Gum disease, periodontitis or periodontal disease, refers to the infection and inflammation of the tissues surrounding and supporting the teeth. It is primarily caused by plaque build-up, which can harden into tartar.
Gum disease treatment refers to the restoration of gum health, and can be both nonsurgical or surgical, depending on the stage and severity of the condition. This ranges from non-surgical solutions such as scaling, root surface debridement and antibiotics, to flap surgery or tissue grafts.
Over time, untreated gum disease can result in gum recession, bone loss, tooth loss and even spread to other areas of the mouth and body. This includes severe complications, such as cardiovascular disease, diabetes and respiratory infections. Effective gum disease treatment not only improves oral health, but also helps reduce your risk of these serious health issues.
Your dentist may ask you about your symptoms and personal lifestyle habits before assessing your medical history to pinpoint any risk factors linked to periodontitis symptoms. During your visit, you should also inform your doctor of any preexisting medical conditions or medications you are currently taking. Your dentist may check your bite, if your gums are pulling away from your teeth, and how loose your teeth are.
To accurately diagnose periodontitis, your dentist will perform a gum examination, where they examine your mouth and gums to check for inflammation, plaque and tartar buildup, or gum bleeding. They may use a dental probe between your teeth and gumline to measure the depth of the pockets, which is the depth of the space around your teeth under the gumline.
For healthy mouths without gum disease, the pockets will be around one to three millimetres deep. If the pockets are deeper than four millimetres, it is likely to be periodontitis. Your dentist may also take a dental X-ray to confirm if there is bone loss in areas with deeper pockets.
Your dentist will be able to recognise signs of periodontitis at an early stage during your routine check-up. Hence, it is important to have regular visits to your dentist so they can keep an eye on your condition over time to ensure that it will not worsen.
There are 4 stages of gum diseases, these are:
Mild periodontitis occurs when bacteria enter beneath your gums. This affects the supporting structures of the teeth and may cause the gums to pull away from the teeth.
Untreated moderate periodontitis results in the destruction of support structures such as gums, ligaments, bones, and other structures of the teeth. Moderate periodontitis is accompanied by pain, bad breath, and infection.
This procedure cleans the outer surface of your teeth above the gum line and between the pockets. Your dentist or periodontist will use a dental instrument, or ultrasonic device to get rid of the tartar and bacteria from your tooth surface and just under the gum line.
Root planing removes the tartar that is stuck under your gum and smoothens the root surface. This removal of the film of tartar prevents further accumulation of tartar and bacteria and allows your gums to attach to the teeth again.
Common Questions We Get
If you have gum disease and there is tartar present in your gum pockets, you may need scaling and root planing to clean out the tartar and treat the condition effectively. This procedure helps to remove tartar, bacteria, and debris from your gum pockets, promoting better gum health and preventing further complications from gum disease.
Scaling and root planing is a procedure that aims to remove tartar from your gums, creating a healthier environment for gum attachment to your teeth. By eliminating this irritating substance, inflammation is reduced, and the healing process is initiated, allowing your gum pockets to heal and improve overall gum health. This treatment is essential for managing gum disease and promoting better gum-to-tooth attachment.
During gum disease treatment, we use specialised instruments to clean the area between your gums and teeth. The gum pocket can trap black tartar, so we use a vibrating ultrasonic or piezoelectric tip to remove the tartar. Hand instruments are also used to smooth the root surface and remove any remaining tartar. If the pockets are deep and require more extensive cleaning, we may apply a topical and local anesthetic to numb the area for a more comfortable experience during the procedure. This process helps improve gum health and promotes healing of the gum pockets.
For those with mild periodontal disease, maintaining good oral hygiene practices can reverse the condition. Keep your teeth and gums clean by flossing at least once every day with standard dental floss or a water flosser and brushing your teeth in the morning and before going to bed for at least two minutes twice daily. These habits can get rid of loosened food particles and bacteria. It is also important to visit your dentist regularly for dental cleaning every six to 12 months.
Antibiotics to treat periodontitis come in both topical and oral forms, such as mouthwash, gel, or capsules. These medications can help to get rid of infection-causing bacteria in the targeted area.
Also known as flap surgery or osseous surgery, your dentist or periodontist will make an incision along your gum line to carefully fold back the tissue, lift the gum, and create a flap. By temporarily moving your gums back from the tooth root and exposing it, your dentist can clean the deep plaque, tartar, and plaque under your gums more effectively. Since gum disease can lead to bone loss, your dentist may also smoothen or contour the underlying bone to allow the gums to settle nicely and allow better access for your toothbrushes. The incision is then closed and stitched back into place.
Common Questions We Get
If you have undergone scaling and root planing but still have gum pockets measuring 6mm and above, it means that further intervention may be required to address the deep gum pockets and prevent the condition from worsening. Your dentist may recommend additional treatments, such as pocket reduction surgery or regenerative surgery, to address the persistent gum issues and promote better oral health. It is essential to follow your dentist’s advice and undergo the recommended procedures to improve the condition of your gums and maintain a healthy mouth.
Research has indicated that when gum pockets remain at 6mm and above despite scaling and root planing treatment, it suggests that the periodontal condition is not stable and may continue to deteriorate. This could be attributed to the limitations of toothbrush bristles, as they can only reach up to 5mm below the gum line to clean the pocket. Any pockets deeper than that is challenging for the toothbrush to remove bacteria and food particles effectively. It is advised to address these deep pockets through additional treatments recommended by your dentist to help reduce the risk of further deterioration of the gum condition and maintain oral health. Following your dentist’s advice and undergoing appropriate procedures can help manage periodontal issues effectively.
During the procedure, local anaesthesia is administered to ensure your comfort. The dentist gently moves the gums to expose the tartar on the tooth root. Using specialised instruments, they thoroughly clean the area between the gums and the tooth, removing all the tartar and smoothing the root surface. The bone is also carefully cleaned and shaped to eliminate any infected material. After the tooth root is cleaned, the excess gum tissue is trimmed and repositioned to stick back to the tooth surface more effectively, eliminating deep pockets that can trap bacteria. You can expect improved gum health and reduced pocket depths following this treatment.
If you are a suitable candidate, our dentist or periodontist may recommend a regenerative gel that stimulates your stem cells to populate the bone/gum damaged by gum disease. With time, your bones and gums damaged by bacteria can regenerate.The periodontal regenerative surgery may be performed together with the bone grafting procedure to enhance results.
Common Questions We Get
If you have gum disease and experience angular or cup-shaped bone defects known as infrabony defects, you may encounter significant bone loss around your teeth. In such cases, certain teeth may become loose or shaky, and some gum pockets may not heal properly as the gum tissue cannot reattach to the tooth surface. These infrabony defects indicate a more severe stage of gum disease and may require specialised treatment to address the bone loss and improve the stability of your teeth and gums. It is essential to seek professional dental care to prevent further complications and maintain good oral health.
In certain cases, even after the gum pocket heals, the affected tooth may still remain mobile or loose. To address this issue, we can grow the bone and loss gum back in some situations and reverse the gum disease process, we may opt for regenerative procedures.
These procedures involve introducing wound healing and growth factors into the gum pocket, providing support for the natural healing process of gum and bone tissues. Additionally, for individuals with wide pockets that do not heal effectively with scaling and root planing, regenerative techniques can encourage better healing and improve the overall condition of the gums and teeth. Seeking professional dental care will determine the most suitable approach to address these issues and ensure optimal oral health.
When a loss of gum tissue occurs due to periodontitis, your gum line recedes and exposes your tooth root. For this treatment, some tissue will be extracted from the roof of your mouth and attached to the affected area, which is why this procedure is also called gum grafting. This helps to cover your exposed teeth root, decrease further gum loss, add thickness to your gum line, and ultimately improve the appearance of your teeth. This procedure is usually used in conjunction with Periodontal Regenerative surgery to grow bone and gums back.
This treatment may be necessary when periodontal disease damages the bone around your tooth root. It involves using a dental bone graft made of different types of bone or artificial material to replace the lost bone. The bone graft is then implanted in the affected area where the bone was destroyed. Bone grafting acts as a scaffold and allows your own cells to grow around the tooth. When new bone grows, it will hold your tooth in place, preventing tooth loss in the long run.
Before any treatment, you will be required to undergo a thorough consultation, including dental x-rays, to better understand the extent of your gum disease and the most ideal treatment needed for your condition. Generally, you should get gum disease treatment if you experience the following:
Results of gum disease treatment vary depending on the severity of the condition and the specific techniques used. In general, patients often notice a significant reduction in gum inflammation, resulting in healthier gums that appear pink and firm instead of swollen or bleeding gums. Treatment also helps to stabilise loose teeth by restoring the supporting bone and gum tissue while reducing periodontal pockets.
With ongoing maintenance and guidance from the dentist, patients are also likely to develop better oral hygiene practices. Other issues linked to gum disease such as chronic bad breath also typically improve as bacterial infections in the gums are treated.
In cases where regenerative surgery is used, patients may see new growth of gum and bone tissue. Managing and treating gum disease have shown to decreases the risk of systemic health issues, such as cardiovascular disease and complications related to diabetes.
After treatment, regular dental check-ups are essential for monitoring gum health and preventing recurrence, contributing to significant improvements in oral health and quality of life.
The number of treatment sessions needed largely depend on individual factors such as the severity of the condition, the type of treatment plan, and how well a patient responds to treatment.
Gingivitis
For gingivitis, one to two professional dental cleaning sessions are generally sufficient, followed by regular check-ups every 6 months to maintain gum health.
Periodontitis
For periodontitis, the deep cleaning procedure known as scaling and root planing may require one or two sessions, depending on the extent of the disease. After the initial treatment, follow-up appointments may be scheduled every 3 to 6 months to monitor progress and provide maintenance cleaning.
Severe or advanced periodontitis
If dental treatments such as regenerative surgery are necessary, additional sessions may be required. Once gum health has been restored, regular maintenance visits every three to six months are usually recommended to prevent recurrence and promote ongoing oral health.
There is no best treatment, but rather one that would be best for your specific condition. Mild cases of gum disease can typically be managed by practicing good oral hygiene, while more severe gum disease may require surgical intervention. This is why routine dental check-ups are important — allowing your dentist to monitor your gum health, in turn, mitigating any signs of potential gum disease before the condition worsens.
The cost of treating gum disease in Singapore can vary significantly based on factors such as the severity of the condition, the specific treatment required, and the pricing structure of the dental clinic. It also helps to check with your insurance provider if your gum disease treatment is covered or eligible for claim.
Less invasive forms of gum disease treatment are generally well-tolerated. Sometimes, an anaesthetic can be administered to ensure that you’re kept comfortable throughout the procedure. It is, however, important to note that the extent of your inflammation and infection can also influence pain levels, especially after complex procedures, which could potentially lead to some post-surgical discomfort. Thankfully, this will subside in time as you heal.
Gum disease can often be effectively treated and managed, but whether it can be "cured" depends on the severity of the condition. Book a consultation at An Dental for a comprehensive oral analysis and personalised treatment plan.
Periodontist in Singapore - Special interest in complex full mouth rehabilitation and dental implants
Dr Marlene Teo is a periodontist currently practising in Singapore. She graduated from the National University of Singapore, where she was the sixth dental graduate in its 64-year history to be awarded BDS Honours.
Periodontist - Special interest in digital dental implants and root recession coverage
Dr. Hu Cidong graduated with a Bachelor of Dental Surgery from the National University of Singapore (NUS) and subsequently completed his Master's in Dental Surgery (Periodontology) at NUS.
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