Frequently asked questions about our unique treatment for loose teeth
People often have questions about loose teeth and what can be done about it. We have selected those asked most frequently and provided some answers for you. Before answering questions we'll run through some of the background to explain why and how this approach came into existence.
Why it works better than other treatments.
Traditionally gum disease has been treated by professional cleaning, sometimes repeatedly, and for many this is successful. We are concerned about those who continue to worsen despite all this effort. To improve results there are a number of gels and tablets which can be professionally prescribed and applied. Having used these we still found some people's condition worsening. We have looked closely at the possible reasons for this, and the main one is that people leave visiting their dentist too late, or their dentist not recognising how rapidly the disease is progressing. We are trying to help these people, but see benefits in our approach for people at an earlier stage of the disease, when we may be able to halt the disease in its tracks, rather than slowly worsening over several years, because traditional treatment is unlikely to completely eradicate the cause of the problem.
As part of his MSc, Ray Steggles undertook reviews of the literature relating to bacterial behaviour and noticed some common themes in relation to bacterial organisation. It has been found that certain substances interfere with the way bacteria act in groups. It is now established that periodontal (gum) disease occurs because of the way bacteria work together. Alone or disorganised they are virtually harmless. So the question is how can we disrupt bacterial organisation? A number of ways of doing so have been discovered. So the next question is, will they work for gum disease perhaps applied with a toothbrush on a daily basis? So far there has been no success, possibly because the medicine isn't concentrated enough, and there is a problem with taste, so it's unlikely people would use it every day. This had us scratching our heads for another solution...and a theoretical one was devised, but not used until a patient attended one day having been told she had no choice but to have a very infected tooth extracted. We discussed the possibility of using this theoretical approach, and if we failed she would lose the tooth and be no worse off, but if we succeeded it could be of significance for many others. Two years after that single treatment the tooth is still functioning perfectly.
This led to its use on a further 100 people with varying degrees of problems. All have shown some improvement, unfortunally the condition of three was so bad that this couldn't prevent the loss of further teeth. At the other end of the scale we have had remarkable results, even when all other traditional non-surgical approaches and proprietary medicines failed, this has brought about improvements.
Some notes about gum disease and why you have it
This is complex disease. Gum disease is caused by bacteria growing into masses called dental plaque. As the plaque grows, because brushing hasn't been effective, our cells detect the bacteria and their products. Some people are very sensitive and their cells fight the bacteria vigorously and the outcome is a lot of tissue damage with swelling and bleeding. Other people's cells are less sensitive and less damage is caused, and they take longer to develop the disease. Some types of bacteria cause greater response by our cells, and these tend to grow in deeper pockets and take longer to develop. If we had a way of completely removing the bacteria there would be no gum disease. If we manage to remove most of them gum disease is slight, and develops very slowly, perhaps never reaching the stage of causing problems during our lifetimes. This is why careful, regular, brushing and flossing can be effective. Unfortunately, most people don't carry these out well enough and the bacteria slowly take over.Once the bacteria have the upper hand it becomes increasingly difficult to control them.
The accepted method of treating advanced gum disease is for the dentist or hygienist to mechanically scrape them away. This is very time consuming, and recent trials have shown that even after five or six hours there are still markers in the blood showing bacteria are present. To lower the blood markers it took six to eight hours of scraping and the use of antibiotic pastes. How many would tolerate this, and afford it? Only after the mass of bacteria was reduced to a very small amount was the antibiotic effective. With our approach, the response appears very much better than others. Less scraping time is required to get a good result, with a treatment of a whole mouth taking about 80 minutes, and we have evidence of bleeding stopping, gums shrinking to normal, teeth tightening, and bone healing. We won't know about the level of markers in the blood until full trials are carried out. It is believed many more bacteria are killed by this new method, allowing the body to heal.
FAQ
Question: How do I know that I have a gum problem?
Answer: You may not be aware until damage has already occurred, and this is why regular visits to your dentist or dental hygienist are important.
If your gums bleed after brushing or eating this can be a sign.
Regularly trapping food between teeth can indicate damage to the tooth or support of the tooth is taking place and should be investigated. Others may notice your bad breath.
Movement of teeth on finger pressure as you feel each one can be an indication.
Question: What's the procedure to receive this type of treatment, and what are the costs?
Answer: Make an appointment for a screening exam by contacting us directly, or if you are under the care of another dentist, ask if they will refer you to us. Until full trials have been completed, they may not be prepared to refer, in which case it will be for you to decide whether you want to be considered for the treatment and contact us direct. Once an appointment is made, you attend for a short examination to determine whether you are likely to benefit, and to discuss the procedures with you. If the treatment is appropriate and you agreed to treatment, an appointment is made for between 20 and 80 minutes, depending on the number of teeth to be treated. The cost includes one or two follow up visits to check progress, and ranges from £100 for treatment of a single tooth to £400 for a whole mouth, where a single visit is required. In the severest cases we recommend two visits, the second a month after the first . Further information can be found by following this link to QSIant periodontal therapy
Question: Does the treatment always work?
Answer: It's not possible to say that it will work for everyone. Sometimes it works very well, and for other people not so well. No scientifically evaluated clinical trials have been carried out, but from the results achieved so far with over 100 people (February 2009) in every case it has reduced swelling and bleeding. Many have teeth which have tightened, but some were so damaged that it was too late to save them. The sooner treatment is started the more certain we can be of a good result. The results of treatment appear to be far better than achieved by other non-surgical approaches. Similar results have been achieved by using surgery, which is much more time-consuming, costly, and uncomfortable. Surgical approaches are generally carried out by specialist periodontologists, whilst this new approach is straightforward enough to be carried out by general dentists and dental hygienists, although it can't become widely available until clinical trials have been completed.
Question: How often do I need this kind of treatment?
Answer: We can't be sure at this stage, but it appears likely that a successful course should give long-term benefits. It does depend on you brushing properly afterwards to prevent new bacteria taking hold. We do know that people who have never had advanced gum problems can prevent disease by brushing and flossing.
Question: Are there any side effects?
Answer: For those who have no allergies to tetracycline or to any edible plants there should be no problem. The plant extract is from a plant eaten by many millions around the world every day. Of course it isn't in the same concentration as placed around the gums. Studies in Denmark show it causes no harm at the concentrations used around gums, when injected into mice at similar and even higher concentrations. Before trying it on any patients, Ray Steggles tested some on his gums, without any ill-effects. No one who has had the treatment has had side-effects, nor has it worsened the situation. All successful gum treatment reduces the swelling of gums and the teeth may appear longer and spaces between the roots of teeth greater. This is not the effect of the treatment, instead it is because of the amount of pre-existing damage caused by the disease. After treatment you may have some sensitivity of roots, and if your diet is poor you may be more likely to get root decay. Again this is not a specific side effect of this treatment, but care is needed to prevent it occurring.
Question: Why isn't it available from my dentist?
Answer: We hope it will be within a few years. Before a medicine can be supplied to other dentists it has to be approved, and this requires a number of trials being carried out. We are trying to get these underway, but the funding to do so runs into several hundreds of thousands of pounds. Where a person attends for treatment here, if in the opinion of the dentist the disease is severe, and there is no already licensed product able to treat the problem effectively, the dentist may, with the patient's informed consent, mix and use a specially prepared alternative. Because we know what is in it, have carried out a risk assessment, and know how it is intended to work, we can in those special circumstances use it. Should you have a gum problem, which your dentist can't get under control, you may ask your dentist to refer to us specifically to be considered for this type of treatment.
Question: Is it available on the NHS?
Answer: It cannot be used on the NHS until it has received medicines approval, requiring clinical trials as mentioned in the previous answer, so the NHS is likely to lag behind what we can do.