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22nd September 2009

We are pleased to be able to offer new diagnostic services to our treatment list so that we may be able to be more precise on causes of decay and gum disease. Both of these diseases occur in people that exhibit a susceptibility to the bacteria that cause them.

GUM DISEASE

It has long been known that the bacteria that cause gum disease are extremely potent and pathogenic. It is also known that the bacteria can be passed from person to person via contact and sharing food and drink. This does not mean that if bacteria are passed on that the recipient would then develop the disease.

There needs to be the correct oral environment coupled with susceptibility to the disease. Progression and treatment of the disease is then further affected by modifying factors such as smoking, type 1 and 2 diabetes, other immunosuppressive conditions, conditions and/or medications which interfere with a person’s ability to perform acceptable plaque control or reduce their body defences against infection.

Gingivitis (gum inflammation) is the first response of the gum tissue to plaque and aggravating factors. This can be simply treated by removing the plaque and giving oral hygiene instruction to ensure that the condition does not occur again. The presence of gingivitis does not mean that the person will necessarily develop gum disease, there needs to be susceptibility, the correct bacteria and the above modifying factors.

Gum disease is mainly characterised by loss of attachment of gum tissue, loss of bone and eventually loss of teeth.

Gum disease can be present without the presence of gingivitis. Treatment of gum disease therefore differs greatly from a general scale and polish. Those of you that have undergone treatment for gum disease at the practice will be aware of this.

In order that we may be able to be more accurate in predicting progression of the disease and specific bacteria in the oral environment and treatment we now have diagnostic tools available to us.

DENTALYSE

PATHOGEN TESTING – we can now identify specific bacteria in the mouth that cause gum disease and treat them according to their pathogenicity. Antibiotics specific to these bacteria can be used alongside the correct treatment modalities. The test is carried out before and after treatment. The test after treatment will determine whether all of the harmful bacteria have been removed. The test can be site specific or can be carried for the whole mouth.

This test will be suggested for those people that have localised deep gum pockets or gum pockets that are not resolving with conventional treatments.

GENOTYPE TESTING- Everyone’s immune system is different; some people are more susceptible to bone loss that others. The immune system of susceptible people typically shows higher levels of inflammation leading to destruction of gum and bone tissues. We are now able to identify susceptible people by detecting the differences in their immune system before any other signs are visible. The effects of these immune differences are dramatically increased in high risk people such as smokers and those with particular medical conditions.

We will be using the genotype test on all potential implant patients to give an idea of healing capacity, healing time and to determine whether they will be at risk of losing the implant. It may also be used if patients with gum disease want to find out about susceptibility for their children or partners.

INFORM DENTAL

This is a process by which we can refer patients in the red category, high risk zone for gum disease to a specialist. There is a shortage of gum specialists in this country and the general dental council (GDC) states that all patients in the above category need to be assessed by a gum specialist. This means that patients may need to travel far and pay large sums of money to a specialist for this service. A typical consultation charge for a periodontist is £250 and treatment sessions can range from £250- £500.

Smile Design Dental Practice is one of the pilot practices for Inform Dental, an on-line referral site which gives us access to the expertise of a gum specialist, Dr Richard Snoad. Inform Dental has been approved by the GDC and Dental Protection. Carole Brennan and Dr Komal Suri have had specific training by Dr Snoad so that gum measurements taken at the practice are calibrated with him and are accurate.

Information gathered in an appointment at the practice, measurements, plaster models of the teeth, photos and x-rays, will be sent to Dr Snoad who will be responsible for creating the correct treatment plan for that patient. Treatment will be carried out at the practice by Carole Brennan and will be overseen by Dr Snoad. The patient will get a pack unique to their condition and treatment. You will also be able to access your own diagnosis, treatment plan and home care instructions on the Inform Dental website by using your patient number which will be assigned to you. All correspondence is confidential and cannot be accessed by anyone else.

Patients that we find are in the red high risk zone or the amber zone with modifying factors will be referred by this method to Richard Snoad in accordance with GDC guidelines. The price for the referral will be £150. Treatment session prices will not vary from our current periodontal therapy prices which are £145 per session.

Please contact the practice on 01296 624163 if you would like more information or to book an appointment.

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