Gum Disease Treatments

Gum disease is a broad term commonly used to describe gingivitis and periodontitis. Gingivitis causes inflammation of the gums without loss of the tissues supporting the teeth, while periodontitis is a deeper chronic inflammatory disease that damages the periodontal ligament and supporting bone.

The good news is that gingivitis can usually be reversed and periodontitis can often be successfully stabilised. Modern treatment focuses on controlling dental plaque, managing important risk factors, professionally cleaning affected areas and maintaining the result over the long term.

If you have bleeding gums, gum recession, persistent bad breath or loose teeth, a dental examination can establish whether you have simple gingivitis or require more extensive periodontal treatment.

What Is Gum Disease?

Dental plaque is a microbial biofilm that continuously develops on teeth. When plaque accumulates around the gumline, it can trigger an inflammatory response in the gingival tissues.

The earliest common form is gingivitis. At this stage, the gums may bleed or become swollen, but there is no periodontal attachment or bone loss caused by the disease.

Periodontitis is different. In susceptible individuals, inflammation becomes associated with progressive loss of the tissues supporting the teeth, including periodontal ligament and alveolar bone.

Not every person with gingivitis will inevitably develop periodontitis, but controlling gingival inflammation is an important part of reducing periodontal risk.

What Are the Signs of Gum Disease?

Possible warning signs include:

• Bleeding when brushing or cleaning between the teeth
• Red or swollen gums
• Persistent bad breath or an unpleasant taste
• Gum recession
• Teeth appearing longer
• Spaces developing between teeth
• Pus around the gums
• Loose or moving teeth
• Changes in tooth position
• Discomfort when chewing in some cases

Periodontitis can be surprisingly painless, particularly during earlier stages. You should therefore not wait for toothache before having persistent gum problems assessed.

What Causes Gum Disease?

Dental plaque is central to plaque-induced gingivitis and periodontitis, but disease severity depends on the interaction between the biofilm and the individual’s immune-inflammatory response.

Important risk and modifying factors include:

• Smoking: one of the strongest modifiable risk factors for periodontitis and tooth loss
• Diabetes: particularly when blood glucose is not well controlled
• Previous periodontal disease: patients who have had periodontitis remain at increased risk of recurrence
• Genetic susceptibility: some people appear considerably more susceptible than others
• Plaque-retentive factors: calculus, certain tooth positions or defective restorations can make effective cleaning more difficult
• Some medicines and medical conditions: these can influence the gums or the body’s inflammatory response

If you smoke, stopping is one of the most valuable changes you can make for your periodontal and general health. Glow Dental provides further information about smoking and oral health.

How Is Gum Disease Diagnosed?

Diagnosis involves more than simply checking whether the gums look red.

A periodontal assessment may include:

• Looking for plaque and calculus
• Checking for bleeding when the gums are gently probed
• Measuring periodontal pocket depths
• Recording gum recession
• Assessing clinical attachment loss
• Checking tooth mobility
• Assessing furcation areas around multi-rooted teeth
• Taking appropriate dental X-rays to assess bone support
• Reviewing risk factors such as smoking and diabetes

In UK dental practice, the Basic Periodontal Examination (BPE) is commonly used as an initial periodontal screening tool. If screening indicates possible periodontitis, a more detailed assessment is required.

What Are the Stages of Periodontitis?

Modern periodontal diagnosis does not simply describe gum disease as mild, moderate or advanced. Periodontitis is classified according to Stage I–IV and Grade A–C, together with its extent and current disease status.

• Stage I: early periodontal destruction
• Stage II: established periodontitis with greater attachment and bone loss
• Stage III: severe periodontal destruction with increased complexity and risk of tooth loss
• Stage IV: severe disease accompanied by additional functional problems such as significant mobility, tooth migration or loss of chewing function

The grade estimates the likely rate of progression and considers important modifying factors such as smoking and diabetes.

This classification allows treatment to be tailored to the individual rather than providing the same “deep cleaning” to every periodontal patient.

How Is Gingivitis Treated?

Plaque-induced gingivitis is generally reversible. Because there is no periodontal attachment or bone loss, treatment primarily involves establishing consistently effective plaque control.

This may include:

• Improving toothbrushing around the gumline
• Daily interdental cleaning
• Professional removal of calculus where present
• Correcting plaque-retentive factors where possible
• Stopping smoking
• Personalised oral-hygiene instruction

A dental hygienist can remove deposits that cannot be effectively removed at home and help you identify areas being missed during daily cleaning.

Does Gingivitis Need a Deep Cleaning?

Not usually in the periodontal sense.

The phrase “deep cleaning” is often used loosely, but simple gingivitis generally does not require the same subgingival root-surface instrumentation used to treat established periodontitis.

If calculus or plaque deposits are present, they should be professionally removed. More extensive instrumentation beneath the gumline becomes relevant when periodontal pockets and attachment loss are present.

How Is Periodontitis Treated?

Current British Society of Periodontology guidance uses a stepwise approach to treatment rather than attempting to complete everything in one appointment.

Step 1: Oral Hygiene and Risk-Factor Control

The first step establishes the foundation for successful periodontal treatment.

It includes:

• Explaining the diagnosis and causes of the disease
• Improving toothbrushing technique
• Daily interdental cleaning
• Professional removal of supragingival plaque and calculus where required
• Stopping smoking
• Addressing diabetes control where relevant
• Managing other modifiable risk factors

This stage is essential because professional periodontal treatment is much less likely to remain successful if plaque repeatedly accumulates between appointments.

Step 2: Cleaning Below the Gumline

Patients with periodontitis usually require professional subgingival instrumentation to disrupt plaque biofilm and remove deposits from affected root surfaces below the gumline.

You may also hear this described as:

• Root-surface debridement
• Periodontal debridement
• Professional mechanical plaque removal
• Scaling and root-surface instrumentation

The older phrase “scaling and root planing” is still widely used, but modern treatment is generally more conservative than historical root planing techniques that deliberately removed substantial amounts of root surface.

The aim is to thoroughly disrupt the subgingival biofilm and remove clinically relevant deposits while preserving healthy root tissue.

Does Periodontal Treatment Hurt?

Periodontal instrumentation can be carried out comfortably for many patients, but deeper areas may be sensitive.

Local anaesthetic can be used where necessary. Whether it is required depends on pocket depth, inflammation, sensitivity, treatment extent and individual patient comfort.

If anxiety has prevented you from seeking treatment, Glow Dental also provides additional support and sedation options for appropriate nervous dental patients.

What Happens After Deep Periodontal Cleaning?

The gums need time to respond before the result can be properly assessed.

At periodontal reassessment, the dental team may check:

• Whether bleeding has reduced
• Whether periodontal pockets have become shallower
• Whether plaque control has improved
• Whether inflammation has resolved
• Which deeper pockets remain
• Whether tooth mobility has changed

Some sites improve sufficiently after non-surgical treatment and require only maintenance. Others remain deep or continue bleeding and need additional treatment.

Step 3: Treating Areas That Have Not Responded

If significant periodontal pockets remain after initial treatment, the next step depends on their depth, anatomy and response.

Treatment may involve:

• Repeating subgingival instrumentation
• Referral to a specialist periodontist
• Periodontal access surgery
• Resective periodontal treatment
• Regenerative periodontal surgery in suitable defects

Surgery is therefore not automatically the first treatment for periodontitis. It is generally considered after effective oral hygiene and non-surgical treatment have been completed and residual disease remains.

What Is Periodontal Flap Surgery?

Periodontal access or flap surgery allows the periodontist to temporarily move the gum tissue so that deeper root surfaces and periodontal defects can be seen and treated more directly.

The aim is usually to improve access to areas that cannot be predictably treated through non-surgical instrumentation alone.

The gum is repositioned and allowed to heal after treatment.

Can Lost Bone Be Regenerated?

In selected periodontal defects, regenerative periodontal surgery can encourage formation of new supporting tissues.

Depending on the defect, treatment may involve materials such as:

• Bone-grafting materials
• Regenerative membranes
• Biologically active materials

True periodontal regeneration ideally involves formation of new bone, periodontal ligament and cementum.

Not every pattern of bone loss is suitable for regenerative treatment, so a periodontist needs to assess the individual anatomy and prognosis.

Can Gum Grafting Treat Gum Disease?

Gum grafting is primarily used to manage selected cases of gingival recession rather than treating the underlying inflammatory cause of active periodontitis.

A soft-tissue graft may help:

• Cover selected exposed tooth roots
• Increase soft-tissue thickness
• Improve certain aesthetic recession defects
• Protect vulnerable root surfaces in selected cases

Active periodontal inflammation should first be controlled before elective mucogingival surgery is considered.

Are Antibiotics Used to Treat Gum Disease?

Antibiotics are not routinely required for most periodontitis patients.

Mechanical plaque control, risk-factor management and subgingival instrumentation remain the foundation of treatment.

Current European periodontal guidelines specifically advise against routine systemic antibiotic use as an adjunct to standard subgingival instrumentation.

Antibiotics may be considered in selected circumstances under professional supervision, but they should not be viewed as a substitute for cleaning affected periodontal surfaces.

Can Mouthwash Treat Periodontitis?

No mouthwash can replace mechanical periodontal treatment.

Certain antiseptic mouthwashes, particularly chlorhexidine, may occasionally be recommended for a limited period as an adjunct to treatment.

Long-term chlorhexidine use is not generally recommended because it can cause tooth staining, altered taste and oral irritation.

Daily toothbrushing and interdental cleaning remain much more important for long-term plaque control.

Does Laser Treatment Cure Gum Disease?

Laser treatment should not be described as a proven replacement for conventional periodontal treatment.

Dental lasers can have useful roles in selected soft-tissue and surgical procedures, and Glow Dental provides laser dentistry.

However, current European S3 periodontal guidance does not suggest routine use of lasers as an adjunct to subgingival instrumentation for Stage I–III periodontitis because available evidence does not demonstrate a sufficiently reliable additional benefit.

The foundation of periodontitis treatment therefore remains effective plaque control, risk-factor management and appropriate professional mechanical instrumentation.

Can Gum Disease Be Cured?

The answer depends on whether the condition is gingivitis or periodontitis.

Gingivitis can generally be reversed because no periodontal attachment or supporting bone has been lost.

Established periodontitis cannot simply be returned to the completely untouched periodontal condition that existed before the disease because attachment and bone have already been lost.

However, periodontitis can often be successfully treated and stabilised, allowing affected teeth to remain functional for many years.

Some periodontal defects can also benefit from regenerative treatment.

Can Periodontitis Come Back After Treatment?

Yes. A patient who has previously developed periodontitis remains at increased risk of recurrence or further progression.

This is why active periodontal treatment must be followed by long-term maintenance.

Step 4: Supportive Periodontal Care

After active periodontal treatment has stabilised the disease, patients enter a programme of supportive periodontal care.

Maintenance visits may include:

• Monitoring periodontal pocket depths
• Checking for bleeding
• Reviewing plaque control
• Reinforcing oral-hygiene techniques
• Monitoring smoking, diabetes and other risk factors
• Professional plaque and calculus removal where necessary
• Localised subgingival treatment if disease recurs

Maintenance is not an optional extra. Long-term periodontal stability depends heavily on continued supportive care and effective daily plaque control.

How Often Do You Need Periodontal Maintenance?

There is no universal rule that every periodontal patient must attend every three or four months.

Current evidence-based guidelines recommend supportive periodontal-care intervals of approximately 3 to 12 months, individually tailored according to periodontal stability and the patient’s risk profile.

Higher-risk patients may need more frequent appointments, while stable patients with excellent plaque control may sometimes be managed at longer intervals.

Factors influencing recall frequency include:

• Residual periodontal pockets
• Bleeding on probing
• Previous disease severity
• Smoking
• Diabetes
• Home plaque control
• Previous tooth loss
• Patient adherence to maintenance

Can a Dental Hygienist Treat Gum Disease?

Yes. Dental hygienists and therapists play a major role in preventing and treating periodontal disease.

A dental hygienist may provide:

• Oral-hygiene instruction
• Professional plaque and calculus removal
• Management of gingivitis
• Subgingival instrumentation within their scope
• Supportive periodontal maintenance
• Smoking and risk-factor advice

Patients with severe, complex or non-responsive disease may additionally need assessment and treatment from a specialist periodontist.

What Can You Do at Home to Help Treat Gum Disease?

Professional treatment cannot compensate for plaque repeatedly accumulating every day.

Effective home care generally includes:

• Brush twice daily with fluoride toothpaste
• Clean carefully along the gumline
• Clean between the teeth every day
• Use appropriately sized interdental brushes where there is sufficient space
• Use floss or tape where contacts are too tight for interdental brushes
• Spit after brushing rather than immediately rinsing with water
• Do not routinely use mouthwash immediately after brushing
• Do not smoke
• Maintain good diabetes control where applicable
• Attend periodontal maintenance at the interval recommended for you

For more advice about fluoride and oral-hygiene products, see our complete toothpaste guide.

Does Smoking Make Gum Disease Worse?

Yes. Smoking is one of the strongest modifiable risk factors for periodontitis.

Smokers are at increased risk of periodontal destruction, tooth loss and poorer treatment outcomes.

Smoking can also make disease more difficult to notice because it can suppress visible gum bleeding.

Stopping smoking substantially benefits periodontal and general health. Read more about smoking and dental health at Glow Dental.

What Is the Link Between Diabetes and Gum Disease?

The relationship between diabetes and periodontitis is particularly important and is considered bidirectional.

Poorly controlled diabetes increases susceptibility to periodontitis and may result in more severe periodontal destruction.

Periodontitis is also associated with poorer glycaemic control. Successful periodontal treatment has been shown to produce modest improvements in blood-glucose control in people with diabetes.

If you have diabetes, periodontal health should therefore form part of your wider healthcare.

What About Gum Disease During Pregnancy?

Hormonal changes during pregnancy can increase the gingival inflammatory response to plaque, making bleeding and swelling more noticeable.

This does not mean pregnancy automatically causes periodontitis, but maintaining effective plaque control remains particularly important.

Professional periodontal and hygiene care can be provided during pregnancy when clinically required.

Read more about dental and gum care during pregnancy.

Can Gum Disease Cause Tooth Loss?

Yes. Severe uncontrolled periodontitis can destroy enough periodontal ligament and supporting bone for teeth to become increasingly mobile and eventually unsalvageable.

However, diagnosis of periodontitis does not mean that tooth loss is inevitable.

Effective treatment and long-term maintenance can preserve many periodontally affected teeth for years or decades.

Extraction is generally considered when an individual tooth has a hopeless prognosis rather than simply because periodontal disease is present.

When Should You See a Dentist About Gum Disease?

Arrange an assessment if you notice:

• Repeated gum bleeding
• Persistent redness or swelling
• Gum recession
• Persistent bad breath or bad taste
• Pus around a tooth
• A tooth becoming loose
• Increasing spaces between teeth
• Teeth moving from their previous positions
• Persistent discomfort when chewing

New tooth mobility, significant swelling or pus should be assessed promptly rather than waiting for a routine hygiene appointment.

Frequently Asked Questions About Gum Disease Treatment

Can gingivitis be reversed?

Yes. Plaque-induced gingivitis is generally reversible when effective plaque control is established because no periodontal attachment or supporting bone has been lost.

Can periodontitis be reversed?

Periodontitis can usually be controlled and stabilised, but previously lost attachment and bone do not simply return to their original condition. Selected periodontal defects can sometimes be regenerated surgically.

Will a scale and polish cure gum disease?

A routine professional cleaning can help manage gingivitis, but established periodontitis may require subgingival instrumentation, reassessment and sometimes specialist periodontal treatment.

Do antibiotics cure gum disease?

No. Antibiotics do not remove the plaque biofilm and calculus responsible for maintaining periodontal disease and are not routinely recommended for most periodontitis patients.

Does laser treatment cure periodontitis?

No. Current evidence does not support laser therapy as a routine replacement for conventional subgingival instrumentation. Lasers can have useful roles in selected dental and soft-tissue procedures, but periodontal treatment still requires effective mechanical plaque control.

Can gums grow back after gum disease?

Inflamed swollen gums can return to a healthier appearance after treatment, but true gum recession usually does not simply grow back by itself. Selected recession defects may be treated with periodontal grafting.

How long does gum disease treatment take?

There is no fixed treatment time. Gingivitis can improve relatively quickly once plaque is controlled, while periodontitis treatment often involves several stages followed by reassessment and lifelong maintenance.

How often should I see a hygienist after periodontitis?

Supportive periodontal appointments are generally personalised between approximately three and twelve months depending on your risk and periodontal stability.

Is gum disease painful?

Often it is not. Significant periodontal destruction can occur without severe pain, which is why bleeding, recession, pocketing and bone levels are more useful indicators than pain alone.

Gum Disease Treatment at Glow Dental

Glow Dental provides both professional dental hygiene care and specialist periodontics in Battersea, allowing treatment to be matched to the severity and complexity of your gum condition.

For gingivitis and preventive care, Glow Dental’s hygienists provide professional plaque and calculus removal together with personalised home-care advice.

Patients with established or more complex periodontitis can be assessed by the specialist periodontal team for non-surgical periodontal therapy, management of persistent pockets and surgical or regenerative treatment where clinically appropriate.

Glow Dental also offers laser dentistry for selected procedures. However, laser treatment should be used where there is a specific clinical indication rather than presented as a routine substitute for evidence-based periodontal instrumentation.

If dental anxiety has prevented you from seeking treatment, Glow Dental can also support nervous dental patients, including sedation options where appropriate.

The first step is establishing the correct diagnosis. Arrange a dental examination, find out more about joining Glow Dental or view our current dental fees.

Conclusion: What Is the Best Treatment for Gum Disease?

The best gum-disease treatment depends on whether you have reversible gingivitis or established periodontitis. Gingivitis is usually managed by consistently effective plaque control and professional removal of deposits where required.

Periodontitis requires a structured approach beginning with oral hygiene and risk-factor control, followed by subgingival instrumentation, reassessment and additional periodontal treatment where pockets remain.

Antibiotics and lasers are not routine replacements for conventional periodontal treatment, while surgery is generally reserved for sites that remain problematic after appropriate non-surgical care.

Long-term supportive periodontal maintenance is essential because successfully treated periodontitis can recur. With appropriate treatment, good daily plaque control, smoking cessation and continued professional monitoring, many patients can stabilise gum disease and preserve their natural teeth for many years.