Gum Treatments and Dental boutique at Northumberland Institute of Dental Medicine

Gum Treatments

What is gum disease?

Periodontal diseases are serious bacterial infections which destroy the attachment fibres and supporting bone that hold your teeth in your mouth. Left untreated, these diseases can and do lead to tooth loss. Periodontal disease is the number one reason why people over the age of 50 in Ireland actually lose teeth. Periodontal infection can affect your general health and hence it is important to control.

What is Periodontics?

Periodontics is the branch of dentistry concerned with the prevention, diagnosis and treatment of gum (periodontal) disease, and the placement of dental implants.

Gum disease treatmentsGum disease is caused by build-up of bacteria in plaque, a sticky colourless film that constantly forms on your teeth. Regular brushing & flossing and hygienist treatment with our hygienists can remove this build up and prevent gum disease from progressing. If plaque is allowed to build up, it will cause irritation to the gums, making them swell up and bleed. This is known as gingivitis. Gingivitis is reversible and is resolved by excellent at-home care and hygienist treatment.

If gingivitis is not treated and the plaque continually builds up, you will be at risk of periodontitis. This is when the fibres around the tooth are damaged by the increase in bacteria, resulting in pockets and ultimately bone loss around the tooth. Periodontitis is a serious and irreversible condition that can lead to tooth loss.

Gum treatments - Scaling and PlaningIf you have gingivitis, we recommend that you visit our hygienists  for regular professional cleaning.

If you have periodontitis, a full initial assessment will be carried out by our periodontists, who will plan a course of treatment specifically tailored to your needs. Quite often, you will have been referred to us by your family dentist.

Treatment will depend on how far the disease has developed. Typically, you will undergo in-depth cleaning – a treatment known as “root debridement”. This may require several appointments. Typical cases last from 3 months to 1 year, but for some people, a lifetime commitment may be required.

As the crowns and roots of the teeth become clean, your gums will tighten up on their root surfaces. Any loose teeth may also become firmer. As periodontal disease is an infection by plaque bacteria and other micro-organisms, treatment will typically involve the application of a topical anti-microbial drug (Dentomycin gel) directly into the gingival crevices & pockets.

In advanced cases, root debridement is not sufficient to achieve optimal results. In this case, surgical treatment using growth factors (Emdogain®) and bone substitute (Geistlich Bio-Oss®) may be required.

To reduce discomfort, all periodontal procedures are completed under local anaesthetic and/orconscious sedation. There may be some post-operative discomfort which you will be advised how to manage by our team.

It is critical that throughout your treatment and following treatment that you maintain a high level of oral hygiene.
You can do this by:
→ Regular brushing; recommended 3 times/day
→ Using fluoride alcohol-free mouth wash daily
→ Using inter-dental brushes daily
→ Eating plenty of fruit & maintain a healthy low-sugar diet; avoid sticky sweets, biscuits, gum, fizzy drinks etc.
→ Visiting your dentist regularly

Your new smile will enhance your appearance, increase your confidence and improve your dentition. Please look after your new smile as a lack of conscientious care can lead to staining, decay, gum problems and many more complications.

Tell me more about Cleaning & Oral Hygiene

Oral hygiene

Oral hygiene is a cornerstone of oral health. Keeping your mouth clean will prevent dental decay, gum disease and bad breath. In order to do this, excellent at-home care is needed. In addition, regular visits to our dental hygienists will ensure that hard to reach areas of the mouth, such as below the gum line or around dental implants, are thoroughly cleaned.

Optimal oral health is possible for all patients. The first step in at-home care involves brushing, which cleans about 80% of the tooth surface. The second step is cleaning between the teeth, using either Tepe brushes or floss, which tackle that hard to reach 20%. Step three involves maintaining a healthy lifestyle including quitting smoking, drinking less alcohol, eating well and managing stress. Finally, step four is professional care – regular visits to your dentist and hygienist.

We recommend that you brush your teeth at least twice daily – morning and night – and if possible, just after lunchtime. If you are brushing correctly, it should take you around 2 minutes to complete.  Watch yourself in a mirror to make sure you use the correct angle of your brush and reach all the surfaces of your teeth.

  • Apply a pea-sized amount of flouride toothpaste to your toothbrush.
  • Begin by cleaning the outside surface of the teeth. Position the brush at a 45˚ angle where your gums and teeth meet. Half the bristles of the brush will be on the tooth, the other half will be on the gums. Gently move the brush backwards and forwards a few times using small, gentle strokes.
  • Use light pressure while brushing (similar to the pressure of writing with a soft pencil).
  • Use a soft tufted toothbrush unless we advise you otherwise.
  • When you are finished cleaning the outside surfaces of all your teeth, follow the same directions while cleaning the inside of the teeth. Now you can clean the biting surfaces of your teeth. Again, we would advise soft gentle pressure.

When you are finished, spit out as much toothpaste as you can. Don’t rinse out your mouth as this will dilute the therapeutic benefits of your toothpaste.

You should change your toothbrush at least every 3 months.

Brushing your teeth will usually clean about 80% of the tooth surface. The remaining 20% can ONLY be properly cleaned through the use of inter-dental cleaners such as dental floss and inter-proximal brushes.

Flossing correctly will take lots of practise so please be patient when you are getting to grips with this. Perseverance will pay large dividends in the long term.

Start with a piece of floss (waxed is easier) about the length of your arm. Lightly wrap most of the floss around the middle finger of one hand. Wrap the rest of the floss around the middle finger of the other hand.

To clean the upper teeth, hold the floss tightly between the thumb and index finger of each hand. Gently insert the floss between the teeth using a back-and-forwards movement. Do not force the floss or try to ram it in to place. Bring the floss to the gum line then curve it into a C-shape against one tooth. Slide it into the space between the gum and the tooth until you feel light resistance. Move the floss up and down on the side of one tooth. Remember there are two tooth surfaces that need to be cleaned in each space. Continue to floss each side of all the upper teeth. Be careful not to cut the gum tissue between the teeth. As the floss accumulates plaque and food deposits (and possibly blood), turn from one finger to the other to get a fresh section.

To clean between the bottom teeth, guide the floss using the forefinger of both hands.

You may wish to use a mouthwash at this stage also.

Don’t be alarmed if your gums bleed or are a little sore for the first few weeks after you begin flossing. As you floss daily and remove the plaque your gums will heal and the bleeding should stop. You should also see the colour of the gums change from a deeper red colour (inflamed gums) to a paler pink colour (healthy gums). If you really look closely at the gums, you’ll also notice that the gums won’t look as swollen and the texture will alter too. This is all good news.

Cleaning teeth with daily brushing and flossing will help keep dental plaque and tartar to a minimum, but a professional cleaning will remove the build-up of tartar in areas where your toothbrush and floss have missed.

Our advice is simple. Visit your dentist and hygienist regularly to ensure that your teeth and gums remain healthy and feel great for a lifetime.

Dental boutique at Northumberland Institute of Dental Medicine, DublinHere at the Northumberland Institute of Dental Medicine we have a dedicated dental boutique and our staff will be happy to advise you on the correct dental care products for you. As you will be aware there are many products on the market it can be confusing and difficult to choose the correct products.

Electric toothbrushes are quite effective for the majority of patients. Oral irrigators (water spraying devices) will rinse your mouth thoroughly, but will not remove plaque. You still will need to brush and floss in conjunction with the irrigator. There are also tiny brushes (inter-proximal toothbrushes) which clean between your teeth. Our hygienists and dentists here will show you how to use these properly when you come to visit. We don’t recommend mouth rinses for children under six years of age.

Gum Reshaping

Crown lengthening, gum contouring and reshaping are common and versatile procedures designed to reshape the gums and/or bone at the base of the tooth. The overall goal is to expose more of the natural tooth surface for functional and/or cosmetic purposes. The procedure is performed by our periodontists, under local anaesthetic and can be done on a single tooth, several teeth or along the entire gum line.

Some patients may be concerned with the ‘gummy’ appearance of their smiles or may find that their teeth appear short. Often, the teeth are the correct length but are partially covered with excess gum tissue. To correct this, the periodontist may suggest a crown lengthening procedure along with gum contouring to remove and reshape gum and/or bone tissue in order to expose more of the natural tooth. The periodontist works closely with each patient to help create a beautiful, natural looking smile.

Crown lengthening may also be necessary when restoring damaged teeth. For example, if there is not enough natural tooth exposed to support a filling or a crown due to severe decay or tooth fracture below the existing gum line, crown lengthening can help to create a more stable base for the appropriate restoration.

Clinical example: Crown lengthening

This lady was unhappy with her crowns and the ugly dark margins at the gum border

Clinical example: Crown lengthening

This case required a combination of gum reshaping and providing some beautiful new crowns for the patient.

Clinical example - gum reshaping

This gentleman was unhappy with the appearance of the gum around his right lateral incisor tooth.

Clinical example - gum reshaping

Dr. O’Donoghue carried out some gum reshaping (“crown lengthening”) to produce a very nice result for the patient.

Gum Recession

Gum recession is a condition in which the gums recede or pull away from the teeth causing the roots to become exposed. People of all ages can be affected by gum recession; sometimes even if a person maintains good oral hygiene. If left untreated, there is a greater risk of decay, sensitivity due to the exposed root, and even the eventual loss of teeth.
Because gum recession occurs gradually, many patients may not be aware of the problem, especially if they are not experiencing any pain or sensitivity. Some of the visible signs of recession may include longer appearing teeth or spaces between the teeth that appear bigger at the bases.

Gum recession

  • Gum disease
  • Poor brushing technique
  • Trauma or injury to the gum tissues
  • Ill-fitting partial dentures
  • Crooked teeth
  • Tobacco use
  • Genetic factors

For some patients, genetic or hereditary factors can cause gums to recede despite good oral hygiene practices. Nevertheless, for most people, brushing teeth twice daily, flossing once daily, avoiding risk factors such as smoking, and seeing our team for regular cleanings and check-ups can effectively prevent gum recession.

The first step in treating gum recession is to determine the cause.

  1. If gum recession is related to tobacco use, we will advise cutting back and/or quitting all together.
  2. If gum recession is caused by brushing teeth too vigorously, we can work with you to help you develop a technique that protects your gums from further damage.
  3. If gum recession is caused by crooked teeth, we may suggest an orthodontic treatment to straighten the teeth before continuing on with other gum treatments.
  4. If gum recession is caused by gum disease (periodontal disease) the first step in treatment will be to have a professional deep cleaning (scaling and root planing) to remove any plaque or tartar build-up on the roots where the gums are receding. This would be followed by improved at-home hygiene practices to help minimize further recession.
  5. If gum recession is caused by ill-fitting partial dentures, we can adjust or remake them for you. In some cases, we can also suggest alternatives to partial dentures.

In the case of advanced recession, treatment may include:

Gum grafting – A surgical procedure in which a thin piece of healthy tissue is taken from another place in the mouth and attached to the receded gums. The procedure is performed by the periodontist who uses a specialised gum grafting material. Once the tissues heal, the previously exposed root will be covered and protected from sensitivity and decay. Grafts can be performed on one or more teeth and may also be used for cosmetic purposes.

Bone grafting – In severe cases, the supporting bone at the base of the teeth may be destroyed.

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