Incorporating smoking and gum disease

Around 15% of the population have periodontal disease. This means that the supporting structures of the teeth (gums and bones) are slowly being lost through the disease process. These teeth may become loose which means you are at risk of eventually losing your teeth. The main cause of periodontal disease is the build up of plaque.

There is new clinical evidence (please ask to see the reports) to suggest that by far the most effective way to manage this disease is as follows:

  • Information to the patient to encourage understanding of outcome when following the correct instructions
  • Correct cleaning at home on a daily basis is of more value than professional scaling.
  • Interdental cleaning (between the teeth) by the patient is essential.
  • Regular visits for monitoring, maintenance and motivation.

You have been identified as someone who is suffering from periodontal disease.The diagnosis will have been discussed with you by your dentist.

You will now be offered two appointments with the hygienist. They will be spaced approximately 3-5 weeks apart and will consist mainly of the following:

  1. You will be shown where to brush
  2. You will be shown which toothbrush is optimal
  3. You will be shown how to use floss and solo brushes
  4. You will be helped to set up a daily “action” and “coping” plan
  5. The consequences of not following all the daily routines will be explained to you
  6. You will practice the above in front of the hygienist.
  7. You may have clinical photographs taken (with your consent). These are private and will be on your file. These photographs are very useful in providing you with a record of your improvement. It is a strong motivational tool. It also provides you and your dentist/hygienist with a record of your progress.
  8. Antibiotics may be prescribed for you at some stage during this process by your dentist.

NB: Please bring your toothbrushes (not toothpaste) with you EVERY TIME YOU COME TO THE CLINIC IN THE FUTURE.

  • If you are not a smoker, initially you may experience some bleeding and tenderness from the gums. This is normal. If this does not happen then it is likely you are not brushing correctly.
  • If you smoke you are much more likely to get periodontal problems. You are urged in the strongest terms to stop smoking.
  • If you continue to smoke you are more likely to lose your teeth.
  • If you do not stop smoking the treatment prescribed for you will have less success.
  • Your doctor can provide you with help and medicine to help you give up smoking.

If you follow the advice you will be given EXACTLY AND REGUARILY

we would expect to see a marked improvement in several of the following-

  1.  Visual – redness and swelling of gums
  2.  X-rays – bone level
  3.  Less mobility of teeth
  4.  Bleeding or plaque scores

Regular compliance with the oral health instruction you are given will keep your periodontal status balanced.

If there is an improvement by the second appointment with the hygienist, then a full mouth ultrasonic debridement will probably be done by the hygienist at this visit. This includes deplaquing and removal of bacteria above and below the gum line.

If there is no improvement by the second appointment with the hygienist,

you will be retrained but no further appointments will be offered for a minimum of three months. It will be at the discretion of the hygienist and dentist whether your motivation and compliance is sufficient to warrant further appointments.

If after one further session with the hygienist (after a minimum of three months gap since the last appointment) there is little or no improvement then the only periodontal treatment we will be able to provide for you is for the dentist to monitor your disease at your regular check up appointments.

You must note that we CANNOT refer you to a periodontal specialist in any of the London teaching hospitals if you have not shown compliance in the oral health instructions and there is no significant and lasting improvement in your oral health.

Please understand that if you do not choose to comply with the advice you are given by the dental staff, then the consequences for your oral health could be severe. It is possible that your bone will recede and your teeth will become loose, leading eventually to the loss of teeth.

The following equipment is recommended by the latest studies into periodontal disease:-

  • Floss
  • Oral B/Braun counter-rotational toothbrushes with round heads
  • Interdental brushes – both manual and electric