Periodontal and Hygiene Treatment.

What is periodontal treatment?

Periodontal treatment addresses disease of the gum and the bone supporting the teeth. Gingivitis is inflammation limited to the gum and is reversible. Periodontitis is the stage at which the supporting bone begins to be lost, and that loss is not reversible, though the disease can be halted and stabilised. Treatment involves thorough cleaning above and below the gum line, together with a plan you can realistically carry out at home.

Why has this been recommended?

Your assessment, including BPE scoring, pocket charting and radiographs where indicated, has shown inflammation or bone loss that needs treating. This may also have been recommended before implant or cosmetic treatment. Placing implants or new restorations in an unstable mouth is building on sand, and I would rather delay the interesting work and get the foundation right.

What to expect during treatment

Treatment begins with explanation and measurement, because you cannot manage what you do not measure. Pockets around each tooth are charted, and this is repeated after treatment so improvement can be demonstrated objectively rather than assumed.

Cleaning is carried out under local anaesthetic where pockets are deep, using ultrasonic and hand instruments to remove deposits from the root surfaces. It is usually completed over one to four appointments depending on extent. Alongside this, you will be shown specific cleaning technique for your mouth, which matters more than anything I do in the chair.

A review follows six to twelve weeks later, with repeat charting. Most sites respond well. Those that do not may need further treatment or referral to a periodontal specialist.

Risks and possible complications

Sensitivity to cold after treatment is common and usually settles over some weeks. As inflammation resolves and gums shrink to their true level, teeth can appear longer and gaps can open between them; this is the disease becoming visible rather than the treatment causing harm, though it is disconcerting if unexpected. Slightly looser feeling teeth in the short term can occur for the same reason.

Some sites do not respond, particularly in smokers, in poorly controlled diabetes, and where cleaning at home does not change. Periodontitis is a chronic condition, so it is managed rather than cured.

Benefits and expected outcomes

Stabilising gum disease is the single most valuable thing most patients can do for the long-term future of their teeth. It reduces the risk of tooth loss, removes bleeding and bad breath, and makes every other treatment more predictable. There is also a growing body of evidence linking periodontal inflammation with cardiovascular disease and diabetic control, so the benefit is not only local.

Aftercare and home care

Twice-daily brushing for two minutes with a soft or medium brush, and daily cleaning between the teeth with interdental brushes of the right size, which will be shown to you. Interdental brushes matter more than floss for most people with periodontal disease.

Maintenance appointments, usually every three to four months initially, are not optional extras; they are the treatment. Stopping smoking has a larger effect on the outcome than anything else available. If you are diabetic, good glycaemic control and gum health support each other.

This page is written by Dr Steve Conteh, BDS (Hons) MSc, GDC 251055, and is general information rather than advice for your particular mouth. Your own plan, costs and risks are set out in writing before any treatment begins. Last reviewed August 2026.

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