Periodontics (Gum Disease)

Periodontal Disease

Periodontal (gum) diseases, including gingivitis and periodontitis, are serious infections which if left untreated, can lead to tooth loss. The word periodontal literally means “around the tooth.” Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth.

Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colourless film that constantly forms on your teeth) causes the gum to become inflamed.

In the mildest form of the disease, gingivitis, the gums redden, swell and bleed easily. There is usually little or no discomfort. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.

Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gum) that become infected. As the disease progress , the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. eventually, teeth can become loose and may have to be removed.

Causes of Periodontal Disease

The main cause of periodontal disease is bacterial plaque, a sticky, colourless film that constantly forms on your teeth. However, the following factors also affect the health of your gums.


Research shows that up to 20% of the populations may be genetically susceptible to gum disease to the effect that teeth can be lost. Identifying these people before they even show signs of moderate disease and getting them into early interceptive treatment may help them keep their teeth for a lifetime.

Smoking/Tobacco Use

As you probably already know, tobacco use is linked with many serious illnesses such as cancer, lung disease and heart disease, as well as numerous other health problems. What you may not know, is that tobacco users also are at increased risk for periodontal disease. In fact, recent studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease.


Diabetes is a disease that causes altered levels of sugar in the blood. Diabetes develops from either a deficiency in insulin production (a hormone that is the key component in the body’s ability to use blood sugars) or the body’s inability to use insulin correctly. According to the American Diabetes Association, approximately 16million Americans have diabetes, however, more than half have not been diagnosed with this disease. If you are diabetic, you are at a higher risk for developing infections, which may cause your diabetes to be more difficult to control and your infection to be more severe than a non-diabetic.


As you probably already know, stress is linked to many serious conditions such as hypertension, cancer and numerous other health problems. What you may not know is that stress also is a risk factor for periodontal disease. Research demonstrates that stress can make it more difficult for the body to fight off infection, including periodontal diseases.

Pregnancy & Puberty

As a woman, you know that your health needs are unique. You know that brushing and flossing daily, a health diet, and regular exercise are all important to help you stay in shape. You also know that at specific times in your life, you need to take extra care of yourself; times when you mature and change, for example, puberty or menopause, and times when you have special health needs, such as menstruation or pregnancy. During these particular times, your body experiences hormonal changes. These changes can affect many of the tissues in your body, including your gums. Your gums can become sensitive and at times react strongly to the hormonal fluctuations, which may make you more susceptible to gum disease. Additionally, recent studies suggest that pregnant women with gum disease are seven times more likely to deliver pre-term, low birth weight babies.


Some drugs, such as oral contraceptives, anti-depressants, and certain heart medicines, can affect your oral health. Just as you notify your pharmacist and other health care providers of all medicines you are taking and any changes in your overall health, you should also inform your dental care provider.

Clenching or Grinding Your Teeth

Has anyone ever told you that you grind your teeth at night? Is your jaw sore from clenching your teeth when you’re taking a test or solving a problem at work? Clenching or grinding your teeth can put excess force on the supporting tissues of the teeth and could speed up the rate at which these periodontal tissues are destroyed.

Periodontics – the treatment of gum and bone infections

Periodontic disease affects the tissue supporting the teeth and is a result of gum infection (periodontitis or gingivitis). Gingivitis is present when the gums become inflamed, looking red and swollen with bleeding occurring when brushing or flossing. As the periodontal disease gets progressively worse the bone attaching the teeth in the jaw is lost, resulting in the teeth becoming loose. If left untreated this condition can result in your teeth eventually falling out.

Some recent scientific studies also suggest a link between gum disease and other systematic disease such as diabetes, heart and lung disease and Alzheimer’s (articles available on request). It is therefore important not only for your oral health but also your general health, to have treatment and eradicate any gum disease present.

The trouble with gum disease is that people can have it for years without noticing it. General oral maintenance is essential for all patients. It’s not only about avoiding decay and fillings but involves looking after your gums. Therefore to prevent and treat gum disease every patient should adhere to the following daily:-

  • Tooth brushing twice a day
  • Use a mouthwash twice a day
  • Interdental brushing/flossing once a day – preferably at night
  • Regularly visit the dental hygienist

Regular hygienist visits are essential in order to monitor a patient’s dental health and identifying signs of periodontal disease. For this reason Dr Howdle and his hygienist work together closely in the diagnosis and treatment of gum disease.


Cosmetic Periodontal Treatment

An essential part of anyone’s smile, is not just the teeth but also the gums which surround the teeth. There should be a maximum of 2mm of gum showing when smiling widely, for the appearance not to have a ‘gummy’ look. In order to create the ideal gum line, gum sometimes needs to be added (cosmetic soft tissue grafting) or removed(gum lifts) to give the ideal result to your smile, using specialist gum sculpting techniques.

Soft tissue grafts

Periodontal procedures are available to stop further dental problems and gum recession and/or to improve the aesthetics of your gum line.

Exposed tooth roots are the result of gum recession. Perhaps you wish to enhance your smile by covering one or more of these roots that make your teeth appear too long. Or, maybe you are not bothered by the appearance of these areas but you cringe because the exposed roots are sensitive to hot or cold foods and liquids.

Your gums may have reduced for a variety of reasons, including aggressive tooth brushing or periodontal disease. You may not be in control of what caused the recession but prior to treatment, your Periodontist will help you identify the factors contributing to the problem. Once these contributing factors are controlled, a soft tissue graft procedure will repair the defect and help to prevent additional recession and bone loss.

Soft tissue grafts can be used to cover roots or develop gum tissue which is absent due to excessive gingival recession. During this procedure, your Periodontist takes gum tissue from your palate or another donor source to cover the exposed root. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity.

What are the benefits of this procedures?

A soft tissue graft can reduce further recession and bone loss. In some cases it can cover exposed roots to protect them from decay. This may reduce tooth sensitivity and improve the aesthetics of your smile. A beautiful new smile and improved periodontal health – your keys to smiling, eating and speaking with comfort and confidence.

Gum Lifts (Crown Lengthening)

Periodontal procedures are available to lay the groundwork for restorative and cosmetic dentistry and/or to improve the aesthetics of your gum line.

You may have asked your Periodontist about procedures to improve a “gummy” smile because your teeth appear short. Your teeth may actually be the proper length but they are covered with too much gum tissue. To correct this, your periodontist performs crown lengthening. During this procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth.

Your dentist or Periodontist may also recommend crown lengthening to make a restorative or cosmetic dental procedure possible. Perhaps your tooth is decayed, broken below the gum line or has insufficient tooth structure for a restoration, such as a crown or bridge. Crown lengthening adjusts the gum and bone levels to expose more of the tooth so it can be restored.