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Periodontal Disease

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Periodontal Information

Below is a summary of the information that will help you to understand why you have been referred to our periodontal practice.  Periodontal disease is usually a slow disease and most people are not aware that they have it.  The most obvious signs of periodontal disease are: bleeding gums, bad breath, bad taste, red or swollen gums, loose teeth, receding gums.

 

GINGIVITIS

Gingivitis is inflammation of the gums and this occurs when the bacterial plaque that forms on our teeth is not removed by proper tooth brushing.  Gingivitis results in red, swollen, tender gums which bleed easily when brushed.  Also, if we don’t clean between our teeth, we may develop gingivitis. In this case, the gums sometimes look puffy and red between teeth but, more often than not, only bleed when they are cleaned with dental floss.  Gingivitis is caused by the accumulation of “Plaque” on the tooth and gum surface.  Plaque is a colourless, sticky film containing millions of bacteria and their by-products which constantly grow on the teeth, and it is the by-products that cause the inflammation.  If gingivitis is not treated, it may lead to a more serious disorder, referred to as Periodontitis.

 

 

PERIODONTITIS

Periodontitis is destructive inflammation of the gums in which the bone and supporting tissues of the tooth are lost.  If the tissue destruction proceeds unchecked, then the teeth will become loose and eventually be lost.  Within the infected crevice around the tooth the bacteria become calcified to form a material called “Calculus”. Treatment of periodontitis involves removing the disease- causing bacteria and their by-products, and consequently, it is important that this calculus be removed from the teeth to eliminate the infection.

 

 

SUSCEPTIBILITY TO PERIODONTAL DISEASE

Periodontal disease is one of the most common diseases in the world.  In a recent survey in Brisbane, severe periodontal disease was noted in 10% of those surveyed.  It is this 10% of the population that are susceptible to progressive periodontal disease.  One’s susceptibility is primarily determined by what level of resistance is inherited from one’s parents, hence periodontal disease can often run in families.  A smoker’s resistance to periodontal disease is much reduced, therefore smokers have far more periodontal destruction.  This is because smoking depresses the immune system, and it is a person’s immune system that protects them against progressive periodontitis.

 

 

INITIAL TREATMENT

The treatment of periodontitis is to scale and clean the roots of the teeth to remove the plaque and calculus from below the gum line.  This removes the cause of the periodontal infection and thus results in healing.  Scaling, cleaning and root planing are the methods most commonly used to clean the teeth and are performed by using both an Ultrasonic Scaler and hand instruments.  Local anaesthetic is usually used during these procedures to eliminate discomfort.  Occasionally (less than 10% of the time) the areas of infection do not respond to scaling and root planing.  In these instances, gum surgery is used to allow visual observation to facilitate the removal of retained plaque and calculus.

 

PLEASE NOTE: Following successful periodontal treatment, the gum will often shrink back as the swelling of the gum inflammation resolves.  In some instances, quite noticeable spaces or gaps will appear between the teeth which can create an appearance concern if it occurs on the upper front teeth. This can be correct by placing a Gingival Prosthesis as pictured below.

 

 

MAINTENANCE TREATMENT

The long term success of periodontal therapy is dependant on the patient carrying out good plaque control and attending the periodontist for regular professional cleaning and reassessment.  This is referred to as a maintenance visit. This is because the bacteria that cause the periodontal disease normally grow in the mouth, and if they are allowed to regrow, then the disease will recur.  Consequently, to prevent the recurrence of periodontal disease, the following are essential:

 

 

 

ORAL HYGIENE

Thorough removal of plaque accumulation around the teeth is very important.  If good oral hygiene is not instituted, then gingivitis will recur in the sites where the plaque is left.  Regrowth of the bacteria that cause periodontal disease will occur and disease will recur in those sites.  In susceptible patients with severe disease, this can occur in approximately 3 months and in more resistant patients it can take up to 1 year.  As nobody is perfect at cleaning their teeth, regular periodontal maintenance visits are very important.

 

 

REGULAR REASSESSMENT VISITS

Regular reassessment visits are essential for people with periodontal disease, as this allows the checking for areas where plaque is inadvertently left on the teeth.  If these areas are professionally cleaned at this visit, then redevelopment of the disease will be prevented at these sites.  Consequently, recurrence of periodontal disease can be prevented and the patient can retain their teeth for life.

 

 

PROFESSIONAL DENTAL FEES AND HEALTH INSURANCE

Professional fees for periodontal and implant therapy

 

 

·        Unlike Medicare, dental fees are not subsidised by the Federal Government and there is no recognised Dental fee schedule.

 

 

  • Fees are set by each dental practice to take account of individual costs of practice which will vary in different practices.

 

 

  • The overhead costs of running this periodontal practice are over 75% of all fees received.

 

 

  • If this practice reduces the fees you pay, then the quality of your care will be compromised.

 

 

  • The fees charged in this practice are kept in accordance with the level of care provided, ensuring the highest quality of treatment possible.

 

 

  • There is no comfort in providing cheap dentistry if it leads to poor quality of care.

 

 

  • The most effective way to reduce your dental costs is to adhere to the preventive dental advice that you have been given, together with your compliance with the periodontal maintenance program that has been individually tailored for your dental health.

 

 

When you take out health insurance to cover you for dental fees, you should beaware that

 

 

  • Each health fund determines what level of rebates it will pay, based on its own commercial requirements.

 

 

  • An important aim of some health funds is, quite appropriately, to make profits for their shareholders as well as to provide rebates for their customers.

 

 

  • The rebates payable on dental fees are unlikely, in many cases, to cover more than 60% for common dental items and may cover less than 20% of the cost of complex and expensive procedures.

 

 

  • For some people, these rebates may be of assistance in offsetting some of the costs of the more expensive procedures but some arrangements may not always represent value for money for routine dentistry for you and your family.

 

 

  • If you have a problem with your private health insurance, you should contact the fund directly. If you are unable to reach a satisfactory agreement with your fund, contact the Private Health Insurance Ombudsman, an independent body formed to help resolve complaints and provide advice and information. The Ombudsman can be reached on 1800 640 695 or by writing to Suite 1201, Level 12, St Martins Tower, 31 Market Street, Sydney NSW 200. Fax: 02 9261 5937.

  • Email: info@phio.org.au

 

 

Before paying premiums for dental benefits, or selecting a particular benefit table, you should ensure that these costs represent value for you and your family.

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