Gum treatment

Gum disease begins as inflammation of the gum alone, which is reversible. Left to progress, it extends deeper: the attachment between gum and tooth breaks down, pockets form, and the supporting bone recedes. Treatment removes the deposits driving that process and stabilises what remains. It does not grow bone back. That is why it comes first — crowns, veneers and implants placed over active disease are built on a site that is still moving.

• Gums bleed when brushing or flossing
• Gums look as though they have receded, or teeth look longer
• Persistent bad breath or a bad taste
• Teeth that feel loose or have drifted
• Before any crown, veneer or implant work
• A previous diagnosis of periodontitis that has not been maintained

• Improved daily cleaning alone, where the problem is gingivitis rather than periodontitis
• Surgical periodontal treatment, for pockets that do not respond to non-surgical care
• Extraction, where a tooth has lost too much support to be saved
• Doing nothing, which allows continued bone loss — this is not a neutral option

• A full set of pocket depth measurements, tooth by tooth
• X-rays showing bone levels
• Bleeding scores
• Your medical history, particularly diabetes, which has a two-way relationship with gum disease
• Whether you smoke, and how much
• Family history, since susceptibility runs in families

1. 1

   Assessment

   Pocket depths measured around every tooth and recorded as numbers, with X-rays showing bone levels. Ask for these figures — without them there is no baseline.

   Carried out by: Partner clinic

2. 2

   Oral hygiene instruction

   Unglamorous, and the single largest determinant of the outcome.

   Carried out by: Partner clinic

3. 3

   Scaling and root surface debridement

   Removal of deposits above and below the gum line, and thorough cleaning of root surfaces within the pockets, usually under local anaesthetic.

   Carried out by: Partner clinic

4. 4

   Reassessment

   Typically some weeks later, with pockets re-measured against the baseline. This is the step most often missing from a package quote.

   Carried out by: Partner clinic

5. 5

   Surgical treatment, if needed

   For pockets that have not responded to non-surgical care.

   Carried out by: Partner clinic

6. 6

   Maintenance

   Ongoing and indefinite, typically every few months. Realistically this needs a dentist or hygienist where you live.

   Carried out by: You

Initial treatment often takes more than one appointment and can be carried out within a trip. Reassessment properly happens some weeks later, and lifelong maintenance cannot be delivered from another country — so plan for a dentist or hygienist at home, and ask the clinic to send your periodontal charts.

• How much bone has already been lost
• Whether you smoke — the most significant modifiable factor
• Diabetes and how well controlled it is
• Your daily cleaning, which determines whether treatment holds
• Whether you can commit to maintenance where you live
• Genetic susceptibility

• The number of teeth and the extent of disease
• How many appointments the initial treatment takes
• Whether reassessment is included
• Whether surgical treatment is needed
• Whether it is quoted separately from restorative work, or absent from the quote altogether

We do not publish price ranges for this treatment. Any figure we could give before a clinic has approved it would be a guess presented as guidance. Your final price comes from the partner clinic in writing, after a dentist has reviewed your case.

• Gum recession after treatment, as inflammation resolves and swollen tissue shrinks back — teeth may look longer afterwards, which is a sign of success rather than a complication
• Sensitivity to cold, often temporary
• Some teeth may feel looser initially
• Not every pocket responds; some teeth may still be lost
• Bone lost before treatment does not return
• Without maintenance, the disease returns

• What are my pocket depths, tooth by tooth? Can I have the chart?
• Is a reassessment appointment included, and when is it?
• When you say curettage, what exactly is being done?
• Is gum treatment included in my quote, or separate?
• Will my gums recede after treatment, and how will that affect the planned crowns?
• Should this be completed before the cosmetic or implant work?
• Who provides maintenance once I am home, and will you send my records?

These are worth asking of any clinic, including ours. A clinic that answers them clearly and in writing is telling you something useful.

This treatment would be carried out by a licensed dentist at the partner clinic you choose, working in periodontics. Dental Anchor does not provide treatment and does not employ dentists.

• Dental implants
• Dental crowns

• Gum disease treatment and curettage: what the words mean

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