Can gum disease be cured, or only controlled?
Periodontitis is gum disease that has spread to the fibres and bone holding the teeth. The 2020 clinical guideline of the European Federation of Periodontology (EFP) describes it as a chronic inflammatory disease linked to dental plaque that, untreated or inadequately treated, leads to the loss of the tissues supporting the teeth and of the teeth themselves.
According to the EFP’s patient information, careful assessment and treatment can usually halt the disease completely, but bone that has already been lost does not grow back by itself. Cleveland Clinic says periodontitis cannot be cured, but it can be managed, and it can come back after treatment. Treatment therefore has an active phase and a maintenance phase with no end date.
What are the four steps of treatment?
The EFP guideline sets out four consecutive steps for stage I–III periodontitis:
- Daily cleaning and risk factors: tailored instruction in brushing and cleaning between the teeth, professional removal of plaque and tartar above the gum line, and support to stop smoking and to control diabetes.
- Cleaning below the gum line: plaque and tartar are removed from inside the gum pockets with hand instruments or sonic or ultrasonic scalers.
- Treating areas that have not responded: once the gums have healed, the pockets are measured again; deep, bleeding pockets are cleaned again or treated surgically.
- Supportive care: regular check-ups and professional cleaning to stop the disease returning.
The guideline’s goal is to leave no pockets of 5 mm or more that bleed when gently probed, and no pockets of 6 mm or more.
How many visits does gum treatment take?
There is no fixed number. The EFP’s patient information says a first professional cleaning can rarely be completed in a single session, and advanced periodontitis may need several appointments. According to Cleveland Clinic, deep cleaning below the gum line (scaling and root planing) takes about one to two hours, in one visit or split across two, and most people return to their normal routine the same day. The EFP guideline accepts cleaning one section of the mouth at a time or the whole mouth within 24 hours. The British Society of Periodontology (BSP) says it is best done under local anaesthetic, for comfort and so that it can be thorough.
The re-check follows “after several weeks”, in the EFP’s words, once the gums have healed. Steps 1 to 3 therefore take weeks rather than days, which matters if you are planning other dental treatment or travel.
When is gum surgery needed?
If pockets deeper than 4 mm remain at the re-check, the EFP’s patient information says further options, including surgery, are discussed. The EFP’s summary of its guideline recommends repeating non-surgical cleaning for remaining pockets of 4–5 mm, and access flap surgery, in which the gum is lifted so the root can be cleaned under direct vision, for pockets of 6 mm or more. Some deep bone defects can be treated with regenerative surgery, using a membrane or enamel matrix proteins, sometimes with a bone graft.
The guideline sets two conditions: surgery should not be done if you cannot keep your mouth clean enough yourself, and it should be carried out by dentists with additional training or by specialists. The NHS notes that your dentist may refer you to a specialist. According to the EFP, surgery is done under local anaesthetic and stitches usually come out after one to two weeks.
What can you do to make treatment work?
The EFP stresses that following the oral hygiene advice is essential for a successful outcome. The guideline recommends interdental brushes alongside tooth brushing, with other aids where the brushes do not fit. The BSP warns that your gums are likely to bleed more at first; this is normal and improves if you keep cleaning.
- Smoking: the guideline recommends support to stop smoking. The EFP says about 90% of cases that do not respond to treatment involve smokers, and that a year after quitting, former smokers respond better than people who still smoke.
- Diabetes: the guideline also recommends diabetes control, which the BSP says should be done with your doctor. The effect works both ways: in a 2022 Cochrane review, cleaning below the gum line lowered HbA1c by an average of 0.43 percentage points (4.7 mmol/mol) after three to four months compared with no treatment or usual care.
Why should gum disease be under control before implants, crowns or braces?
- Implants: the EFP says periodontitis must be treated before an implant is placed, and that around 22% of implants in patients with periodontitis develop peri-implantitis. See peri-implantitis for the signs.
- Crowns and bridges: according to the EFP’s guideline on advanced (stage IV) periodontitis, a temporary restoration can be placed early during gum treatment if needed, but the final restoration follows a final assessment of whether the supporting teeth or implants can be maintained. Both should be easy to clean. See zirconia crowns.
- Orthodontics: the same guideline recommends starting orthodontic treatment once the goals of gum treatment have been reached, checking the gums ideally at every orthodontic appointment and pausing active treatment if the disease flares up again. See orthodontics for adults.
What if gum disease is found before treatment in Türkiye?
Photos and X-rays do not show everything; gum health is judged at an examination that measures the gum pockets. The General Dental Council advises speaking to your own dentist before going abroad for treatment. If they have diagnosed gum disease, mention it when you send photos, X-rays and recent findings for our preliminary assessment. Because the re-check comes several weeks after cleaning, it can make sense to start the first steps at home before you travel.
If our examination shows active gum disease, implants or final crowns may have to wait until it is controlled. We plan appointments around your travel dates; whether one or two trips are likely depends on your plan. Which steps of gum treatment you need, and where they are best carried out, is discussed at the examination.
What does your dentist at home do afterwards?
Supportive care is long-term work for a dentist near you. The EFP guideline recommends visits every 3 to a maximum of 12 months, depending on your risk; the EFP’s patient information says they are usually every three to six months, and the BSP expects every three months at first, until the disease is stable. Your dentist checks whether inflammation has returned, reviews your cleaning routine and removes plaque professionally.
Before you leave, you receive a copy of your treatment summary and copies of your X-rays to take to your dentist. If your pockets were measured, ask for those measurements too, so that later findings can be compared with them. Our aftercare and follow-up page explains the rest.
How is gum health assessed at Rönesans?
At our clinic in Serdivan, Sakarya, the examination covers your teeth, gums, tartar and existing fillings and crowns. X-rays are taken where needed, and when the dentist decides it is necessary, a cone-beam CT (CBCT) scan shows the bone around the teeth in three dimensions. Tartar is removed with ultrasonic and hand instruments, followed by polishing; the dentist may also use a device that removes plaque with a spray of air, water and fine powder. Whether you need deep cleaning below the gum line, gum surgery or regenerative treatment is assessed at the examination.
Before treatment starts, you know which dentist will treat you and receive a written treatment and cost plan, tooth by tooth, with unit and total costs; the cost is confirmed after the examination. Follow-up after treatment follows a defined process. Please tell us if you smoke, have diabetes or take regular medication.
You can send photos and X-rays on WhatsApp at +90 532 363 49 54 for a preliminary assessment, call us on +90 264 606 09 43 or write through our contact page; during working hours we reply in English and German within 15 minutes. See also planning your visit and dental implants.