Gum disease treatment
Gum disease is inflammation caused by plaque bacteria at the gum line. In its early stage, gingivitis, it is reversible. Once it has damaged the bone around the teeth it is periodontitis, which can be controlled but not reversed. Treatment starts with a gum assessment.
What is gum disease treatment?
Gum disease starts with plaque, the soft film of bacteria that forms on teeth through the day. Where it sits undisturbed at the gum line, the body responds with inflammation, and the gums become red, swollen and inclined to bleed. That stage is gingivitis. It affects the surface of the gum only, nothing underneath has been damaged yet, and it genuinely reverses: with the hardened deposits professionally removed and the plaque disturbed properly at home, gums settle over a matter of weeks. If it is left, the inflammation works deeper, and this is where gum disease becomes a different problem. In periodontitis the fibres and bone that hold the tooth in its socket are destroyed, the gum separates from the tooth into a pocket that is impossible to clean with a toothbrush, and teeth eventually loosen and drift. Bone does not grow back. Treatment at that point aims to stop the process and hold what is left, which is a genuinely good outcome, but it is not the same as undoing it. The reason this catches people is that it does not hurt. Gum disease is largely painless until it is advanced, so there is no symptom telling you to do something while doing something is still easy. Bleeding when you brush is the signal most people have and most people ignore, on the assumption that they are brushing too hard. Gums that are healthy do not bleed. Some people are at higher risk than others. Smoking is the big one, and it also masks the bleeding that would otherwise warn you. Poorly controlled diabetes raises the risk, and the relationship runs both ways, because gum inflammation makes blood sugar harder to control. A diet high in sugar feeds the bacteria. Some people are simply more susceptible than others for reasons that have nothing to do with how well they brush, which is worth saying plainly, because people with advanced gum disease are often told it is their fault when the picture is more complicated than that.
When might you need gum disease treatment?
Gums that bleed when you brush or floss
The most common sign and the one most often dismissed. Healthy gums do not bleed when cleaned normally.
Red, puffy or tender gums
Healthy gum is firm and pale pink. Swelling and colour change mean the body is responding to bacteria at the gum line.
Bad breath that does not shift
Bacteria in deep pockets produce odour that brushing, mouthwash and mints do not reach.
Gums that have receded
Teeth looking longer than they used to, or a step you can feel where the tooth meets the gum.
Teeth that feel loose or have drifted
A later sign. Teeth moving, spacing opening up, or a bite that feels different are all worth having looked at promptly.
A family history of losing teeth to gum problems
Susceptibility runs in families. It is worth mentioning at a check-up so your gums are monitored more closely.
What happens, in short
Gum assessment
Measurements are taken around each tooth to record where the gum has detached, along with x-rays to see the bone level. That is what separates gingivitis from periodontitis, and it is a named part of a comprehensive check-up.
Explaining what the measurements mean
You should be told which teeth are affected, how far it has gone and what the realistic aim is, before any treatment is agreed.
Cleaning above and below the gum line
Hardened deposits are removed from the tooth and root surfaces, including inside the pockets where a toothbrush cannot reach. Deeper areas are usually done in stages and with local anaesthetic.
Working out what changes at home
This is the part that decides the result. Which brush, which technique, what goes between the teeth, and whether smoking is in the picture.
Review
The gums are measured again after they have had time to respond. Comparing the two sets of numbers is how you know whether it is working rather than guessing.
Maintenance, or referral
Gums that have been treated need cleaning at set intervals to stay stable. Where the disease is severe or not responding, we refer you to a periodontist, a registered specialist in gum treatment.
What does it cost?
A gum assessment is included in a comprehensive check-up and clean, so most people find out where they stand as part of a normal visit. Treatment itself is quoted after that assessment, because what it involves depends on how many teeth are affected and how deep the pockets are, and quoting it beforehand would be guessing. You get the quote in writing, itemised with item numbers, before anything starts. If your extras cover includes general or major dental, part of it is usually claimable, and we claim on the spot through HICAPS.
You get a written, itemised quote with item numbers before any treatment starts, so you can check it with your health fund. Health funds · Payment options
Can gum disease be reversed?
Gingivitis can, completely. Periodontitis cannot, because the bone that has been lost does not grow back, but it can be stopped and held stable.
That distinction is the single most useful thing to understand about gum disease, and it is why the gum measurements matter. It is also why we would rather find it at a check-up than have you arrive when a tooth has started moving.
Why don't my gums hurt?
Gum disease is largely painless until it is advanced. Pain is not the warning system here, and waiting for it means waiting too long.
The signals you get instead are bleeding, swelling, bad breath and, later, movement. Bleeding is the earliest and the one people most often explain away as brushing too hard. Brushing too hard damages gums in a different way, and it does not make healthy gums bleed.
What does gum treatment actually involve?
Careful cleaning of the tooth and root surfaces above and below the gum line, in stages, with local anaesthetic where the pockets are deep.
It is not the same as a routine scale and clean, which works on what is above the gum. The aim is to leave the root surfaces clean enough for the gum to reattach against them and the inflammation to settle. It is usually done over more than one appointment so that each area gets proper time.
Does gum disease affect the rest of your health?
There are recognised links. Untreated gum disease can affect heart health and makes diabetes harder to control.
These are associations described in public health guidance rather than a simple chain of cause and effect, and you should be cautious of anyone selling gum treatment as a cure for something else. What is well established is the diabetes relationship, which runs both ways: poorly controlled blood sugar worsens gum disease, and gum inflammation makes blood sugar harder to manage. If you have diabetes, it is worth telling us.
What happens if it is left?
It progresses. The bone continues to be lost, pockets deepen, teeth loosen and drift, and eventually they are lost or have to be removed.
The uncomfortable part is that this happens quietly over years, and by the time teeth are visibly moving, a lot of the supporting bone has already gone. Losing teeth to gum disease also complicates what can be done afterwards, because implants need healthy bone and healthy gums to sit in.
Why does it need ongoing maintenance?
Because the pockets left behind after treatment are still harder to clean than a healthy gum line, so plaque rebuilds in them faster.
Gums that have been treated and then left alone tend to relapse. Regular maintenance cleaning at an interval set for your gums, rather than a standard six months for everybody, is what keeps the result. It is a long-term arrangement rather than a course of treatment that finishes.
Will you have to remove my teeth?
Not as a starting point. The aim is always to stabilise what is there, and teeth that look hopeless at first sometimes firm up once the inflammation settles.
Where a tooth has lost too much support to be saved, we will tell you, explain what the options are for the gap and give you time to think rather than deciding on the day. Removing a tooth is a decision, not a default.
Symptoms that can lead here
More about gum disease treatment
Other questions people ask
Is bleeding when I brush normal?
No. It is the most common early sign of gum disease and it is worth having looked at. Healthy gums do not bleed when you brush or floss normally. If you have only just started cleaning between your teeth, some bleeding for the first week or so while things settle is expected, but bleeding that carries on is not.
My gums started bleeding in pregnancy. Is that gum disease?
It is usually pregnancy gingivitis, which is the early and reversible stage. Hormonal changes make gums react more strongly to the same amount of plaque, and bleeding commonly appears around the second trimester. It responds well to a professional clean and careful home care. Have it looked at rather than waiting it out, because gingivitis left alone is what turns into the advanced form.
Is gum disease the same as gingivitis?
Gingivitis is the early, surface-level stage of gum disease, and it is reversible. Periodontitis is the advanced stage where the bone supporting the teeth has been affected, and that part cannot be reversed. Both are gum disease. Which one you have is what the gum measurements establish.
Does smoking make it worse?
Considerably, and in two ways. It increases the risk and the severity, and it reduces the bleeding that would otherwise have warned you something was wrong, so smokers often present later. Gum treatment also works less well while someone is smoking. We are not going to lecture you about it, but we will tell you honestly what difference it makes.
Can I treat gum disease at home?
What you do at home decides whether treatment holds, so it is genuinely half the job. But hardened deposits below the gum line cannot be removed by brushing, flossing or mouthwash, and pockets that have formed will not clean themselves out. The two parts work together and neither one succeeds alone.
Do I need a specialist?
Most gum disease is managed by a general dentist. Where it is severe, where it is progressing despite treatment, or where surgery might help, we refer you to a periodontist, who is a registered specialist in gum treatment. Our dentists are general dentists and we will say so plainly when a case belongs elsewhere.
Will my health fund cover gum treatment?
Usually in part, if your extras cover includes general or major dental, though how much depends on your policy and your annual limit. We claim on the spot through HICAPS, and the written quote has the item numbers on it so you can check with your fund first.
How often will I need to come in?
More often than the standard six months if your gums have been treated, and the interval is set for your gums rather than as a general rule. Your dentist will tell you what yours should be and why, and it can be stretched out again if the gums stay stable.