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What is periodontitis?

Gum disease (periodontitis) refers to an infection-induced inflammatory process involving tooth-supporting structures.

Approximately 5% to 20% of any population suffers from severe generalized periodontitis even though moderate periodontal disease affects a majority of adults. This most common human oral disease is caused by certain bacteria which start to increase in number and virulence when the related risk factors such as multiplying bacterial deposit can grow undisturbed under the unreachable gum pockets while producing by-products which may stimulate the body’s defensive inflammatory response in the around the teeth. This chronic inflammatory disease may progress and cause gradual bone destruction over the years when not treated efficiently.

How the progression of periodontitis can be recognised?

The inflamed swollen gum called gingivitis may be recognized during brushing when bleeding. In some individual gingivitis may progress to gum disease (periodontitis) when untreated. Consequently, over time the affected patient may experience increased gum-bleeding, bad breath, drifting teeth, gum recession, and tenderness in the gum. Controversially, bleeding from the gums may be less noticeable in smokers, as nicotine has an adverse vasoconstrictive effect on blood vessels by decreasing the local blood circulation hence reduced bleeding from diseased gum. As periodontitis is usually pain-free, it can be left unrecognized until its very progressed stages. Therefore, to treat the periodontitis in a timely manner, it is paramount that dental clinicians in particular the gum specialist or periodontist investigate into the specific clinical signs and symptoms and radiographic features of gum disease at an early stage of its progressive destruction.

Is periodontitis correlated to the other systemic chronic inflammatory disease?

Based on the case studies, clinical research, and epidemiological studies there are strong evidenced-based associations between chronic gum infection or periodontal disease and cardiovascular disease (CVD), Alzheimer’s disease, erectile dysfunction syndrome, low-weight child disease, premature parturition.

Read more on the correlation between Periodontal and other systemic inflammatory disease e.g., cardiovascular diseases

Causes of Periodontitis

Retention or accumulation of dental plaque around the teeth, may gradually enhance the number and virulence of the bacterial colonies which may in turn reduce natural defence system of the local tissue. The salivary minerals and gingival crevicular fluid may gradually cause sedimentation of growing bacterial plaque and creation of harder deposit called tartar or dental calculus. This the bacterial growth is further facilitated along the roots surfaces causing an inflammatory process which destruct the peripheral periodontal tissues via the gum pockets. This bacterial infection-induced inflammatory process which causes progressive destruction of the tooth-supporting/periodontal tissues is called periodontitis.

The pathologic pocket around the root surface favour the colonization, growth and multiplication of the virulent bacteria which are capable to destruct the tissues both directly by releasing destructing enzymes, toxins and other bi-products which compromise the body’s defence mechanisms, and indirectly by inflammatory stimulation of the local immune system.

Read more about the diagnosis, and treatment of periodontal disease

Prevention of the Periodontal Disease

The risk factors involved in the emergence and progression of the periodontitis, could be divided in the local virulent factors e.g, number and type of virulent bacteria, the host factors such as the ability of the individual’s local and systematic defence mechanisms coupled with the tissue healing capacity, the presence of the confounding risk factors which compromise the host response e.g. smoking, certain drugs regulating the tissue response as well as inherent immune-suppressive factors such as stress, systematic disease. Factors prevailing the chronic gingivitis should be recognised and addressed during professional dental and periodontal examinations and treatment sessions.

It is scientifically well-proved that smoking adversely affects the status of the local health, healing, and immune response of periodontal tissues and successful treatment of gum disease as a result.

Treatment of Periodontitis

With careful assessment and treatment, it is usually possible to completely halt the progress of periodontitis. The key to success is to eliminate the bacterial plaque which is triggering the periodontal disease process and to establish excellent oral hygiene practices.

At London specialist dentist, we provide the following periodontal specialist services:

  • Clinical assessment, diagnostic, treatment of the patient with aggressive and chronic periodontitis.
  • Diagnosis and treatment planning for patients with the oral manifestation of systemic disease.
  • Clinical assessment, diagnostic, treatment of patients who require post/endodontic and/or pre-prosthodontic root amputation and crown lengthening.
  • Clinical assessment, diagnostic, treatment of young patients who require pre-orthodontic surgical tooth exposure, and patients who require post-orthodontic surgical soft tissue and hard tissue regenerative procedures.
  • Clinical assessment, diagnostic, treatment of patients with clinical periodontal disease symptoms in need of occlusal re-organization by means of fixed and removable prosthodontics.
  • Clinical assessment, diagnostic, treatment of patients presenting with peri-implantitis.
Online Periodontal Self Assessment

At London Specialist Dentist, we implement Triple-Wavelength-Technology using the latest generation of LASER in dentistry. SiroLaser Infrared wavelength is effectively used in the decontamination of infected periodontal, peri-implant pockets, and infected root canals, as an adjunct to the mechanical and chemical debridement within the periodontal, peri-implant, and Endodontic treatment protocols. This means the indication for adjunct use of antibiotics and their consequent side effects is drastically reduced.

Periodontology London

At London Specialist Dentist, we implement the innovation technology of laser-assisted periodontal therapy (LAPT) to improve periodontal health with minimal discomfort following both non-surgical or surgical periodontal treatment intervention. During endodontic treatment, LASER is utilised after preparing and rinsing the root canal in addition to the conventional treatment.

What is gum depigmentation?

Excessive melanin can be caused by reaction to local invasive thermal or toxic chemical trauma e.g., smoking and certain types of medications leading to discolouration and hyper-pigmentation of the gum, hence aesthetically disturbing gum for some individuals.
Darker gums or gingival hyper-pigmentation can also be hereditary or genetically predisposed in some specific races with darker skins. Another local cause of gum discolouration is impregnation or absorption of micro-particles from the leaking amalgam (silver) filling into the gum.

What is the treatment for gum depigmentation?

Melanocytes, are melanin-producing cells could be targeted by the LASER treatment which dramatically reduces the melanocyte activity hence melanin synthesis. The gingival depigmentation or gum bleaching procedure is usually a quick and painless procedure.
The treatment can be performed under local anaesthesia and completed in one visit. In cases of heavy deep pigmentation, more than one visit may be needed.

FAQ – What do patients usually ask about periodontology?

Could patients with the uncontrolled periodontal disease develop an increased incidence of cardiovascular disease?

CVD encompasses a variety of cardiovascular pathologies, such as angina pectoris, myocardial infarction, and heart failure, as a result of inflammatory processes caused by atherosclerosis.

Atherosclerosis causes a compromised natural blood flow to the heart and increases strain on the heart, manifesting symptoms of CVD, including intense chest pain, breathlessness, dizziness, and fatigue.

Based on the consensus report of periodontitis and cardiovascular disease (CVD), periodontal pathogenic bacteria could induce the development of atherosclerosis in the form of deposit stagnation along cardiac inner blood vessel walls, hence reduced vascular diameter and eventually vascular occlusion. 

Atherosclerosis causes a compromised natural blood flow to the brain. A temporary disruption of the brain blood supply may lead to a transient ischaemic attack and, when prolonged, to stroke.
If you have any concerns about the health of your gums or potential periodontal issues, it’s essential to schedule an appointment with a qualified periodontist and gum specialist.

Periodontology Case Studies

See our periodontology before and after photos from our happy patients.

Before and After Treatment

Treated advanced generalised periodontitis followed by restorative correction of the advanced gum recession.

Periodontology Case Study London

Before and After Treatment

Thin periodontal biotype, gingival recession, reduced vestibular depth, aberrant frenum/muscle pull, exposed root surface.