Gum Disease Treatment

What Is Gum Treatment?

Gum treatment addresses the disease that destroys the tissue and bone holding your teeth in place. It begins as gingivitis - inflammation confined to the gum, entirely reversible - and progresses to periodontitis, in which the attachment between gum and root breaks down, pockets form, and the bone around the tooth is lost. Bone lost to periodontitis does not grow back on its own.

This matters more than most patients are told. Periodontitis is the leading cause of tooth loss in adults - ahead of decay - and because it is usually painless, people discover it when teeth start to move, not when it starts. It is also the reason a cosmetic plan sometimes has to wait: veneers or implants placed into diseased gums fail, and no amount of ceramic compensates for a failing foundation.

Signs of Gum Disease

• Bleeding when brushing or flossing. The single most reliable early sign, and the one most often dismissed. Healthy gums do not bleed.
• Red, swollen or tender gums instead of firm and pale pink.
• Persistent bad breath or a bad taste that returns within hours of brushing.
• Receding gums - teeth that look longer than they used to, or sensitivity at the neck of the tooth.
• Teeth that have moved, gaps that have appeared, or a bite that feels different.
• Loose teeth, or pus at the gum margin. These are late signs.

You can have significant periodontitis with none of the dramatic symptoms. That is why the pocket depths around every tooth are measured at examination rather than estimated by eye.

Stages of Gum Disease

What Is Root Surface Debridement (Curettage)?

It is the deep cleaning of the root surfaces below the gum line - what patients usually call curettage or deep scaling. Ordinary scaling removes deposits you can see, above the gum. Once a pocket has formed, hardened deposits sit on the root surface inside it, where no toothbrush reaches and where they hold the inflammation open. Removing them, and smoothing the root so that the gum can reattach, is the core of non-surgical periodontal treatment.

It is not a cosmetic clean. It is the treatment that stops the bone loss.

How Is It Done?

1. Charting. Pocket depths are measured at six points around every tooth and recorded, with radiographs to show the bone level. This chart is the baseline against which the result is judged.
2. Local anaesthetic. The area treated is numbed. Deep cleaning without anaesthetic is uncomfortable and, more importantly, tends to be incomplete because the patient cannot tolerate thorough work.
3. Debridement. Ultrasonic instruments and fine hand curettes remove calculus and infected deposits from the root surfaces and smooth them.
4. By quadrant. The mouth is usually treated in two to four sessions rather than all at once, so each area is done properly.
5. Re-evaluation. Six to eight weeks later the pockets are measured again. Where they have closed, you move to maintenance; where they have not, further treatment is planned. Without this re-measurement nobody can tell you whether the treatment worked.

Scaling or Deep Cleaning - Which Do I Need?

Scaling above the gum treats gingivitis and prevents disease; it is what a routine hygiene appointment is. Deep cleaning below the gum treats periodontitis, requires anaesthetic, takes longer, and is planned by quadrant. The difference is not the level of thoroughness - it is what the measured pocket depths say. If your gums bleed and you have been having a routine clean for years without the pockets ever being charted, ask for the chart.

Does It Hurt?

Not during, under local anaesthetic. For a few days afterwards the teeth are often sensitive to cold and the gums are tender - that is normal and settles. A desensitising toothpaste helps, and we can apply a fluoride varnish for the same reason.

One honest warning: as inflammation resolves, swollen gum tissue shrinks back to its healthy size, so gaps may appear between teeth that were previously hidden by puffy gum, and teeth can look longer. That is healing revealing the true bone level, not the treatment causing damage - but you should be told about it beforehand rather than discovering it in the mirror.

After Gum Treatment

• Brush gently but do not stop brushing the treated area. Bacterial plaque re-forms within hours, and the treatment fails without daily disruption of it.
• Use the prescribed mouthrinse for the period stated, not indefinitely - chlorhexidine stains teeth with long-term use.
• Expect sensitivity to cold for a week or two.
• Soft food for the first day or two if the gums are tender.
• Stop smoking, if you can. Smoking is the strongest modifiable risk factor in periodontitis; it constricts the blood supply, masks the bleeding that would have warned you, and roughly doubles the rate of attachment loss. Treatment in a smoker responds measurably less well.
• Come to the re-evaluation. The appointment that measures whether it worked is the one people skip.

Does Gum Recession Come Back?

Gum that has receded does not regrow by itself, and no toothpaste or rinse reverses it. What treatment does is stop it progressing - which is the important part, because recession that keeps advancing ends in tooth loss.

Where an individual recession is causing sensitivity, an aesthetic problem or continuing loss, it can be covered surgically with a connective tissue graft, and the results in suitable cases are good and stable. That is a separate, planned procedure, and it is only worth doing once the underlying inflammation is controlled and the cause - often aggressive brushing with a hard brush, or a thin biotype under orthodontic movement - has been addressed.

When Is Flap Surgery Needed?

When pockets remain deeper than about six millimetres after non-surgical treatment, instruments can no longer reach the base of the pocket reliably. Flap surgery lifts the gum, allows the root surfaces and bone defects to be cleaned under direct vision, and where the defect shape allows, bone graft material and a membrane can be placed to regenerate lost support.

It is planned after the non-surgical phase, never before it - a mouth that is still inflamed and heavily plaque-covered is not a mouth to operate in.

What Happens If Gum Disease Is Not Treated?

Bone loss continues silently. Pockets deepen, teeth loosen and drift, gaps open between front teeth, chewing becomes uncomfortable, and eventually teeth are lost - often several at a time, and often the ones that matter most for chewing. Replacing them then becomes harder and more expensive precisely because the bone that an implant would need has already gone.

There is also the wider picture, which we state carefully because the evidence is about association rather than proof of cause: periodontitis is consistently associated with cardiovascular disease, poorly controlled diabetes and adverse pregnancy outcomes, and treating it improves glycaemic control in diabetic patients. Chronic inflammation in the mouth is not sealed off from the rest of the body.

Care After Gum Treatment

Periodontitis is controlled, not cured. What keeps it controlled is unglamorous and daily: brushing twice with a soft brush at the gum margin, cleaning between the teeth every day with interdental brushes sized to your spaces rather than floss alone, and maintenance appointments every three to four months rather than every six. Patients on a proper maintenance programme keep their teeth at rates far higher than those who are treated once and discharged. That is the whole of the evidence in one sentence.

Gum Treatment for Visiting Patients

Periodontal treatment is one of the treatments we most often tell international patients to complete at home, and we would rather say that than sell you a package. It is delivered in quadrants over several weeks, and it needs re-measurement at six to eight weeks and maintenance every three to four months - a rhythm that does not fit a single trip.

What does work: if you are here for implants, crowns or veneers, the gum condition is assessed and treated first, because none of those treatments succeeds on an inflamed foundation. Where the disease is limited, treatment can be completed during your stay; where it is advanced, we will tell you honestly that the restorative plan needs to wait, and we will send your chart and radiographs to your dentist at home so the periodontal care continues there.

Why We Do Not Publish Gum Treatment Prices

Because the treatment is priced by how many quadrants need deep cleaning, whether surgery is required and how many maintenance visits follow - none of which is known before the pockets are charted. A clinic that quotes a single price for "gum treatment" before measuring is quoting for a hygiene appointment, whatever it is called. After the examination you receive a written plan by quadrant, including the re-evaluation.

Gum Treatment in Kusadasi

Our clinic is in Cumhuriyet Mahallesi in Kusadasi, with five treatment units and radiographic equipment on site, so pocket charting and bone assessment happen in the same appointment. The clinic is authorised by the Turkish Ministry of Health, and your first examination is carried out by Tugce Arslan.

If your gums bleed when you brush, that is the moment to have them examined - not when a tooth becomes loose. Gingivitis is fully reversible; the bone lost in the stage after it is not.

The information on this page is general and does not replace a clinical examination. The stage of gum disease and the treatment it requires can only be determined after examination and radiographic assessment.