Professional Mechanical Plaque Removal (PMPR) for Gum Disease

Information about Professional Mechanical Plaque Removal (PMPR) at Bristol Dental School

What is professional mechanical plaque removal?

Professional Mechanical Plaque Removal is the removal of plaque above or below the gums by a trained professional.

For patients who have gum disease (gingivitis or periodontitis) the aim of Professional Mechanical Plaque Removal is to remove plaque bacteria to allow the gums to heal.

For Professional Mechanical Plaque Removal to be successful, it is important that your oral hygiene is good before starting treatment. This will be discussed and checked (using plaque scoring) before treatment. If plaque levels are too high, further oral hygiene improvement will be needed before Professional Mechanical Plaque Removal can be conducted.

Why do I need Professional Mechanical Plaque Removal?

Above the gums: If plaque is causing your gums to bleed, plaque removal above the gums is required.

Below the gums: If periodontal pockets of 4mm or above are detected in your mouth, plaque removal below the gums will be required to remove the bacteria from these pockets.

What happens during treatment?

A dental professional will discuss which areas require Professional Mechanical Plaque Removal.

If teeth on both sides of your mouth require treatment, the dentist will usually provide treatment on one side of the mouth at a time.

  1. Above the gums:
    1. Specific instruments are used to remove plaque above the gums. Some remove plaque by being pulled up the teeth and some use vibrations and water.
    2. Usually patients do not need to be anaesthetised (numbed) for this procedure. However, if it’s very sensitive, sometimes local anaesthetic can be used.
    3. This treatment is usually completed in one visit.

  2. Below the gums:
    1. Local anaesthetic is administered to minimise any discomfort during treatment.
    2. Specific instruments are used to clean below the gum and in the periodontal pockets. Some remove plaque by being pulled up the teeth and some use vibrations and water
    3. This treatment is usually conducted over two visits and can take up to two hours per visit.
    4. A review appointment at approximately 3 months is required to review your response to Professional Mechanical Plaque Removal below the gums.

What are the advantages of Professional Mechanical Plaque Removal?

Maintaining gum health: Removing the plaque bacteria from above and/or beneath the gums allows the gums to heal.

Prevent disease progression: Regular attendance for Professional Mechanical Plaque Removal has shown to significantly reduce the rate at which gum disease (gingivitis and periodontitis) progresses.

Periodontal pockets: In patients with periodontal pockets, Professional Mechanical Plaque Removal below the gums can prevent pockets getting deeper. In some cases, Professional Mechanical Plaque Removal can resolve periodontal pocketing.

What are the risks of Professional Mechanical Plaque Removal?

Professional Mechanical Plaque Removal BELOW the gums has the following risks:

Recession: Healing of the gums can cause your gums to shrink (recede). This can expose the roots of the teeth. Gum recession can cause sensitivity and a change in appearance of the gums.

Sensitivity: If you are experiencing sensitivity, please mention this to the dental professional at your review or a future appointment. They can recommend toothpastes that can help with this.

Repetition of treatment: Treatment often needs to be repeated on a periodic (e.g. 3 monthly) basis for ongoing improvements to be seen.

Oral hygiene: If oral hygiene (regular brushing and cleaning in between the teeth) is not maintained, root surface debridement will not work.

Response to treatment: Some patients do not respond to Professional Mechanical Plaque Removal even if they have excellent oral hygiene.

Risk factors: Factors which may negatively affect the outcome of treatment include:

  • Poor oral hygiene
  • Smoking
  • Poorly controlled diabetes
  • Very deep periodontal pockets

What are the alternatives of Professional Mechanical Plaque Removal?

We will always discuss the options available to you in depth before any decisions are made. Such options may include:

  • Gum surgery: In select cases, gum surgery may be suggested.
  • Antibiotics: The use of antibiotics is rarely used to treat gum disease.

What happens after treatment is finished?

It is normal for your gums to feel sore after Professional Mechanical Plaque Removal. If the pain is bothering you, over the counter painkillers can be used according to the recommended dosage. Gentle cleaning techniques and mouthwashes will be provided to help oral hygiene during initial healing.

Between 3 weeks to 3 months after finishing treatment, you will need to attend a follow up session. This session will show us how effective Professional Mechanical Plaque Removal has been and whether another course is necessary. If your gum health stabilises, you will not require further dental treatment.

When all of your dental treatment is complete, you will be discharged from the dental school. We advise that you find a dentist outside the dental school to continue to look after your gum health.

Types of questions you may want to ask?

  • How long will Professional Mechanical Plaque Removal take?
  • How can I clean my teeth before and after Professional Mechanical Plaque Removal?

And finally…

Maintaining good oral hygiene is crucial for healthy teeth and gums, and will help reduce the risk of decay and gum disease.

Brush your teeth twice daily for 2 minutes with fluoride toothpaste and clean between your teeth with floss or interdental brushes.

Smoking and alcohol increase the risk of oral disease. If you want to quit smoking or reduce your alcohol intake, please talk to the clinician you see for further advice.

It is important to attend dental check-ups regularly, as this will help your dentist to identify any dental disease early.