Hygienist Services & Gum treatment

Advanced Preventative care, Live longer with healthy gums….

Bleeding gums are a sign of some form of gum disease and more than 80% of us (UK population) suffer from some type of it. It affects our general health and our well being.

Gum disease can come in the many forms including Gingivitis (inflammation/swelling of the gums) and Periodontitis (advanced inflammation/swelling of the gums progressed to destruction of the ligaments around the teeth). It can have not only damaging effects on the oral health and teeth, but can also affect the general health of the body. Research has shown the links between periodontal disease and diabetes, cardiovascular disease, obesity, and various nutritional difficencies among others.

Gum disease of either forms is caused by a build up and formation of particular species of bacteria in the mouth. These films of bacteria as well as causing damage, are a common cause of bad breath and can actually be spread via saliva so can be seen spreading from person to person. Untreated, gum disease progressing can cause loose teeth and then eventual loss of teeth  Read More..

It can be prevented so let’s work together and reach the day there is no gum disease in Angel. Its in your hands and we can help you to eliminate gum disease.

Treatment includes reducing the amount of bacteria (plaque and tartar) in our mouth. It is possible by efficient daily oral hygiene at home (brushing with a clean brush, flossing and using inter dental brushes) but even through brushing and flossing we cannot remove every trace of bacteria.  Only a Hygienist or Dentist can remove this difficult to reach plaque which hardens in the form of tartar

Be aware that life style or some medical conditions can increase the risk of gum disease

SMOKING: reduces the blood flow to the gums and slows healing

DIABETES: can delay gum healing, especially if blood sugar level is not well controlled,  .

HORMONAL CHANGES: such as in pregnancy

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We offer different levels of oral hygiene sessions:

Our dental hygienist carries out a professional scaling and polishing of teeth that includes the removal of plaque and tartar deposits ensuring healthy teeth and gums. She will also advise you on how best to look after your teeth at home with instructions on brushing, the use of inter-dental brushes, flossing and dietary advice. If your last Hygienist session was more than 6 months ago and you are not regular attender you may be asked to see a dentist first. Also if your teeth are crowded or stained, you are wearing braces, fixed retainer or have an implant, you will be offered an advanced cleaning using Air flow and sparkle polish. 

More people loose their teeth due to gum disease rather than dental decay. Regular visits to the dental hygienist in Angel help to prevent gum disease and therefore help you to keep your teeth for as long as you heart!

Our Angel Smile Preventive Plan includes two free sessions of Hygienist treatment per year.

Read more about our Dental Hygienist in Angel Smile Dental Care

Oral Health advice: See short video clips about how to brush correctly, and proper methods of flossing

Air Flow Sparkle Polish : Stain Removal

A memorable experiences of tooth cleaning  and fresh breath with a choice of flavours of: Mint, Orange, Berry or Cherry.

prophyflexpictures

ProphyFlex Tooth Stain Removal in Angel, Islington, London

We often hear this comment after Air flow treatment from many clients:

” My teeth have never felt this clean before! “

This involved using ultrasonic and manual instruments to remove all tartar build up around the teeth and gums followed by an advanced level polish called AirFlow.

Airflow is an innovative high end power automatic polish/wash combination using a jet of air, water and natural SALT particles (Natrium bicarbonate) that is propelled onto the tooth surface following deposit removal after hygiene. This jet can perfectly reach inter-dental areas,  gum margins and most inaccessible areas for the brush or any other polishing system, hence removing all the stains from smoking, tea, red wine and other day to day build up.

Although this is not a tooth whitening treatment, many clients have commented on how much whiter their teeth appeared afterwards.

Air flow cleaning is safe, quick and painless.

 

If your last Hygienist session was more than 6 months ago and you are not a regular attender you may be asked to see a dentist first.

After your exam appointment it may be the case that you have more extensive build up and inflammation than usual, and you have advanced gingivitis and risk of periodontitis. In this case it may be necessary to carry out deeper scaling of all bacteria and deposits underneath the margin of the gums. This may be prescribed by your dentist/hygienist if you are deemed susceptible to periodontal disease and may be necessary in order to re-stabilise gum health.

The diagnosis of advanced gum disease (periodontitis) is established by inspecting the soft gum tissues around the teeth with a probe measuring the depth of pockets around the teeth. If pocket depths are over 5.5 mm then there is ligament attachment loss and more complex treatment will be necessary.

This will involve initially evaluating the bone level using a full mouth radiograph to determine the amount of bone loss around the teeth, in addition to an extensive pocket charting examination which measures and records the amount/severity of disease for assessment of progress and success of treatment in future.

Clinical treatment involves local anaesthetic to carry out Root Surface Debridement (using Ultrasonic Debridement and Manual Debridement)  removing the bacterial growth which has caused the gum disease. In addition to this classical treatment disinfection is additionally carried out using a high tech diode Laser.

Laser periodontal therapy is used as supportive technique in conjunction with classical procedures of gum treatment showing promising results for eligible patients. The laser is used following mechanical calculus and plaque removal from pockets to disinfect  and further eliminate bacteria so as to help the of gums achieve state of health through its anti-inflammatory effect.

This modern laser technology allows bleeding, pain and swelling to be limited because periodontal laser therapy is less invasive than regular surgery. Recovery and healing times are all shorter.

 

Root Planing and the Debridement

We will book you for a review 1 month after these sessions and reassess the progress

Scaling and Root Planing are performed first
Laser energy is applied into the pocket to decontaminate and coagulate the soft tissue
The diode laser tip is placed into the pocket
Pocket depth is measured before the treatment and three months post treatment

Bacterial reduction using laser:

Laser periodontal therapy is not yet considered as single treatment however as supportive technique in conjunction with classical procedures of gum treatment shows promising results for eligible patients. The classical protocol used to treat periodontal infections is scaling and root planning. Sometimes, however, bacteria under gum level are difficult to eliminate and despite several treatment sessions, they grow back and repopulate the periodontal pocket.In addition to classical protocol in these cases we use dental laser following mechanical calculus and plaque removal from pockets to disinfect area between the gum and the root.  use of laser light as anti-infective approach to treat biofilm/plaque-induced gum diseases. The laser light is used in this context as a complement to the routine techniques of treating periodontal diseases.  Aim is eliminating  infection through its antibacterial property and promoting the return of the periodontium to a state of health through its anti-inflammatory effect.

In some cases we use laser to remove the inflamed gum tissue from around the root. When infected tissue is removed and the root is exposed, the root scaling can begin. This involves scraping off the calculus and plaque built up below the gumline around the root. The dentist then smooths the root with instruments to remove any rough spots that might attract bacteria and cause future infections.

The benefits of using lasers for diseased gum tissue are:

  • No block or big anesthetic is needed
  • Lasers can target the diseased areas precisely and accurately.
  • Bleeding, pain and swelling are limited because periodontal laser therapy is less invasive than regular surgery.
  • Recovery and healing times are shorter

After the initial mechanical and laser therapy to treat your periodontal disease, your dentist will then review the response to the initial therapy at approximately 3 months. The healing from periodontal disease can be varied and there may be sites that do not respond to initial therapy and may require advanced care.

At this point your dentist may then suggest a focused re-treatment of non-responding sites or persistent pockets. Apart from focused conventional mechanical therapy, advanced care may include the additional usage of local antimicrobial agents. These are antibacterial agents that are target delivered in the form of chips/gels to the sites that require additional attention after initial therapy. Periochip for example contains the agent chlorhexidine gluconate in a microchip format inserted into the pockets requiring therapy, and aims to assist in pocket reduction.

After a further review following re-treatment, non responding sites may be considered for possible surgery.

Gum Treatment

Gum treatment and application of PERIOCHIP

In the majority of cases gum disease can be controlled with non surgical measures however in some cases surgical treatments for gum disease will be needed when all other treatment options have been carried out.  Your dentist will inform you in this case.

Examples of such procedures are :

  • Flap surgery/pocket reduction surgery.
  • Bone grafts.
  • Soft tissue grafts.
  • Guided tissue regeneration.
  • Bone surgery.

GENETIC TESTING

We are one of the very few practices available in the UK offering a comprehensive genetic and microbiological analysis with our periodontal disease (gum disease) treatment allowing us to give the very highest standards of care at our clinic.
It is very important to emphasise that excellent levels of oral hygiene and professional treatment are necessary in order to maintain good periodontal health, however we are now aware through extensive research that there are other risk factors which affect management and outlook on periodontal disease. Established risk factors such as smoking and diabetes are well recorded in research over many years, however there has now been evidence to show genetic factors can have a major influence over the presentation, development and progression of the disease. We can see two patients who each may have the same level of oral hygiene but their severity, extent and progression of the disease can be markedly different.
Genetic testing allows us to be able to record the levels of the gene which regulates production of IL-1B. This is a mediator which causes severe inflammation, bone destruction and soft tissue loss which is released when the gums encounter bacteria. If levels of this gene are high, more IL1 is produced and this can cause more support loss. If levels of this gene are low, less is produced and
hence the damage can be much less.
It has been shown that patients who have a positive result can release up to 4 times the levels of IL-1B and this has shown to make it 3 times as likely for them to lose their teeth (8 times as likely if they also smoke) compared to negative result patients. This is significant for us at the clinic because we will know on this basis that positive result patients may require much closer monitoring and likely additional treatment if symptoms are to occur. This can be a crucial advantage to us for stabilising high risk patients early on.

MICROBIOLOGICAL TESTING

Periodontal (gum) disease is an inflammatory disease that causes support loss around the teeth as a result of response to specific bacteria. It is therefore a big advantage to know which species of bacteria are present before treatment begins
Certain strains of aggressive bacteria can be present which can confirm a diagnosis of aggressive disease. This will affect our management at the clinic as it may involve more intensive treatment with certain types of antibiotics in conjunction with periodontal cleaning
For both microbiological testing and genetic tests two separate swab samples are taken from the mouth and sent to a state of the art specialist laboratory that we work with at Angel smile. This laboratory will then process the result and send a comprehensive report back to us which we will then discuss with you

Background

The General Dental Council permits patients to directly access the services of dental hygienists from 1 May 2013.
Previously, a dentist had to see a patient prior to prescribing hygiene treatment. This meant that you would have been examined to see whether you had oral problems that warranted further treatment or investigation.

Direct Access

You need to understand the scope of what a dental hygienist does and can’t do. A hygienist can see you to provide oral hygiene advice, remove stain, tartar, bacterial deposits, and other debris. In relation to gums, the hygienist can advise you on the progression of gum disease, but more advanced conditions need to be assessed by a dentist, and the hygienist then continues treatment under the prescription of the dentist.

Dental hygienists can’t diagnose or give the prognosis (the likely outcome) of diseases such as decaying and broken teeth, or prescribe antibiotics, painkillers or any other drugs to alleviate symptoms.
Visits to hygienists is not a substitute for full dental examinations.

Referral to dentist

If the hygienist advises you to see a dentist, it is because they feel that it is in the interests of your health, it is outside the scope of what they are allowed to do, or they are uncertain about treating you without further advice.
There are very rare circumstances when a hygienist can’t start treatment, and before they are prepared to continue, insist that a dentist assesses you. These may relate to your medical history and general health, or the condition of your mouth, which gives them concern.

Consent

I have read and understand the limitations of direct access to a dental hygienist and agree to be treated under the direct access arrangements. I understand that the hygienist is not responsible for the overall health of my mouth and that regular visits to a dentist are still required.