The 5-hour treatment that can banish gum disease - and straighten teeth

Gum disease, the primary cause of tooth loss, affects up to 50 per cent of the population with often irreversible consequences.

Early signs of infection are swollen or bleeding gums, bad breath and sensitivity. Known as gingivitis, if caught early the condition is easily treated with professional cleaning.

But in serious cases, the gums and underlying ligaments can become infected. This condition, periodontitis, may result in the teeth moving out of alignment. It can attack without symptoms and, despite careful oral hygiene, erode the bone supporting teeth and cause gums to recede.

Rosemarie Holzhauer

Infection had caused Rosemarie Holzhauer's teeth to separate and protrude

But now, a remarkable treatment aimed at chronic sufferers is being pioneered by dentists at The Hale Clinic in Central London.

Periodontitis is the result of pockets developing between the tooth roots and gum, within which minuscule food particles become trapped and bacteria flourish.

Rosemarie Holzhauer

Smiles better: The procedure helped realign Rosemarie's front teeth

Dentists usually fight periodontitis through teeth scaling and root planing, using metal scrapers to reach the roots, remove sticky yellow tartar  -  plaque that has hardened on the teeth, encouraging bacterial growth  -  and smooth the irregular surfaces to which bacteria cling. This can often involve cutting the gums.

Conventional treatment is to clean one quarter at a time  -  most patients are unhappy about longer sessions which involve anaesthetising the entire mouth. The process can take a month and can allow bacteria to reinfect cleaned areas between appointments.

Continued flare-ups mean extractions are the only option.

The new procedure, called BOST  -  Bone One Session Treatment  -  involves the mouth being cleaned in one session, lasting four to five hours.

Hale clinic dentist Dr Yvan Micholt says: 'We use a gentle gum-stretching technique to reach the root surfaces. Infected tissue is spongier and elastic, so it is possible to gently push it back manually using tiny scoop-shaped instruments known as curettes. The gum can then be stretched just like skin, allowing us to cleanse the infected tooth underneath.

We scale and rootplane-every square millimetre of every tooth and root, as deep as any pocket reaches. A thin layer of dentin, the material that cements the tooth into the gum, which will have been colonised by the bacteria and impregnated with their destructive enzymes, is scraped from the root surface. This regrows.'

BOST's success also depends on patients maintaining a simple, painless daily hygiene regime afterwards, using an AirPerio Kit  -  a plastic handle called a perio-aid which is held like a pencil, and a set of disposable hygienic wooden points called aeros that fit into the end. The aero is slim enough to be painlessly pushed up into the gums to clean underneath.

'This stops bacterial growth by allowing oxygen to reach under the gums. Bacteria can only thrive in the absence of oxygen,' says Dr Micholt.

Only two per cent of patients have repeat infections, he claims. 'We often see patients who have been advised by several dentists to have multiple extractions, and we save their teeth,' says Dr Micholt.

'Of course, some problems can be so severe that extraction is the only option. But we prefer to give each tooth its chance.'

Gum disease

Rosemarie Holzhauer, 48, a medical administrator and mother of two from West London, underwent BOST in June. She admits missing hygienist appointments when her children were young, but in later years 'I flossed if I just looked at food'.

However, as Dr Micholt says: 'Gum disease can run in families, meaning that almost no matter what a patient does, or how much they clean, they will still suffer.'

Indeed, Rosemarie's sister also had periodontitis and credits BOST, which she had five years ago, with saving her teeth.

In Rosemarie's case, infection had caused her teeth to separate and protrude.

'I had to do something. My gums didn't bleed and weren't sensitive, but they had started to recede,' she says.

A conventional practitioner had advised her to have up to ten teeth removed.

'But my sister's teeth and gums are now fine and her dentist admits that he is stunned by her recovery,' says Rosemarie. 'When I found a practitioner in London, I booked myself in.'

Initially wary of a half-day dental session, Rosemarie was surprised at how easy it was. 'The treatment was carried out while I lay on a warm waterbed. The dentist was so gentle it didn't even hurt when he injected me with anaesthetic.

'I was given a break whenever I needed one and the anaesthetic meant I didn't feel any pain, just a few moments of slight discomfort. I closed my eyes and floated off.

'My mouth felt a bit sensitive afterwards but I was able to eat soup and ice cream for supper that night and I felt back to normal the next day.'

About 3,000 people worldwide have had BOST, and the British Dental Association has cautiously welcomed it.

The treatment costs up to £5,000 but Rosemarie is thrilled with the results.

'Dr Micholt fitted a splint  -  a small wire  -  to the back of my teeth to keep them in place so they didn't wobble or stick out. I have no gaps, and I feel great.'

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