With nearly 50% of the population suffering from it, gum disease is one of the most prevalent diseases in the country. The most common form of the disease, chronic periodontitis, mostly affects adults over the age of forty and is characterised by the loss of bone, gum and other surrounding structures responsible for anchoring teeth into their sockets. Triggered by the invasion and multiplication of particular bacteria, chronic periodontitis is a slowly progressing disease involving complex interactions between host and parasite. The natural progression of the disease results in the loss of the tooth as there is nothing left to hold it into the mouth, regardless of the health of the tooth itself.
Periodontal disease is very complex and not completely understood. Studying it and isolating all the different bacteria involved has proved very difficult. Consequently, the aetiology of periodontal disease is not black and white. However, there are correlations between the prevalence and severity of the disease with a number of risk factors including genetics, smoking, oral hygiene and even the presence of some systemic diseases.
Unusual cases aside, most instances of periodontal disease arise when bacteria are given time to flourish, multiply and encourage the invasion of further, more pathogenic, bacteria. Located deep inside the natural pockets around all teeth, these bacteria slowly begin to destroy the tissue. Products released from this continual destruction kick the host immune system into action. Interestingly, in situations where the disease continues to flourish (when the immune system is not capable of combatting all the bacteria) the host defences appear to exacerbate the situation, further destroying local tissues in a bid to both access the bacteria and destroy them. Maintaining good oral hygiene undoubtedly reduces the risk of periodontal disease, as the immature bacteria are constantly removed before they have a chance to grow more dangerous.
With periodontal disease awareness growing, some of the most expensive dental law cases arise from the failure to recognise and treat the disease early on. These days, screenings for periodontal disease are carried out in every routine examination and more patients understand the condition that once may have gone undiscussed.
Treating chronic periodontal disease requires comprehensive oral hygiene instruction, along with the eradication of any risk factors such as smoking. Cleaning above the gum line is always carried out and once it can be seen that the patient is able to achieve a high standard of oral hygiene the next stage of treatment can begin.
Root surface debridement (RSD) is the term given for the manual removal of bacteria and their debris from the below the gum line. During periodontal disease, tissue that would once have been attached to the tooth becomes destroyed, creating a pocket around the tooth. After anaesthesia is achieved, small instruments can be inserted into the pockets so that the bacteria and debris can be removed, allowing the tissue to once again reattach. Generally the combination of RSD, oral hygiene instruction and risk factor removal are adequate to arrest the disease and allow the mouth to return to health.
In some circumstances, the gums around the odd tooth may not respond to standard periodontal treatment despite compliance and efficiency. Designed ‘because every tooth matters’, PerioChip is a biodegradable chip impregnated with chlorhexadine digluconate that, when used as an adjunct to standard periodontal treatment, has been shown to more than double the chance of success.
Chlorhexadine digluconate might ring a bell; it is the active ingredient used in the popular product, Corsodyl. While Corsodyl is effective at improving gum health in early periodontal disease, even if it were able to saturate the deep pockets associated with severe disease it would be washed out again momentarily. PerioChip, containing the same chemical, can be inserted into the pocket where it will remain until it biodegrades in seven days. Popular amongst periodontists, PerioChip is the only biodegradable, antimicrobial product available in the UK and, because it contains only antibacterials and not antibiotics, there is no danger of bacterial resistance.
For more information on periodontal disease and PerioChip, visit www.periochip.com.