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Periodontists have additional training over both Hygienists and General Dentists. If you have been referred to a Periodontist it is because your usual Dentist and/or Hygienist have reached the limit of their access and they are concerned about your gum and general health. General Dentists and Hygienists can generally only manage periodontal pockets up to 5mm in depth. Beyond this point your gum disease can accelerate towards tooth loss; it is also critical to manage any medical issues which can affect your treatment, your management and/or your gum disease. Periodontists have further training in assessing medical conditions affecting your Periodontal health, as well as longer and finer tools for accessing difficult areas, or if this doesn’t work we can discuss whether more complex periodontal intervention is a suitable option.
Once you have been treated and are maintaining an excellent standard of home care, we may discuss whether your general dentist and/or hygienist feel comfortable accepting some responsibility for your periodontal care. Whoever is responsible for your periodontal health, you must always ensure you continue regular dental checks with your general dentist, as a Periodontist is not allowed to undertake fillings, root canals, dentures or other normal dental treatment.
Your consultation appointment is designed to allow us to get to know you. We need to discuss your medical history and current conditions in detail as a surprising amount of health conditions have an impact on periodontal health. We then need to examine your oral tissues, both outside and inside your mouth, chart your teeth and measure your gums to get an estimation of how severe your gum disease is and what you may expect over time. We will then discuss periodontal disease, how it works, which factors have contributed to your disease and what we can both do to control the disease process. Your commitment to home care and control of “risk factors” such as diabetes and smoking are central to managing periodontal disease. We will also discuss what is expected of you with respect to home care. At the end of your appointment we will recommend initial treatment and provide you with a treatment plan and costs.
We will only provide treatment at a consultation appointment if you are an emergency patient in severe pain, or if you have specifically travelled in from remote regions to see us. If you are expecting treatment at the same time as your consultation appointment, it is imperative that you inform us when you make your appointment so that we can arrange a suitable amount of time, as well as advise you of the additional costs involved.
Periodontal, or gum, disease is an infection caused by overgrowth of normal mouth bacteria. Plaque that forms on the teeth is a bit like a slime layer that forms on a boat that is left to sit in the water. Just like the boat, eventually the slime layer will turn in to “barnacles”. In the mouth and on the teeth we call this calculus and you will be unable to remove this with your floss or toothbrush. Not everyone gets gum disease, it is usually worse in people with a compromised immune system such as smokers, diabetics (type I and II), pregnant women, people with autoimmune disease, people undergoing chemotherapy and occasionally there is a genetic factor. Management of gum disease requires physical removal of the hard and soft “barnacles” on your teeth, both above and below the gum line, as well as careful management of any other factors which can contribute to your gum disease susceptibility.
Sometimes, despite everyone’s best efforts, teeth can’t be saved and they need to be extracted. There are many replacement options you can discuss with your dentist such as removable dentures, conventional tooth supported bridges, or dental implants. Dental implants are made from titanium which is unique in that it integrates with your body. Sometimes your dentist will refer you to a Periodontist for surgical placement of the implant in to your jaw bone. You will then go back to your dentist for the crown, or tooth, to be constructed on top of the implant. At Western Periodontics, we are proficient in all of the major implant systems so your dentist doesn’t have to compromise on their choice of implant.
Some people show too much gum when they smile. While there can be many causes, sometimes treatment can be as easy as trimming away some of the excess to show the full contour of the teeth. We call this a “gum lift” and it is a small change which can make a huge difference to your confidence.
Having dental treatment done can feel very invasive and many people have significant anxiety about a visit to the dentist or Periodontist. While we will always do our best to make you feel as comfortable as possible, sometimes we can use medications to help you manage. This can be as simple as a small tablet to help you relax, but still be awake, through “Twilight” sedation or a full general anaesthetic at an accredited private hospital. Let us know if you’re particularly nervous and we can discuss which options may be best for you.