What is a Periodontist?



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What is a Periodontist?

A periodontist is a dental specialist who focuses on the treatment of

periodontal (gum) disease and other oral conditions affecting the soft and

hard tissues of the mouth. Periodontal disease affects the support around

teeth including the jawbones and gum.
After five years of dental school

and years in general dental practice, the periodontist completes an

additional 3 years of university based training.

The periodontist provides a comprehensive range of diagnostic, nonsurgical

and surgical services aimed at improving the periodontal health.
Pre-prosthetic surgery can be provided to improve aesthetics and function

of restorations such as crowns and bridges. The placement of dental

implants is frequently undertaken by periodontists especially when

aesthetics are paramount. Periodontists work closely with other members

of the dental team, particularly dentists, hygienists and other dental

specialists.


All the BCPI Periodontists are members of ANZAP (the Australian and New Zealand Academy of Periodontists) the peak professional body representing periodontists in

Australia and New Zealand. Members of the Academy abide by a code of

ethics and behaviour as well as agreeing to set minimal levels of

continuing professional education. Membership is only open to those

periodontists with the highest level of professional skill, knowledge and

integrity. Most ANZAP periodontists are also members and fellows of the

Royal Australasian College of Dental Surgeons.

GUM DISEASE


What is Periodontal Disease?

There are a wide range of diseases affecting the gums, which are grouped

under the general heading of periodontal disease. All of these conditions are treated by the BCPI team. They include:

• Gingivitis

• Chronic Periodontitis

• Aggressive Periodontitis

• Periodontitis as a Manifestation of Systemic Diseases

• Necrotizing Periodontal Diseases


What is Gingivitis?

Gingivitis is the mildest and most common form of periodontal disease.

Less than optimal oral hygiene causes the gums to become red, swollen,

and bleed easily. There is usually little or no discomfort at this stage.

Bleeding gums are a sign of disease, healthy gums do not bleed.

Gingivitis is reversible with professional treatment and good regular oral

care at home.
What is Chronic Periodontitis?

This chronic inflammatory process results from one of the most common

infections in humans. It is not usually painful and effects at least 20% of

the adult population. When the inflammation of gingivitis is unable to be controlled the disease progresses to Periodontitis. The result is loss of the supporting structures around

the teeth (gum and bone) which causes the formation of pockets and or

recession of the gums. If untreated it may result in the loss of teeth. With

appropriate professional and home care the condition can usually be stabilised.
What is Aggressive Periodontitis?

This is a rare but severe from of periodontitis which frequently (but not

exclusively) begins in early adult life and untreated can result in the loss

of many or all of the teeth. It occurs in patients who are otherwise

clinically healthy. Common features include rapid loss of attachment for

the teeth and bone destruction and it may occur in more than one

member of a family. It is a very difficult condition to manage and such

cases should be treated by periodontists. The Team at BCPI are experienced in treating this difficult form of periodontitis.


What is Periodontitis as a manifestation of Systemic Diseases?

A large number of systemic diseases can affect the gums including

diabetes, leukaemias and HIV infection. In some conditions the gum

condition may also play a role in the systemic condition. It is

recommended that patients with these conditions should have specialist

periodontal input into their management.



What are Necrotizing Periodontal Diseases?

This is a small group of painful conditions that may result in significant

loss of gum tissue and sometimes the underlying bone. It may result in

permanent loss of support for the teeth and compromised aesthetics.

They are most often seen in young adult smokers particularly at times of

stress but may also be associated with HIV infection and

immunosuppression.
What causes periodontal disease?

The main cause of periodontal disease is bacterial plaque, a sticky,

colourless film that constantly forms on your teeth. It needs to be

constantly removed to ensure the proper balance between the bacterial

assault and the body's response. In addition there are a number of

factors,, which may also have detrimental effects on the health of your gums.

• Smoking/Tobacco Use

• Diabetes

• Genetics

• Medications

• Pregnancy and Puberty

• Poor Nutrition

• Stress

• Other Systemic Diseases


How does Gum Disease effect your health?

It has long been understood that a number of systemic health conditions

can have detrimental effects on gum health. In recent times, there has

been an increasing body of evidence suggesting an association between

gum disease and poor general health. The nature of these associations is

unclear. It may be that the systemic condition is caused (at least in part)

by the gum disease or it may be that having gum disease is just a marker

for increased risk of also having a systemic illness. Studies into these

areas are ongoing.

At this point that there is insufficient evidence to suggest that, treatment

of periodontal (gum) diseases will reduce the risk of systemic conditions.

However, it is not unreasonable to expect that a large area of persistent

inflammation (as often found in untreated gum disease) is likely to have

some systemic consequences. There is no evidence that treatment of

periodontal diseases results in any increased risk of developing systemic

disease.


Some of the systemic conditions associated with periodontal diseases

include:


• Atherosclerosis (Heart Disease and some Strokes)

• Diabetes

• Preterm low-birth-weight babies

• Rheumatoid arthritis

• Respiratory Diseases

The BCPI team are always working to keep you up to date with the

latest findings in this area.


How is Periodontal Disease treated?

There are a range of proven treatments for periodontal disease. All of these are available at BCPI and your periodontist will recommend the most appropriate treatment for your case. Not all treatments are applicable for every patient. Commonly non-surgical treatment

involving thorough debridement (cleaning) of the tooth root surfaces will

be undertaken often over a number of appointments. In some cases

periodontal surgery may be required to gain adequate access to the root

surfaces. Periodontal surgery is necessary when your periodontist

determines that the tissue around your teeth is unhealthy and cannot be

repaired with non-surgical treatment.

A range of surgical treatments may be available to achieve a number of

aims. Commonly surgery may be undertaken to:

• Gain access to the root surfaces

• Reduce the depth of periodontal pockets

• Regenerate lost periodontal attachment

• Increase the amount of tooth above the gum for restorative

procedures

• Graft tissue into areas where disease has result in loss of gum

tissue.
Systemic antibiotics may sometimes be indicated as a adjunctive treatment and dental implants may be an option when teeth have been lost.

IMPLANTS


Are You a Candidate for Dental Implants?
Dental implants are titanium screws that are placed in the jaw bone to replace missing teeth. Following a period of healing they are then restored with crowns and or bridges or may be used to help support a denture. Titanium is used as many years of research has shown that it integrates with the surrounding bone. Sometimes implants have modified surfaces to help improve the speed of healing around the implant. In carefully chosen cases, the success rate of dental implants is very high (98%+). A review of cases placed at BCPI and published in the Australian Dental Journal reveals success rates equal to or higher than those published internationally. (http://www3.interscience.wiley.com/journal/122400882/abstract).
The ideal candidate for a dental implant is in good general and oral

health. Adequate bone in your jaw is needed to support the implant, and

the best candidates have healthy gum tissues that are free of periodontal

disease. Assessment of the bone usually requires radiographs and often

CT scans. In some cases, it may be possible to graft or grow bone into a

compromised site prior to implant placement.

Dental implants are intimately connected with the gum tissues and

underlying bone in the mouth. Since periodontists are the dental experts

who specialize in precisely these areas, they are ideal members of your

dental implant team.

Not everyone is suitable for dental implants. The BCPI periodontists are experienced in selecting cases that may benefit from dental implants.
What Can Dental Implants Do?

• Replace one or more teeth without affecting adjacent teeth.

• Support a bridge and eliminate the need for a removable partial

denture.


• Provide support for a denture, making it more secure and

comfortable.


What are the Advantages of Implants over Dentures or a Bridge?

Dental implants maybe an ideal solution to the problem of missing teeth.

• Aesthetics - Dental implants can look and feel like your own teeth

• Tooth-saving - Dental implants don't sacrifice the quality of your

adjacent teeth

• Confidence - Dental implants can allow you to once again speak and

eat with comfort and confidence!

• Reliable - The success rate of dental implants in many situations is

high.
What types of Implants are used?

• There are a large number of different implant systems available. At BCPI usually one of 4 proven, well researched leading brands of implants will be utilized. The implants themselves are made of titanium and may have range of different surface coatings and

treatments to allow better and faster integration with the bone. The

implant substitutes for the missing root of the tooth.

• Most implant systems can be placed as either a one or two stage

procedure depending on the clinical need for more or less healing.

• Your BCPI periodontist, in consultation with your restorative dentist/

specialist will decide what it the best system to use in your situation.



Looking after your implant.

  • Just like teeth, your implant(s) requires the regular care of daily oral hygiene measures. You will be taught specific techniques for cleaning your implant(s).

  • Regular ongoing checks for your implants are important to maintain the health of the surrounding tissue in the same manner as your natural teeth.



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