This patient was concerned about a gap that had appeared between her front teeth, and reported occasional bleeding gums. Her dentist referred her to Manoj Tank, the Specialist in periodontics (gum disease treatment) at Elmsleigh House.
On examination, she had generalised inflammation around her gums, with deep pockets of infection around her top front teeth (periodontitis). She also reported smoking four cigarettes a day for nine years as well as a suspected genetic susceptibility to periodontitis given her sister also has gum disease. She was otherwise medically fit, and used an electric toothbrush twice a day with occasional interdental toothpicks.
Manoj diagnosed generalised aggressive periodontitis. Periodontitis is a pathological inflammatory disease of the supporting tissues of the teeth. Progression of periodontitis results in the loss of the gum attachment and bone support around teeth. Natural tooth positioning in the mouth is determined by a balance of forces between the tongue, lips, gums and teeth. Should there be changes in the balance between any of these forces, this is likely to result in drifting of tooth position. Drifting typically occurs in patients who have lost periodontal attachment and bone support around some of their teeth.
Manoj prescribed non-surgical periodontal therapy, and advised her to stop smoking in order to achieve optimal results. The patient had stopped smoking by the start of her treatment, which involved full mouth non-surgical root surface debridement under local anaesthetic split over two consecutive days, with antibiotic follow up to remove infection. He showed her how to use interdental brushes effectively, starting with the green ‘TePe’ interdental brush for the gap between her upper front teeth. She was also asked to use a 0.2% chlorhexidine mouthrinse for the first week following her non-surgical treatment.
Three months later she saw Manoj for a full periodontal reassessment, which saw a marked reduction in bleeding and an improved mouth freshness. She remained an ex-smoker and had kept up excellent oral hygiene habits, having moved up to the purple ‘TePe’ interdental brush for the gap between her front teeth as the inflamed gums healed. She was pleased with her gum health and was not concerned about having any cosmetic treatment to close the gap between her front teeth.
The patient saw Manoj every three months for specialist periodontal maintenance over a year, during which time she found the space closing between her upper teeth and smaller ‘TePe’ interdental brushes fitting in the gap.
The patient subsequently saw Adrienne, one of our dental hygienists, every three months for maintenance, and returned to see Manoj for her annual periodontal review. The gap between her upper front teeth had completely closed, and she could now only fit the yellow ‘TePe’ interdental brush in this space.
This patient is now being successfully maintained by her own dental hygienist in general practice.
If you have any periodontal concerns, book a consultation with Manoj Tank, our specialist in periodontics, who works in conjunction with Hans-Dieter John, our periodontal surgeon, and our dental hygiene team for effective treatment of gum disease and long-lasting results.
