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Dentistry/Sore gums after plane and scale treatment


Hi Dr Peck,

My question is about periodontics. About two weeks ago, I underwent a scale and plane at my periodontist for the left half of my face, after having the right side done about two weeks before that.

I have noticed that after the second treatment, the gums around my left molars have started bleeding when I floss them and are very sore, despite not bleeding before the scale and plane. The gums are slightly swollen and a slightly darker pink colour than the rest of my gums. The gums also feel a bit 'flappy' and loose, a bit like they did just after the scale and plane. Additonally, in the last two days I have also started having a bit of bleeding between two of my molars on the right side when I floss, although I have had no bleeding there at all in the month since the scale and plane.

Should I be concerned about this swelling and bleeding? I note that this did not occur after the first round of treatment on my right side. I am concerned that I am doing something wrong in my homecare or that I require further treatment asap.

I use an electric toothbrush and changed the brush-head about three weeks ago. I floss for 30-45 mins every night and try to be thorough - my periodontist has said that 'flossing too much' isn't an issue. I have tried brushing with a soft, non-electric the past two days and the relevant gums seem to be a bit less sore than before, but I am concerned that this is less effective at cleaning than the electric toothbrush.

For background, this is how I currently understand my case: I am 21 years of age and have been found with a 6-7mm pocket at tooth 11. I also have 5mm pockets at 17, 27, 37, 47, 46, 15 and 12 (I have had all my wisdom teeth removed). There seems to be no explanation for the severity of tooth 11 - it has also seen some mobility, about 2mm downward and forward, which is apparently uncharacteristic of this degree of bone loss. My periodontist has tentatively attributed this to traumatic occlusion with my lower teeth. I have previously had orthodontic work and had continued to wear my retainer weekly, which may have aggravated the mobility in tooth 11, with the underlying gum issues. In the past, I did not floss, but since being referred about 5 weeks ago, I have been flossing daily, along with brushing twice a day. I am booked in for a follow-up in three months, however I will be overseas for 6 months after that and it may be difficult to access periodontic care overseas. Naturally, I have no interest in losing any of my teeth any time soon and am anxious to make sure this is the case.

Many, many thanks in advance.

Hi Victoria and thanks for your question.

Sorry to hear about your dilemma.  First, a few things about perio in general:

Perio treatment is a long-term, chronic process and the results can take some time to be noticed, so be patient and try not to stress in the short-term.  It is brilliant that you are seeing a periodontist because early detection and treatment is vital to the success of perio treatment in general.  You mention that your oral hygiene home care is good, and well done.  What I also suggest for perio patients, is the use of interdental brushes in addition to flossing as well as a water-pick.  This is a very valuable tool for flushing out any loose debris under the gum without the risk of additional damage and one can fill the water container with an agent such as chlorhexidine (such as Corsodyl or Eludril mouth washes) for additional anti-bacterial action.  This is because it is impossible to floss effectively sub-gingivally, which is where your problem lies.  Another thing, don't avoid brushing any area that bleeds - keep up your regular home care with extra attention to that area and limit personal stress as much as possible as this does affect oral health - and eat correctly and sleep enough.

The rest is upto your periodontist and oral hygienist and with the correct approach, your pockets will hopefully reduce.  I hope this helps, take care.

Kind regards
Dr Craig Peck


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Dr Craig W Peck ( B.Med.Sc., B.Ch.D., Clin. Botox, Cosmet. Derm.)


I am a General Dental Practitioner, with special interests in Cosmetic Dentistry & facial aesthetics and Periodontology, placing a strong emphasis on the establishment and maintenance of a healthy periodontium (the support structure of the tooth) before cosmetic options are considered. I uphold all principles of prevention above interventional treatment and try as far as possible, to remain conservative in my approach. I believe in detailed, open and honest patient discussion, establishing what the patients expectations are and what the reality is of achieving this and involving the patient at every level of the treatment. I have strong principles on ethical treatment and appropriate patient management. I have chosen to treat and rehabilitate many nervous and phobic patients, who, for whatever reason, find it impossible to take part in the very important task of even a routine check-up. I will accept questions relating to general and cosmetic dentistry (in conjunction with the use of facial cosmetic procedures) and dental fears/phobias. I will be more than willing to answer any academic questions in dentistry, biology, physiology, psychology and health sciences in general. As most dentists will tell you, there is often not only one way of dealing with a dental issue - so very often, there is no precise right and wrong way of approaching the problem. All clinicians vary when it comes to treatments and what works best in their hands is often the treatment that is advised. Be understanding of this and bear in mind that nothing lasts forever! Patients are happy to accept only a one-years warrantee when buying a new car, but seem to expect that dental work is going to last them their lifetime.


I have worked for many years in the UK and RSA as a general dental practitioner - within the NHS, private practice and the government dental health services. I am certificated for the administration of Botox and Dermal Fillers for facial lines and wrinkles as I have attended further courses in minimally invasive facial cosmetic procedures. I started seeing an increasing number of patients who presented with severe to moderate dental fears, even with full-blown phobias, so I started with the slow and patient task of tackling this problem and have successfully rehabilitated many patients. The key is good, effective, concise and understandable communication, shifting control from the dentist to the patient in order to slowly, but confidently, regain their trust back in dentistry, thereby giving them the feeling of achievement and this self-empowerment which drives them to the next level of treatment.

Academy of General Dentistry. American Dental Education Association. IAPAM (International Association for Physicians in Aesthetic Medicine). Professional Speakers, Writers and Managements Consultants in Dentistry. The British Dental Association. UK Aesthetics Group. ARC - Aesthetic Professionals. Botox. Aesthetics & Beauty. American Association for Dental Research. FDI - World Dental Federation. SOURCE1uk. World Dental Hygiene Forum. ProDentalCPD. Public Health Dentistry. Dentist Network. LinkedIn. Who's Who of South Africa.

B.Med.Sc. Degree (Medical Physiology and Medical Virology; Physiology Cum Laude; Stell 1994). B.Ch.D. Degree (Bachelor of Dental Surgery; Clinical Dentistry Cum Laude; Stell 1997). CPR and CPR-Advanced Courses (2000/2001; UK). Clinical Botox (UK, 2001). Cosmetic Dermatology (Botox and Dermal Fillers; RSA 2011).

Awards and Honors
Placed on the Dean's List at University for academic achievement (1994). Highest achievement in the subject Dental Materials. Medal from 3M and the Radiology Association of South Africa for highest achievement in the subject Dental Radiology and Imaging. Medal from The Periodontal Association of South Africa for highest achievement in the subject Periodontology. Highest achievement for Oral Medicine. Highest achievement in Oral Pathology. Received the DASA (Dental Ass. of South Africa) Gold Medal for highest achieving dental student across the 5 1/2 years of the Degree. Passed the subject, Clinical Dentistry with distinction in final year.

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