Gum Health

we need you to have healthy gums!

At EVOLUTION Orthodontics  you will see some of the best orthodontics around. This is because our patients follow are recommendations to achieving the best gum health which is so critical towards the quality results evident on this website.

Here is a typical conversation of its importance at the first visit:

Patient: 'I really want my teeth straightened!'

Orthodontist at Evolution Orthodontics: 'Sure. Lets see how.'

Pause while orthodontist has a look....

Orthodontist: ' No problem with the brace. However, before orthodontics, we need to get the gums better. Do you want me to show you how?'

Patient: 'Please!'

Orthodontist: ' Healthy gums, like healthy skin, it should not bleed. If you were to scratch your finger nail bed and it started to bleed you would think something is wrong and you would probably go to your doctor. Its the same with gums. Its a warning sign!'

Orthodontist: 'Disclosing solution will show the cause of the problem.'

Below is a picture of the disclosed teeth.

Disclosing solution

Orthodontist: 'The coloured bits is the plaque. This is bacteria irritating the gums that causes the bleeding on brushing. It normally takes 20 circles going over the part where the gum joins the tooth and then between the teeth to remove it. The bleeding will happened on brushing for the next few days and gradually less and less as they heal. The plaque will return over 12 hours which is why dentists recommend brushing twice a day and you have to keep up with it. If you ignore the gum bleeding or brush less it will only get worse.'

We would show the patient the technique as the pressure to use is also important. Over-scrubbing will cause gum recession!

At the second visit the picture shows the huge improvement.

During treatment the patient maintained high standards by the use of disclosing tablets.

Two days after removing the brace:

10 visits and 14 months of orthodontics, another happy patient and orthodontist.





However, its not always good news

Here is the bad news:

If you have generalised gum bleeding we will be unable to accept you for orthodontics. If you are under the NHS you will need to undertake oral hygiene phase with a hygienist and reassessed. This will mean a longer wait as you will be at the back of the queue.

Please remember for NHS patients we provide specialist orthodontics under contract with the NHS. One of the requirements in the 2015 NHS guidelines is patients should have good gum health. We assess gum health due to its importance at every visit. We will be honest and make no apologies in informing if your gum health it is not suitable for orthodontics. Even though it is a 'negative' aspect of the visit, we would show how gum health can be improved. Virtually all are grateful we have taken the time to show and educate in an informative manner.

Here is the  good news:

Gums that bleed on brushing is a disease - gingivitis. This is reversible with good oral care. Our approach to oral health promotion been researched and evidence based and were invited to present the results at the British Orthodontic Conference. Though it would be easier recommending floss or electric brushes, research and literature searches show this is not the way forward.


Eventually, gingivitis will causes bone

This is when it is called periodontitis.  Bone lost cannot be regenerated and left to proceed the teeth will eventually loosen and fall out.

Gum Health

Here is a x-ray of a patient seen at EVOLUTION Orthodontics as the teeth had drifted and the patient wanted to close the gaps and straighten the teeth. The x-ray shows the result of periodontitis: bone loss and loss of teeth!

By ensuring our patients meet strict requirements for gum health before we accept them for orthodontics ensures we achieve the best results and lowest failed treatments in the UK ( data supplied by the BSA Eastbourne 2018).

What does plaque look like under a microscope?

Now you know why we want you to come here with a clean mouth.

Disclosure: all our sterilisation processes meet with the Health Technical Memorandum 01-05 decontamination in primary care dental practice.

We keep both manual and electronic audits and verification test results to ensure no cross-infection occurs in our clinic.

If at anytime patients attend with 'negligent' oral hygiene we make no apologies not to carry out any clinical procedures.

If you need additional help with the care of your gums see a hygienist and link up to the following: Links to Gum Health

Mahesh Patel, Director and Clinical Lead, for and behalf of EVOLUTION Orthodontics

26th Jan 2019

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