Prevention and essential care
Gum Treatment
Bleeding gums are often the first sign of gum disease, and they usually do not hurt. We treat gum problems at two levels: scaling and polishing in the early stages, and subgingival scaling and root planing, a deep clean of the root surfaces, once pockets have formed. After examining your gums, we explain clearly which one you need.
- Scaling and polishing
- For inflamed gums and routine care; usually 30–60 minutes
- Root planing
- For deeper pockets; under local anaesthetic, area by area
- Review
- About 6–8 weeks after deep cleaning
- Maintenance
- Usually every 3–6 months after gum disease
What is it?
Plaque, a film of bacteria, builds up on the teeth every day. If brushing and cleaning between the teeth do not remove it, it hardens into tartar (calculus), which a toothbrush cannot shift. Plaque and tartar irritate the gums, which become red, swollen and quick to bleed. This early stage is called gingivitis, and with the right treatment and good home care it can be reversed.
If the inflammation carries on for a long time, the small groove between tooth and gum deepens into a pocket and the bone that holds the tooth starts to be lost. This more advanced stage is called periodontitis. Lost bone does not usually grow back on its own, but treatment can often stop the disease from progressing. That is why we plan gum treatment in two levels.
Scaling and polishing
For gingivitis and routine care, plaque and tartar above and just below the gum line are removed with ultrasonic and hand instruments, and the teeth are then polished. It usually takes 30–60 minutes and most people do not need an anaesthetic.
Subgingival scaling and root planing (deep cleaning)
With periodontitis, the cleaning goes down inside the gum pockets to the root surfaces. Under local anaesthetic, tartar and bacterial deposits are removed from the pockets and the root surfaces are smoothed. This helps the gums heal and the pockets shrink. Treatment is usually done area by area, over one or more visits. In advanced cases, gum surgery by a specialist periodontist may be needed afterwards. Healthy gums also matter before dental implants and orthodontic treatment.
When can it be considered?
- Gums that bleed when you brush or floss
- Red, swollen or tender gums
- Bad breath or a bad taste that does not go away
- Receding gums, or teeth that look longer
- Loose or shifting teeth, or new gaps between them
- Visible tartar build-up
- Routine preventive care, and looking after implants, crowns and bridges
Examination and planning
At the examination we look at the colour of your gums, any bleeding and how much tartar there is. A fine measuring probe is used to check the depth of the groove between each tooth and the gum. In healthy gums this groove is usually 1–3 mm deep; pockets of 4 mm or more that bleed can be a sign of gum disease. X-rays are taken when needed to see the bone levels.
We also talk about your general health. Smoking and diabetes are among the main risk factors for gum disease and also affect how well treatment works. If you have diabetes, keeping your blood sugar steady helps your gums too. Pregnancy, some medicines and a family history of gum disease are also taken into account.
We then decide together which level of care you need. For gingivitis, scaling and polishing plus good home care are often enough. For periodontitis, root planing is planned: the mouth is usually divided into areas and the treatment is completed in one or more visits. About 6–8 weeks later the pockets are measured again. If they have healed, you move on to regular maintenance; if deep pockets remain, we discuss further treatment or referral to a specialist periodontist.
If your teeth are sensitive or dental visits make you anxious, let us know. We explain each step beforehand and can stop for breaks.
How the process works
Examination and measuring
Your gums are examined and pocket depths are measured, with X-rays if needed.
Home care
We show you a brushing technique that suits you and how to use interdental brushes or floss.
Scaling and polishing
Tartar above and just below the gum line is removed and the teeth are polished.
Root planing (if needed)
Under local anaesthetic, the pockets and root surfaces are cleaned area by area and the roots are smoothed.
Re-evaluation
About 6–8 weeks later the pockets are measured again to check healing and any need for further treatment.
Maintenance
After treatment for periodontitis, maintenance visits are usually every 3–6 months.
Digital tools that may be used
- Intraoral photographs
- Let us show you the tartar and the state of your gums on screen and compare at later visits.
- Digital X-rays
- Taken when needed to check the level of the bone supporting the teeth and the areas between them.
- Intraoral scan
- Records the gum line and the position of the teeth digitally, which can help us follow changes over time.
Aftercare
Recommended
- Brush twice a day for about two minutes with a fluoride toothpaste
- Clean between your teeth every day with interdental brushes or floss
- In the first days after deep cleaning, keep brushing gently but regularly with a soft brush
- Use a desensitising toothpaste if your teeth feel sensitive
- Keep your maintenance appointments
Best avoided
- Smoking, which raises the risk of gum disease and slows healing
- Stopping brushing because your gums bleed
- Eating before the numbness wears off after deep cleaning
- Using a hard-bristled brush or pressing too hard when brushing
Whether a treatment suits you can only be decided after an examination. Timelines and stages vary from person to person.
Frequently asked questions
What is the difference between scaling and root planing?
Scaling and polishing removes deposits above and just below the gum line, which is enough for gingivitis and routine care. Root planing goes down into the gum pockets to clean and smooth the root surfaces. It is needed once gum disease has progressed and pockets have deepened, and it is usually done under local anaesthetic.
Does scaling damage the teeth?
No. Scaling removes hard deposits stuck to the teeth and the surface is then polished; the aim is to protect healthy tooth structure. A smooth feeling and short-lived sensitivity afterwards are normal.
How many visits does root planing take?
It depends on how many pockets there are and how deep they are. It can be done in a single visit or split into areas over several visits. After the examination we give you a plan and an estimate of the number of visits.
How will I feel after deep cleaning?
The anaesthetic wears off within a few hours. Your gums may feel tender for a day or two. Sensitivity to cold can last a few weeks and usually fades over time. As the inflammation settles and the gums tighten, they may recede slightly, so teeth can look a little longer or small gaps may appear between them.
How often should I come in?
If your gums are healthy, the interval depends on your risk; for most people about every six months works well. After treatment for periodontitis, maintenance visits are usually every 3–6 months, because the disease can become active again without regular care.
My gums bleed when I brush. What should I do?
Bleeding when you brush can be an early sign of gum inflammation. Keep brushing gently rather than stopping, and book an examination.
Can gum disease be cured?
Gingivitis can be reversed with treatment and good home care. With periodontitis, lost bone does not usually grow back on its own, but treatment and regular maintenance can often stop the disease from getting worse. Advanced cases may need gum surgery by a specialist periodontist.
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Questions about gum treatment?
You can send your questions on WhatsApp or reach the practice by phone.