---
title: Periodontal therapy, whitening and bonding
description: Ms C saw Manoj Tank for periodontal therapy due to gum disease affecting the mobility of her upper teeth. Kit Spears whitened and bonded for aesthetics.
image: https://www.elmsleighhouse.co.uk/hubfs/Case%20studies/Ms%20C%20Perio%20Bonding%20Gallery.jpg
---

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## [Periodontal therapy, whitening and bonding](https://www.elmsleighhouse.co.uk/blog/periodontal-therapy-whitening-and-bonding)

 September 07, 2021

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**  [Periodontics](https://www.elmsleighhouse.co.uk/blog/topic/periodontics) [Gum disease](https://www.elmsleighhouse.co.uk/blog/topic/gum-disease) [Cosmetic bonding](https://www.elmsleighhouse.co.uk/blog/topic/cosmetic-bonding) [Whitening](https://www.elmsleighhouse.co.uk/blog/topic/whitening)

![Ms C 30-5-17](https://www.elmsleighhouse.co.uk/hs-fs/hubfs/Blog%20Images/Ms%20C%2030-5-17.jpeg?width=400&name=Ms%20C%2030-5-17.jpeg)

 

![Ms C 30-5-17 left](https://www.elmsleighhouse.co.uk/hs-fs/hubfs/Blog%20Images/Ms%20C%2030-5-17%20left.jpeg?width=300&name=Ms%20C%2030-5-17%20left.jpeg)

 

![Ms C 30-5-17 right-1](https://www.elmsleighhouse.co.uk/hs-fs/hubfs/Blog%20Images/Ms%20C%2030-5-17%20right-1.jpeg?width=280&name=Ms%20C%2030-5-17%20right-1.jpeg)

 

Ms C saw Manoj Tank, the Specialist in periodontics at Elmsleigh House, due to concerns about the mobility of some of her teeth caused by gum disease.

 

On examination, Manoj found she had lost supporting bone due to gum disease around most of her upper teeth, but that her lower teeth and gums were generally maintainable. Gum disease begins when the bacteria in plaque produce toxins that irritate and inflame the gums, destroying the fibres and bone that support the teeth. The gums then separate from the teeth, creating spaces between them (called pockets) that become further infected. Left untreated, teeth become loose and ultimately may be lost.

 

In order to address the gum disease, Manoj performed root surface debridement on her upper teeth. This involved removing the hard deposits above and below the gum line (in the gum pockets) to thoroughly clean the root surface, and allow for healing.

 

After a healing period of 12 weeks, Manoj re-evaluated Ms C’s gum health and found it had significantly improved alongside her excellent teeth cleaning regimen at home. He would review Ms C again in a year, but in the meantime discharged her back to her dentist, Kit Spears, to follow-up with cosmetic improvements.

Kit advised he could improve the look of Ms C’s teeth with whitening and then composite bonding material to mask the spaces (‘black triangles’) between some of her upper teeth.

 

First Kit took impressions of Ms C’s teeth, and whitening trays were made to fit her teeth precisely. She was shown how to apply carbamide peroxide whitening gel to the trays and fit them securely in place.   
Ms C took home her trays and sufficient whitening gel to wear the trays for two to fours hours each day, until she achieved the brighter shade desired.

 

![Ms C 22-5-19 b4 bonding](https://www.elmsleighhouse.co.uk/hs-fs/hubfs/Blog%20Images/Ms%20C%2022-5-19%20b4%20bonding.jpeg?width=400&name=Ms%20C%2022-5-19%20b4%20bonding.jpeg)

 

![Ms C 26-2-18 whitening](https://www.elmsleighhouse.co.uk/hs-fs/hubfs/Blog%20Images/Ms%20C%2026-2-18%20whitening.jpeg?width=400&name=Ms%20C%2026-2-18%20whitening.jpeg)

 

Kit then matched the composite bonding material to Ms C’s whiter teeth, and shaped and contoured it to close the black triangles and improve the look and symmetry of her smile. Kit ensured a natural appearance when shaping, as closing the gaps fully would make the teeth look too square and unnatural.

 

![Ms C 22-5-19 bonding](https://www.elmsleighhouse.co.uk/hs-fs/hubfs/Blog%20Images/Ms%20C%2022-5-19%20bonding.jpeg?width=400&name=Ms%20C%2022-5-19%20bonding.jpeg)

 

![Ms C 22-5-19 post bonding left](https://www.elmsleighhouse.co.uk/hs-fs/hubfs/Blog%20Images/Ms%20C%2022-5-19%20post%20bonding%20left.jpeg?width=384&name=Ms%20C%2022-5-19%20post%20bonding%20left.jpeg)

 

![Ms C 22-5-19 post bonding right](https://www.elmsleighhouse.co.uk/hs-fs/hubfs/Blog%20Images/Ms%20C%2022-5-19%20post%20bonding%20right.jpeg?width=368&name=Ms%20C%2022-5-19%20post%20bonding%20right.jpeg)

 

Kit and Ms C were delighted with the results, which were obtained without local anaesthesia or drilling her teeth, *ie* a minimally invasive approach to improving Ms C’s smile.

 

Ms C maintains regular check-ups with Kit as well as dental hygiene appointments, and will return to see Manoj for a review in a year’s time.

 

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