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Treatment might be painful, but this would depend on which treatment you are undertaking specifically because periodontal treatment helps a range of different people with different severities of gum disease. Your dentist will probably use a local anaesthetic during the treatment if they believe you’ll be at risk of severe pain. A periodontist will assess your medical history as a starting point. Issues relating to general health are likely to affect the gums and bone structure of your mouth. Things that can come into consideration are pregnancy, diabetes, heart disease, and many other conditions. The varying nature of each individual case makes it vital for a periodontist to assess your specific needs.

During gum grafting, they’ll use a soft tissue graft. This graft may be either a synthetic material or tissue taken from another area of your mouth. It will be placed to cover exposed tooth roots.Multiplication: through continued growth and maturation of existing plaque micro-organisms and the further recruitment of later colonisers. [19] Flap surgery: During this procedure, a periodontist (gum specialist) makes an incision along your gum line and temporarily lifts your gum tissue away from your teeth. This allows them to see your teeth roots easily and clean them thoroughly. If infection caused bone loss, your periodontist may re-contour your underlying bone ridge. This makes the affected areas much easier to clean once healing takes place. Periodontal diseases can be caused by a variety of factors, the most prominent being dental plaque. Dental plaque forms a bacterial biofilm on the tooth surface; if not adequately removed from the tooth surface in close proximity to the gingiva, a host-microbial interaction gets underway. This results in the imbalance between host and bacterial factors which can in turn result in a change from health to disease. Other local or systemic factors can result in or further progress the manifestation of periodontal disease. Other factors can include age, socio-economic status, oral hygiene education and diet. Systemic factors may include uncontrolled diabetes or tobacco smoking. [15]

Also acute necrotizing ulcerative gingivitis and necrotizing ulcerative periodontitis, it is a type of periodontal disease different than many other periodontal diseases. Clinical characteristics include gingival necrosis (breakdown of the gums), gingival pain, bleeding, halitosis (bad breath), as well as a grey colour to the gingiva and a punched out appearance. [ clarification needed] It is treated through debridement, usually under local anaesthetic due to immense pain. To maintain and treat the condition completely, a chlorhexidine mouthwash should be recommended to the patient to use twice daily, oral health instruction should be provided (using a soft bristle toothbrush or electric toothbrush twice a day) and an interdental cleaning aid, such as floss or interdental brushes, which cleans the areas that the toothbrush cannot reach. The patient should also be educated on proper nutrition and diet and healthy fluid intake. Smoking cessation should occur not only to completely eradicate the disease but also for the health of the patient. Pain control can be done through ibuprofen or paracetamol/acetaminophen. In the case of an immunocompromised patient, antibiotics should be prescribed. Assessment of treatment should be done after 24 hours of treatment and continued every 3–6 months until signs and symptoms are resolved and gingival health and function restored. [55] Chronic periodontitis [ edit ] Treatment with antibiotics may be recommended if you have a very serious infection. Antiseptic mouthwash may be recommended by a hygienist to help discourage the growth of bacteria. However, a mouthwash can't remove plaque already built up on your teeth - this must be brushed off or removed by a hygienist. The aim at Pure Periodontics is to preserve your teeth wherever possible and if it is advisable. By the end of this appointment you will be fully informed about your periodontal condition and have a sound understanding of the proposed treatment as well as the likelihood of success. a b Newman, M., Takei, H. Klokkevold, P. R., Carranza, F. A. (2015). Carranza's Clinical Periodontology (12th ed.). St. Louis: Elsevier IncYour period can last between 2 and 7 days, but it will usually last for about 5 days. The bleeding tends to be heaviest in the first 2 days. A periodontist is a dentist who specializes in preventing, diagnosing, and treating gum disease. They also help you manage signs of advancing gum problems like oral inflammation. Smile lift:Some people have excess gum tissue that covers part of their teeth when they smile. People who want to improve the appearance of their smile can have a smile lift. During this procedure, your periodontist removes gum — and usually a small amount of bone — from around the affected teeth. Your periodontist can perform a smile lift as a stand-alone procedure or they may recommend it in combination with veneers. A risk factor is a variable that in health can be defined as "a characteristic associated with an increased rate of a subsequently occurring disease". [23] Risk factors are variables that contribute to disease, rather than being factors that induce disease. Risk factors may be seen as modifiable and non-modifiable. Modifiable risk factors are often behavioural in nature and can be changed by the individual or environmental circumstances, whereas non-modifiable factors are usually intrinsic to an individual's genetics and cannot be changed. To determine risk factors for a disease, evidence-based research and studies are needed for evidence, with longitudinal studies giving the most statistically significant outcomes and the best reliability for determining risk factors. Risk factors often coexist with other variables, rarely acting alone to contribute to a disease. Risk factors can be genetic, environmental, behavioural, psychological, and demographic in nature. [24]

Periodontal diseases take on many different forms but are usually a result of a coalescence of bacterial plaque biofilm accumulation of the red complex bacteria (e.g. P. gingivalis, T. forsythia, and T. denticola) of the gingiva and teeth, combined with host immuno-inflammatory mechanisms and other risk factors that can lead to destruction of the supporting bone around natural teeth. Untreated, these diseases can lead to alveolar bone loss and tooth loss. As of 2013 [update], periodontal disease accounted for 70.8% of teeth lost in patients with the disease in South Korea. [12] Periodontal disease is the second most common cause of tooth loss (second to dental caries) in Scotland. [13] Twice-daily brushing and flossing are a way to help prevent periodontal diseases. [14] In the UK, dentistry is categorised into general, community, public health, hospital and armed forces care. Each category has its own challenges but supports individuals with combating and improving their dental issues. Dentists also have a duty to make a patient’s visits calm and comfortable, so that any preconceived notions are forgotten. a b AlJehani, Yousef A. (2014). "Risk Factors of Periodontal Disease: Review of the Literature". International Journal of Dentistry. 2014: 182513. doi: 10.1155/2014/182513. PMC 4055151. PMID 24963294. Irreversible interaction: bacterial adhesins recognise specific host receptors such as pili and outer membrane proteins. The different species of bacteria bind together and require specific receptors to interact with the pellicle. [20]An oral health therapist is a member of the dental team who is dual-qualified as a dental hygienist and dental therapist. They work closely with dentists and a number of dental specialists including periodontists. It is common for the oral health therapist to be involved in the treatment of gingival and periodontal diseases for patients. Their scope of practice in this area includes oral health assessment, diagnosis, treatment and maintenance and referral where necessary. They also have expertise in providing oral health education and promotion to support the patient to maintain their at-home oral care. [47] Oral health therapists are employed by the dental team to share the responsibilities of care. They are an important asset as they have been uniquely and specifically trained in preventative dentistry and risk minimization. This allows the dental team to work more competently and effectively as dentists can manage more complex treatments or significantly medically compromised patients. [48] Periodontist [ edit ] There are many risk factors that contribute to placing an individual at higher risk for developing gingival and periodontal diseases. However, the only aetiological factor for periodontal disease is bacterial plaque, or biofilm. Identification of one's risk factors plays an important role in the diagnosis, treatment and management of periodontal diseases. It was previously believed that each human being had the same risk of developing periodontal diseases, but through the identification and classification of risk factors, it has become well understood that each individual will have a differing array of risk factors that generate susceptibility and contribute to severity of periodontal disease. If you have more serious periodontitis and other treatments haven't worked, your dentist may refer you to a periodontist for gum surgery. a b c d Weinberg, M., Westphal, C., Froum, S. J., Palat, M. P., & Schoor, R. S. (2010). Comprehensive Periodontics for the Dental Hygienist (3rd ed.). Upper Saddle River, N.J.: Pearson Education