Periodontology

Periodontal disease

Periodontal (gum) disease refers to the inflammation and infection of the tissues that support the teeth. Initially, disease starts as bacterial populations grow with failure to adequately remove plaque with effective oral hygiene techniques. Initially the gums become red, swollen, tender and bleed when brushing. Bad breath can also be a symptom. This is the earliest stage of disease and is called “gingivitis”. This is reversible and can be managed with improved oral hygiene. Professional cleaning, together with Oral hygiene instruction is beneficial. Left untreated, disease may progress. Periodontitis is when the gum condition progresses beyond gingivitis into a chronic, destructive, irreversible inflammatory state. The bacteria penetrate deeper into the gum and bone tissues. tissues and surrounding periodontium. The invading bacteria trigger a host response (this is a reaction of living tissue to the presence of a foreign material) in defence. However, while trying to protect against the invading bacteria, the host defences also lead to the destruction of the periodontium (the supporting structure for the teeth, consisting of periodontal ligament, cementum, gingiva, and supporting bone).

Symptoms include bleeding gums, bad breath and loose teeth; however disease progression can often be insidious, progressing unbeknownst.

Regular dental examinations are essential for early diagnosis. Without treatment, tooth may become inevitable.

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Meet Our Periodontal Team

Dr Gabriella Leatherdale-Tiba

Clinical Lead in PeriodontologyGDC No: 214556

DMD (2011), MSc (Periodontology, 2022)

I treat patients with periodontal disease referred to me by other dentists both with conventional therapy (root surface debridement, bone regeneration surgeries) as well as using laser (waterlase) where it's necessary....

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Sally Hooper

Dental HygienistGDC No: 4717

Dip DH (Cardiff University, 1994)

I'm passionate and motivated in helping patients with their dental health. Encouraging them their use of daily toothbrushing and interdental cleaning....

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What are the possible side effects?

Teosyal dermal filler is a considered a very safe medical substance which is highly biocompatible and biodegradable. A local anaesthetic may be used to minimize any discomfort at the time of injection. Bruising, redness and some slight swelling at the site of treatment does sometimes occur, although rarely lasts more than a few days.

How long does the Dental Implant procedure take?

The duration of the Dental Implant procedure varies depending on numerous factors, such as the number of implants placed, whether bone build up or soft tissue modification is needed, and the patient’s overall oral health. In general, the process involves multiple stages and can take several months to complete. You will be advised on time scale following completion of the planning stage.

Will I need further treatment after the root canal treatment?

The dentist will always fill the hole in the tooth after the root canal treatment. However, in some case the tooth may need a crown to protect the tooth, reducing fracture risk. Root filled teeth tend to be significantly weaker than healthy teeth and are prone to fracture. Not all teeth need crowns after root canal treatment, but it is common for the back teeth that do most of the chewing to need a crown after completion of root canal treatment. Your dentist will advise.

How soon can I be treated?

Our waiting times for an NHS examination and treatment appointments, for new and historic patients, vary. Our reception team will happily update you on current waiting times.

The NHS contract funds a set amount of dental activity for the year and we are obliged to deliver this evenly over the twelve months.

The level of NHS funding provided is not high enough to enable us to meet the demand for NHS care that exists.

These factors lead to long waiting times to access NHS care.

Private care can be provided at all times with a minimal wait.

Your dentist will be happy to go through all available options including that of accessing some treatment options on a private basis alongside an NHS course of treatment.

What is a Dental Implant?

A Dental Implant is a small titanium screw that is surgically placed into the jawbone to replace the root of a missing tooth. It serves as a stable foundation for attaching prosthetic teeth, offering a durable and natural-looking solution.

Is root canal treatment always successful?

With all procedures there is a possibility that it may not work. This applies to root canal treatment as well as any other treatment. There are a variety of reasons why it may not work. some of these reasons include but are not limited to:

Failure to adequately disinfect, leaving bacteria in the canal system, resulting in recurrence of infection.

Failure to instrument all the canal system. In some teeth the root canals can be incredibly small (often as small as one tenth of a millimetre across or even smaller). Dentists who carry out a lot of root canals usually utilise high powered magnification to help them find and treat such small canals.

Failure to fill and seal the root canals adequately, allowing bacteria from the mouth to reinvade the root canal system and set up infection again.

Inappropriate instrumentation technique that does not allow for adequate disinfection and sealing of the root canals.

Severe fracture of the tooth leaving remnants that cannot be fixed again.

If the dentist feels there is a significant risk of treatment failure, possible causes will be discussed, so you can make an
informed decision regarding treatment.

What is the aftercare following implant surgery?

Folowing implant placement, we will provide you with appropriate medication, including a mouthwash, and written post operative instruction detailing aftercare and what to expect. You will experience some swelling, bruising and discomfort. The extent of which will depend on the treatment complexity, as well as your general health. We advise sticking to a soft diet, avoidance of alcohol and smoking, as well as no strenuous excercise in the first few days after surgery.

This will all be discussed with you at your visits.

Can I meet my dentist before the treatment?

Absolutely! Your clinician wil introduce themselves when you meet at your first visit. Building a strong patient-dentist relationship is important to us. Your initial examination visit enables us to understand your needs and address any concerns. We ensure open communication, so you can freely discuss any worries before proceeding with treatment. Your comfort and peace of mind are our top priorities.

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Can I have orthodontic treatment on the NHS?

We are not funded by the Local Health Boards to provide orthodontic services. All orthodontic work carried out at our practices is done so under a private treatment agreement. Generally, only patients under the age of 18 are eligible for an NHS orthodontic referral. Your dentist will offer to put you on a waiting list an NHS orthodontis, provided you fulfil the referral criteria. Irregularities of teeth which are less than 4mm out of line (e.g. open bites of less than 4mm) or deep bites with no functional problems will not qualify for NHS treatment.

Which practice should I join?

The Cox & Hitchcock Dental Group operates several dental practices across South Wales. Fot your convenience, we would recommend joining us at your nearest location to home or work . For some advanced treatments, you may benefit from the services offered at a particlar site. We will advise you accordingly. You can find your nearest dental practice by browsing all our locations.

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What does a CBCT scan involve?

A CBCT scan is a simple procedure. The patient is carefully positioned (this takes a couple of minutes), asked to keep absolutely still, and the machine then rotates 360-degrees around the head while capturing a radiographic image. The computer software then uses this information to reconstruct a 3-D image. The scan time varies depending on the image required, but generally takes around 10 seconds to complete.