Gum Therapy

What we look for

At a gum assessment we measure the depth of the space between each tooth and the gum around it. Healthy gums sit at one to three millimetres. Deeper than that and the pocket holds bacteria that a toothbrush cannot reach, which is what drives the process forward.

We combine those measurements with X-rays that show the bone level around the roots. Bleeding tells us there is inflammation now; the bone level tells us how much ground has already been lost. Both matter for deciding what treatment is appropriate.

Scaling and root planing, and what the appointment is like

This is a deeper clean than a routine hygiene visit. The work happens below the gumline, removing hardened deposits from the root surfaces so the gum can reattach to a clean surface instead of an infected one. The area is numbed, and the mouth is treated in sections across more than one visit rather than all at once, so you are not leaving with everything frozen.

Expect some tenderness for a couple of days and some sensitivity to cold that fades over a few weeks as the gums tighten back down. Teeth can feel slightly longer afterwards, because gum that was swollen has settled.

Maintenance is the part that decides the outcome

Gum disease is managed, not cured. After treatment, most patients move to a maintenance schedule of every three or four months rather than every six, because the pockets that have been treated re-colonise faster than healthy gums do.

Patients who keep that schedule generally hold onto their teeth. Patients who go back to twice a year tend to be back in the same position within a couple of years. It is not a sales pitch, it is the pattern we see.

What makes it worse, and what you can change

Smoking is the strongest factor within your control. It reduces blood flow to the gums, which both speeds the disease up and masks it, because gums that should bleed do not. Treatment works less well in smokers, and that is worth knowing before rather than after.

Diabetes runs in both directions with gum disease: poorly controlled blood sugar makes the gums worse, and active gum infection makes blood sugar harder to control. If you are diabetic, tell us, because it changes how closely we watch.

Grinding does not cause gum disease but it accelerates the damage where disease is already present, by loading teeth that have lost bone support. Genetics matter too, which is why some people with excellent brushing still develop it and some heavy smokers never do. That is not a reason to give up on the parts you control.

Common Questions

My gums bleed when I brush. Is that normal?

No. Bleeding is the earliest reliable sign of inflammation. At the earliest stage it often reverses with a professional clean and a change in technique, which is why it is worth having looked at rather than brushing more gently around it.

Is scaling and root planing painful?

The area is numbed, so the appointment itself should not hurt. Tenderness for a day or two afterwards is normal, as is cold sensitivity that eases over the following weeks.

Why do I need cleanings every three months now?

Treated pockets are re-colonised by bacteria faster than healthy gums are. The shorter interval is what keeps the disease from progressing again, and it is the single strongest predictor of whether treatment holds.

Can gum disease be reversed?

The earliest stage, where only the gum is inflamed, can be. Once bone has been lost around the roots, that bone does not grow back on its own. Treatment then aims to stop further loss and keep what is there, which in practice means keeping your teeth.