotics.

Trimming of sharp orthodontic wires (not reliable re cementation of loose brackets, or replacement of missing brackets).

Treatment is only to be offered after careful assessment.

Cosmetic orthodontics

Cheshire Dental Centre provide many of these treatments. We may now be able to progress some of our Quick Straight Teeth cases. We will be in touch with each patient shortly, but please allow us to contact you; we hope that it is understandable that we will be prioritising patients with urgent dental need.

The PPE (personal protective equipment) requirements for the above are not too onerous, and we will not look too different to normal. As you are aware, the cross-infection control at Cheshire Dental Centre has always been exemplary and one of our top priorities.

Although we have been organised with the new PPE guidelines well in advance there may be the occasional time where we are awaiting stock. All practices are attempting to source the necessary PPE we need to keep you and us safe, but supplies are scarce and consequently very expensive.