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Periodontist

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"I've been going to the Smile Cliniq for the past couple of years, and the treatment, care and advice from Chetan and his team has been faultless. Highly recommended." - A.S.
"Yet again I have been blown away by Smile Cliniq. After my filling fell out on Sunday night, I was distraught. But I phoned the Cliniq in the morning and got an appointment for the same morning. Dr Kaher put me at ease, even though I was very anxious, and did an amazing job on my..." - Robyn B
"What a great dental clinic! I was having issues with a tooth and Dr Sarita Kotecha was brilliant. Solved my dental issue quickly and explained everything in a way that made me actually enjoy the appointment (!!). They were able to squeeze me in last minute too. Highly recommend t..." - Saya Jones
"The service was so good at Smile Cliniq by Dr Sarita Kotecha, I recommended my wife to change dentist. We've been looking for a good dentist since moving to London 2 and 1/2 years ago and the quality we had received from our previous dentist was sub-standard. That all changed at ..." - Greg Jones
"I have had a dentist phobia for many years and would shake all over whenever I was there. Dr Chetan Kaher changed that. He was calm and very patient and understanding of my anxiety. All the staff are thoughtful and friendly. I don't shake anymore, which is wonderful. I still have..." - DEBRA MERRITT
"Fantastic service, professional and top notch technology. Very hygenic and Dr Chetan Kaher has a very steady and experienced hand. Highly recommend." - Amrita Chauhan
"I have had a dentist phobia for many years and would shake all over whenever I was there. Dr Chetan Kaher changed that. He was calm and very patient and understanding of my anxiety. All the staff are thoughtful and friendly. I don't shake anymore, which is wonderful. I still have..." - DEBRA MERRITT
"Friendly and helpful manager. Dentist was also friendly and efficient,Gave me lots of advice about dental care showing video." - Filippa Milioto
"Needed an emergency appointment, I was seen the same day! Great service and friendly staff" - Elena Milioto
"I found the the team at smile very professional and friendly, nothing was too much trouble. Chet presented all the options and my selected course of treatment took place over a year. As it involved one of my front top teeth I had some concerns and Chet was always available to ans..." - Irin Wu
"I have a hereditary tendency to get dental cavities, ensuing painful dental treatments, which left me scared of visiting dentists. Now, in my early thirties, I did everything to avoid dental checks. I also gave up on having cavity-free teeth. Two years ago, I was forced to find a..." - Rukmini
"I have just finished my year long lingual brace treatment with Dr Sarita Kotecha which has been a huge success. I'm so happy with the results! The staff at Smile Cliniq have always been friendly, helpful and welcoming; fitting me in for last minute appointments when necessary and..." - Maayan Bianca
"My wife needed to see a dentist on an emergency basis on a Saturday after a bad fall the evening before. We called on Saturday morning and they were able to take us that afternoon. The quality of care, both technically and inter-personally, could not have been better. If we lived..." - Hal N.

Specialist Periodontist Gum Treatment

A periodontist is a dentist who specializes in treatment of gum disease. Here at Smile Cliniq, winner of Best Practice and Best Dentist, we are fortunate to have Dr Evdokia Chasioti as our specialist periodontist at our practice in Finchley, London. She is recognised by the GDC as a specialist periodontist, she is an international member of the American Academy of Periodontolgy and a member of the British Society of Periodontolgy and the Association of Dental Implantology, UK.

Testimonials about Dr Evdokia Chasioti

I have been seen by Ms Chasioti several times in the last few months and have had different procedures to help difficulties caused by gum disease.

On every occasion, Ms Chasioti has been very thorough and she explains possibilities and answers questions in a clear way.

She has an easy-going personality and is gentle and considerate when working.

She spends time to make sure that her work is effective and that it feels right and comfortable.

I feel very confident in the work that Ms Chasioti did and would definitely recommend her. I am very grateful for the difference she has made for me

Sue Irvine

ABOUT GUM DISEASE

Gum disease is a condition where the tissues surrounding the teeth (periodontium) have become inflamed due to bacteria. The primary cause of gum disease is plaque. Plaque is a film that surrounds the tooth and it is composed mainly of various types of bacteria, which stick to your teeth and roots over and below the gum line. Plaque begins to form within minutes after brushing and flossing and if it is not removed daily with good oral hygiene plaque hardens into calculus (or tartar). Calculus can only be removed with a professional cleaning or periodontal treatment.

There are two types of gum disease: gingivitis and periodontitis. The initial stage of periodontal disease is called gingivitis and can often be completely reversed. Gingivitis is when the gums are inflamed, swollen and have a tendency to bleed when flossing or brushing. If gingivitis is not treated, the gums begin to pull away from your teeth, leaving little pockets around the tooth. This pocket traps plaque that can’t be reached with brushing and turns into calculus. Plaque and tartar build up cause further irritation. This can lead to bleeding gums, a funny taste and bad breath. It can also cause the gums to recede and if this occurs, dentine may become exposed and the teeth may become more sensitive to hot and cold substances. At this stage, the condition can be treated with a simple hygiene appointment with your hygienist or dentist and good oral hygiene practice at home.

Periodontitis is when gingivitis has progressed to bone loss. Pockets are formed in between the tooth and the gums. The supporting gum tissue and bone that holds the teeth in place deteriorates. The bone supporting the tooth can be lost causing the tooth to become wobbly and it affects your ability to chew and speak properly. At this stage, the lost bone and tissue cannot be re-grown. The aim of the treatment for periodontitis would be to prevent further progression of the disease in order to keep as many teeth remaining in your mouth for as long as possible.

Periodontitis refers to a number of inflammatory diseases affecting the tissues that surround and support the teeth. A diagnosis of periodontitis is established by inspecting the soft gum tissues around the teeth with a periodontal probe and by visual analysis of radiographs, to determine the amount of bone loss around the teeth.

Periodontitis is a common problem amongst adults and is a major cause of tooth loss. It is therefore advisable to see a periodontist as soon as the problem is detected. The earlier the periodontitis is treated, the higher the chance of keeping your own teeth in your mouth for longer. Factors such as smoking, diabetes, heart disease and hormonal changes may also be contributing to the deteriorating gum condition and we will advise you if you need to make any changes in order to improve your gum condition after consulting directly with your medical doctor.

At Smile Cliniq our Specialist Periodontist is Evdokia Chasioti. We recommend patients to consult with her, if the disease is moderate or advanced.

Gum and Periodontal disease Treatment

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Please click here for more information on gum recession. Please click here for more information about Laser Gum Treatments and here for gum de-pigmentation (gum bleaching).

THE CONNECTION BETWEEN PERIODONTAL DISEASE AND GENERAL HEALTH

A series of reports were recently published from the American Academy of Periodontology (AAP), in collaboration with the European Federation of Periodontology (EFP), with scientific data linking periodontitis, to other systemic diseases, including diabetes, cardiovascular disease and adverse pregnancy outcomes. There is strong evidence that periodontitis provides an increased risk for future cardiovascular disease and also that there is an independent association between periodontitis and diabetes. Periodontal treatment may provide favorable effects on diabetes outcomes in some patients and therefore regular comprehensive periodontal evaluations should be part of a diabetes management plan. Women considering pregnancy should consult with the periodontist to act towards the prevention and minimisation of periodontal bacteria when present and minimize the risk of bacteria getting into the blood stream, which happens when gum bleeding is present. Also, evidence suggests a relationship between periodontitis and other systemic diseases, including chronic obstructive pulmonary disease, pneumonia, chronic kidney disease, rheumatoid arthritis, obesity and metabolic syndrome.

Since the mouth is part of our body, our body senses the presence of the harmful periodontal bacteria and action should be taken towards the prevention and treatment of periodontal disease towards a healthier lifestyle (click here for more information).

 

 

An early and easy diagnosis of periodontal inflammatory processes can be of major importance for the prevention and treatment of systemic diseases.

PERIODONTAL MARKERS AND DIAGNOSTIC TESTS

Periodontal tissue damage and inflammation can be measured with quick and completely painless tests in the clinic followed by laboratory tests. The tests can discover hidden inflammation very early, even before clinical symptoms begin to appear such as periodontal destruction, bad breath and/or loosening of teeth.

In advanced periodontal disease cases, the test identifies different types of the most harmful periodontal bacteria that are responsible for different types of the disease. The overall benefit of the test is profound since it aids in formulating a personalized treatment plan targeted to the existent specific periodontal bacteria.

The enzyme test measures the active Matrix Metalloproteinase-8 (aMMP-8) in mouth rinse fluids or between the gum and the tooth (dental sulcus). This is the major enzyme for periodontal inflammation and it is known to be responsible for the collagen destruction of the gum.

The PCR periodontal bacteria test results provides us with a comprehensive analysis of the exact type of pathogenic periodontal bacteria affecting each patient. Specific recommendations for successful treatment strategy are formulated for each individual patient.

Collecting the sample is a completely painless and easy process. Plaque is collected by the periodontist with paper strips that are placed between the gum and the tooth in periodontal pockets and it only takes two minutes in the dental chair. The plaque is sent and analyzed at the laboratory and a report is processed to significantly improve the quality of care we grant to our patients.

TREATMENT OF PERIODONTAL GUM DISEASE

  • Periodontal Consultation
  • Oral Hygiene
  • Scaling and Root Debridement
  • Surgical Periodontal Treatment
  • Stabilization of Movable Teeth-Teeth splinting
  • Guided Bone/Tissue Regeneration around Teeth

SCALING AND ROOT PLANING

Scaling is the removal of plaque and calculus above the gum line and root planing is the removal of plaque and calculus below the gum line which contains millions of bacteria from the root surfaces. The periodontist will use an ultrasonic scaler to remove calculus from above and below the gums, and various hand instruments to access bacteria deeper within the pockets. This is performed under local anaesthetic in order to guarantee no pain. Treatment of periodontitis is a lifelong commitment. Even after having treatment with a periodontist it cannot be stressed enough how important it is to follow a strict oral hygiene regime at home to keep periodontitis under control. For more information on how to look after your teeth at home, please click on our oral hygiene guide. All specialist treatments are carried out at the Smile Cliniq Dental surgery in Finchley, North London. If you think you require treatment from our Specialist Periodontist Dr. Evdokia Chasioti, or want to ask a few questions about seeing her, just simply call our number on 020 8090 9077. You can also contact us via email at [email protected].

SURGICAL PERIODONTAL GUM TREATMENT

The distance between your gum and your teeth (periodontal pockets) may be too deep for you and the Periodontist or hygienist to keep clean. Under such circumstances pocket elimination is one of the most common surgical procedures used to treat periodontal disease. To gain access to the deep periodontal pockets the gum is pulled back gently. The periodontist can then visualize and remove thoroughly all plaque and calculus (tartar). The bone cavities caused by the disease are smoothed over and the gum tissues are positioned even with the bone level to reduce the periodontal pockets, and minimize the spaces under the gums where disease causing bacteria can hide. Tiny sutures are placed to stabilize the new gum position. A protective dressing often is placed around the teeth to cover and secure the surgical area. Sedation can be used to keep you comfortable and relaxed, if needed. You will have a follow up appointment in 7-14 days to remove any remaining sutures, evaluate your healing, and review oral hygiene.  Three months after surgery you will have a periodontal cleaning.

STABILIZATION OF WOBBLY TEETH-TEETH SPLINTING

When the teeth are compromised from a periodontal point of view and have lost most of their bone and gum support due to periodontal disease, they become wobbly. As a result the chewing efficiency, phonetics and function are compromised. To increase patient comfort during chewing we can connect multiple teeth together (teeth splinting) to reduce mobility and improve the patients function and chewing efficacy. Also, when the teeth are used as abutments for partial dentures they can be connected together to increase support of the periodontally compromised teeth. However, splinting makes oral hygiene procedures difficult. To ensure the longevity of the connected teeth, special attention must be taken towards oral hygiene.

To connect teeth to each other, the enamel surface of the tooth is etched, most commonly with a 37% solution of phosphoric acid and composite resin can then be bonded to the etched surface to rigidly connect the teeth to each other. The connection can be strengthened by adding a fibre or metal framework. No healthy tooth substance is removed and if the splint requires repairs in the future it can be easily reinforced without harming sound tooth structure.

GUIDED BONE/TISSUE REGENERATION AROUND TEETH

When periodontal disease is established in the mouth, inflammation is present, periodontal pockets are formed around the teeth and the bone that supports the teeth is lost. The harmful bacteria that hide in the deep pockets create bone irregularities. When the shape of these irregularities allows it, we can use artificial bone substitutes with growth factors that enhance periodontal regeneration and re-grow the bone that was lost, increasing the longevity of the teeth and eliminating the deep pocket where the harmful bacteria could hide. This periodontal surgical grafting technique is called Guided Tissue and Bone Regeneration and the most up to date procedures that contribute to periodontal regeneration are available in the clinic by Dr. Evdokia Chasioti

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Smile Cliniq Limited. A company registered in England and Wales. Company number 08279068.

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