Practice News

our service

March 2020

I am delighted to announce that our extended contact activity has just been confirmed. Should you wish to make an appointment for yourself or someone else, kindly get in touch with us at your convenience. -Conrad Costa



May 2018

We have updated our privacy policy in accordance with GDPR legislation. Our website does not track you, nor do we collect any information about you whilst you browse our website. We do not covertly make you mine Bitcoin on our behalf nor do we drop any cookies or sell you adverts. We value our own privacy very much and therefore have a lot of respect for your online privacy.

Patient satisfaction Survey

August 2016

Our patient satisfaction survey, which had been ongoing since April, is now closed. We would like to thank all those who participated. We would nonetheless welcome your feedback (whether written, verbal or by email) at any time. Our Friends and Family Test remains ongoing.

New Practice manager

January 2016

We would like to extend a warm welcome to Ms Angelique van Woerkom, who joins us at Castle and Costa as our new Practice Manager. Angelique has many years of experience as a Dental Care Professional and had worked for us frequently as a locum. She is familiar with our working system and is very eager to learn and help us improve our service.

New Associate Dental Surgeon

August 2015

We are pleased to welcome Dr Gavin Gill to our practice as our new associate dental surgeon, following the retirement of Dr Gillian Fellows. Dr Gill has many years of experience in general practice and in teaching hopsitals and will prove to be an asset to our team.

CQC inspection and report

June 2015

We are delighted to announce that Castle and Costa Dental Surgeons have passed their CQC inspection. Following a visit by two inspectors, we were given a clean bill of health - as well as a few suggestions - which we have taken on board. For more information, visit our Resources page.

Dementia Awareness training

November 2014

We extend our congratulations to our dental care professionals and dentists after they were awarded an NVQ level II in dementia awareness training. This will enable us to engage with our patient base better and to improve our understanding of their condition.

Conrad and audrey Costa

March 2013

We are pleased to announce that following the sad demise of Mr Castle, Conrad and Audrey Costa have recently taken over the running of the practice and will strive to maintain and improve the good standard of care that Castle and Costa have been delivering to the non-ambulatory for the past years.

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Periodontal Disease

Periodontal disease is more commonly known as "gum" disease and as its name implies, is a disease affecting the supporting structures of the tooth (the periodontium).



Healthy bone and gum around a tooth, the gum only 'pockets' about 2mm. In periodontal disease, the gum is chronically inflamed and swells up, leading to a detachment of the gum fibres that stick to the tooth, forming deep periodontal pockets.



In gingivitis, the gums gets inflamed and swells. They will be sore to touch, and may bleed easily. At this stage, healing occurs simply if the patient brushes more thoroughly. The gums presents 'false' pockets of >2mm, as the depth of the healthy pocket is increased only because the gum is bigger, not because of bacterial destruction.

These pockets are colonised by bacteria which relase their own toxins thus making the periodontal fibres loose and weak, leading to further shrinkage of the gums and the bone that supports the teeth. Periodontal disease may not be painful except in end-stage disease, where the teeth start getting mobile and painful to bite on.



In initial periodontal disease, plaque stagnates in the 'false' pockets which become a safe haven for bacteria. Bacterial toxins infiltrate the gum and cause destruction of the gum next to the tooth margin.


At a later stage as the gums shrink back further, bone destruction occurs, thereby reducing the structural support for the tooth. Pockets deepen, and mobility may set in.

It is therefore quite a dangerous disease as it may go un-noticed by the patient for a number of years and may be diagnosed casually on a routine dental check-up when it might be too late to treat in certain cases. It is therefore important to visit the dentist regularly, even if there is no obvious cause for concern or any symptoms, and have a scaling done regularly to remove all calculus from the teeth, which might be a factor that promotes periodontal disease.


Is it posible to treat gum disease?
When diagnosed early enough, periodontal disease can be treated successfully and the disease stopped, although any bone or gum loss that may have occurred might not be reversed.


Following initial gum therapy and coupled with regular pocket cleansing, healing starts with the reduction of inflammation in the gums, followed by a reduction in pocket depth and consequently, cessation of bone destruction.


Healing is complete when gum inflammation and swelling go down completely, and pocket depth returns to the normal 2-3mm, thereby making the gum margins cleansable again. Some bone healing may occur, although bone regeneration does not usually occur unaided. Bone and gum grafts may be required to restore aesthetics in sensitive areas.

Any signs of bleeding from the gums must be followed up by more careful brushing at that particular spot, as that implies that the gums will have been irritated by the presence of plaque which causes gingival inflammation, which in turn if left unchecked might lead to periodontal disease. Smoking plays a big part in periodontal disease, not least as the bacteria that cause the disease thrive in an atmosphere of reduced oxygen, as would be the case for people who smoke. Your dentist might recommend seeing a specialist if periodontal disease is especially severe.

See our Oral Hygiene page for more information.