Gum Disease Treatment (Periodontal Treatment)
General periodontology is where gum treatment starts: pocket depths are charted, bleeding on probing recorded and the maintenance interval set from them.
- Comprehensive examination
- Professional cleaning
- Preventive protocol
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Written by: Dr Ferit Kaval, PhD · Medically reviewed by: Dr Hakan Kaval
A general periodontal appointment is where gum treatment starts: pocket depths are charted, bleeding on probing is recorded, and the maintenance interval is set from those two measurements rather than from a calendar. In 41 patients followed for two and a half years after active therapy, sites that consistently did not bleed on probing predicted the absence of attachment loss with a negative predictive value of 98%, while bleeding itself predicted progression in only 6% of cases (PubMed 2262585). In adults without severe periodontitis, scheduled scaling produced no measurable difference in gingivitis over 24 to 36 months against no scheduled treatment (PubMed 30590875).
- 01Recall frequency is a risk decision, not a fixed number. In a Cochrane review of two trials with 1,736 participants, adults on risk-based recall and adults on six-month recall showed no difference over four years in decayed surfaces, percentage of bleeding sites or oral-health-related quality of life (1,478 participants, high-certainty evidence; PubMed 33053198).
- 02What routine scaling reliably changes is calculus. Pooling two trials with 1,711 participants, the standardised mean difference for gingivitis between six-monthly scaling and no scheduled scaling was -0.01 (95% CI -0.13 to 0.11), against -0.32 (95% CI -0.44 to -0.20) for calculus, and the review states the clinical importance of that small reduction is unclear (PubMed 30590875).
- 03A treated periodontitis patient moves onto supportive care every three to four months, built on mechanical plaque removal. Adding an Er:YAG laser, a low-dose doxycycline or photodynamic therapy produced an overall attachment level change of -0.233 mm (95% CI -1.065 to 0.598, p = 0.351) on weak evidence (PubMed 32060940). If a plan sold to you lists such adjuncts as the reason for its scope, ask what they add.
- 04The general appointment produces the pocket chart that decides the route: staging and grading of the disease on one side, surgery where pockets fail to close on the other. That is why it is booked before any restorative work is scheduled.
Periodontology is the field concerned with the specialized system of hard and soft tissues that support your teeth and keep them in their place in the jaw. This apparatus, known as the periodontium, has some very important functions: It securely attaches the teeth to the jaws.
| At a glance | |
|---|---|
| Duration | 1-2 sessions |
| Materials Used | Ultrasonic instruments · Manual periodontal instruments |
How Disease of the Gingiva and Gingivitis Present
This section describes gum recession.
It is the situation where the gum is pulled under the enamel layer, which is the protective layer of the tooth, and the root surfaces are exposed.
The root surfaces of the teeth are not resistant to external factors. When gingival recession occurs, the root surfaces are exposed. When gingival recession is not treated, sensitivity (twinges) and root caries may occur on the root surfaces over time and tooth can be lost.
Today, there are many treatments, both surgically and non-surgically, for gum recession. Surgically exposed root surfaces can be closed with microsurgical techniques and restored to the state they were in before the recession or further recession of the gum can be prevented. Sutures are removed 10-14 days after the microsurgical procedure and the tissue is left to heal.
Gingivitis is the condition in which bacterial plaque and tartar formed by the accumulation of food residues on the tooth and root surfaces cause inflammation in the gums along with bleeding and redness. Most of the time, these bacterial plaque and tartar are firmly adhered to the root surfaces of the teeth and cause the bone under the gum to dissolve due to inflammation. Loosening and abscess can occur in the teeth due to this bone resorption and teeth can be lost. When gum treatment is done, inflammation disappears and bone resorption stops.
Treatment Process
- 01Consultation: Initial examination and needs assessment; imaging where required.
- 02Treatment: Pocket measurement, cleaning, home-care guidance.
- 03Follow-up: Outcome review and aftercare guidance.
Periodontology and Gingivitis Care in Istanbul
Gingivitis care and laser gingival treatment are part of periodontal treatment planning.
Sometimes, gum surgery can be performed with microsurgical techniques and bone graft material can be used to replace the lost bone.
In order to prevent the recurrence of gingivitis, teeth should be brushed as and often as recommended by the dentist and oral hygiene should be paid attention to.
Before all dental treatments such as implant treatment, crown, bridge, zirconium, filling and prosthesis, braces, gums should be checked, inflammation should be removed and then these procedures should be performed. Otherwise, severe gingivitis may occur in the future and the treatments performed fail.
When a tooth also needs a root canal, the steps, the number of visits and the cost factors for patients travelling to Istanbul are described in our guide to root canal treatment in Turkey.
Laser Gingival Treatment
Today, lasers are used in many areas in gum treatment. It is especially used to ensure the harmony of the gums called 'pink aesthetics' with the teeth, to eliminate gum growth and to increase the visibility of the teeth.
In addition, lasers can be used to eliminate gingivitis, accelerate wound healing and eliminate bacteria.
- 1.Lang NP, Adler R, Joss A, Nyman S. Absence of bleeding on probing. An indicator of periodontal stability. J Clin Periodontol 1990;17:714-21. PubMed 2262585
- 2.Lamont T, Worthington HV, Clarkson JE, Beirne PV. Routine scale and polish for periodontal health in adults. Cochrane Database Syst Rev 2018;12:CD004625. PubMed 30590875
- 3.Fee PA, Riley P, Worthington HV, Clarkson JE, Boyers D, Beirne PV. Recall intervals for oral health in primary care patients. Cochrane Database Syst Rev 2020;10:CD004346. PubMed 33053198
- 4.Trombelli L, Farina R, Pollard A, Claydon N, Franceschetti G, Khan I, et al. Efficacy of alternative or additional methods to professional mechanical plaque removal during supportive periodontal therapy: A systematic review and meta-analysis. J Clin Periodontol 2020;47 Suppl 22:144-154. PubMed 32060940
- 5.Suvan J, Leira Y, Moreno Sancho FM, Graziani F, Derks J, Tomasi C. Subgingival instrumentation for treatment of periodontitis. A systematic review. J Clin Periodontol 2020;47 Suppl 22:155-175. PubMed 31889320
- 6.Jervøe-Storm PM, Eberhard J, Needleman I, Worthington HV, Jepsen S. Full-mouth treatment modalities (within 24 hours) for periodontitis in adults. Cochrane Database Syst Rev 2022;6:CD004622. PubMed 35763286
- 7.Wambier LM, de Geus JL, Chibinski AC, Wambier DS, Rego RO, Loguercio AD, et al. Intra-pocket anaesthesia and pain during probing, scaling and root planing: a systematic review and meta-analysis. J Clin Periodontol 2016;43:754-66. PubMed 27097588
- 8.Wambier LM, de Geus JL, Boing TF, Chibinski ACR, Wambier DS, Rego RO, et al. Intrapocket topical anesthetic versus injected anesthetic for pain control during scaling and root planing in adult patients: Systematic review and meta-analysis. J Am Dent Assoc 2017;148:814-824.e2. PubMed 28843499
- 9.von Troil B, Needleman I, Sanz M. A systematic review of the prevalence of root sensitivity following periodontal therapy. J Clin Periodontol 2002;29 Suppl 3:173-7. PubMed 12787217
- 10.Heitz-Mayfield LJ, Trombelli L, Heitz F, Needleman I, Moles D. A systematic review of the effect of surgical debridement vs non-surgical debridement for the treatment of chronic periodontitis. J Clin Periodontol 2002;29 Suppl 3:92-102. PubMed 12787211
Planning your stay in Istanbul
Clinical sessions for Periodontology General: 1-2.
The exact schedule is written into your treatment plan after the examination.
Flights, arrival and follow-up after you fly home: how we plan your trip to Istanbul
What our guests say.
Real reviews from Google and Trustpilot; guests who had this treatment come first.
I visited for teeth cleaning and teeth whitening, and all of my procedures were completed quickly and professionally. I would like to sincerely thank the patient consultant, Ms. Ecran, for her kindness and support, Dr. Ferit for his excellent care, and Endodontic Specialist Dr. Melike for her prompt diagnosis and treatment. The entire team was friendly, attentive, and professional. I left the hospital very satisfied. Thank you to everyone for their outstanding service.
I recently had a gum graft procedure at Mosdent and had an excellent experience. The dentist was highly skilled, my contact person was very helpful and the overall cost was quite reasonable. The entire team was friendly and professional. I definitely recommend Mosdent.
I recently visited Mosdent for two different procedures—my daughter’s tooth extraction and my own dental implants—and I couldn’t be more impressed! From start to finish, the team was professional, caring, and highly skilled. They made my daughter feel completely at ease during her extraction, ensuring a smooth and pain-free experience. As for my dental implants, the entire process was handled with precision and expertise. The staff took the time to explain everything clearly, and the results have been fantastic! I truly appreciate their exceptional service, friendly approach, and high level of professionalism. If you’re looking for a trustworthy dental clinic that puts patient care first, I highly recommend Mosdent
Super pro and very friendly and concerned about your health not only about your money.
Who is this treatment for?
- Exposed root surfaces due to gum recession
- Sensitivity or soreness on the root surfaces
- Gum inflammation accompanied by bleeding and redness
- Tooth mobility or abscess due to inflammation
- The need to eliminate gum overgrowth
- The need for regular follow-up in people with a history of gum disease
- The need for a gum check before implants and other dental treatments
Doctors specialising in this treatment
Frequently asked
01How often should scaling be performed?+
Twice a year is the standard recommendation. Those with a history of gum disease may require 3-monthly follow-ups as advised by their clinician.
02Does scaling damage enamel?+
No. Professional scaling does not harm tooth surfaces; on the contrary, by preventing gum inflammation it protects long-term dental health.
03How is deep cleaning (scaling and root planing) done?+
In subgingival cleaning, tartar and bacterial plaque that reach into the gum pocket are removed from the root surface with hand instruments or sonic and ultrasonic tips. In a systematic review, pocket depth fell by an average of 1.4 mm 6 to 8 months after treatment, 74% of pockets closed, and the type of instrument did not change the result (PubMed 31889320).
04How long does gum treatment take?+
Subgingival cleaning of the whole mouth is done either within 24 hours or quadrant by quadrant, with at least a week between sessions (PubMed 35763286). A Cochrane review of 20 randomised trials and 944 participants found no additional gain in pocket depth at 6 to 8 months for either schedule (PubMed 35763286). The result is assessed by measuring the pockets again at that point.
05Is gum treatment painful?+
Sensitive areas can be numbed with local anaesthesia or with an anaesthetic gel placed in the pocket. In a meta-analysis of nine studies, the gel reduced the risk of pain during probing and cleaning against placebo with an odds ratio of 0.025 (PubMed 27097588). Injected anaesthesia gave lower pain intensity than the gel (PubMed 28843499).
06Will my teeth be sensitive after gum treatment?+
Root sensitivity is common after subgingival cleaning and eases within a few weeks. In a systematic review, the prevalence of root sensitivity was 9-23% before treatment and 54-55% after it, with intensity rising in the first 1-3 weeks and then falling (PubMed 12787217). Because the review rests on only two studies, these figures carry limited evidence.
07What is the difference between deep cleaning and flap surgery?+
In deep cleaning the pocket is cleaned without lifting the gum; in flap surgery the gum is opened surgically and the root surface is cleaned under direct vision. In a meta-analysis of six randomised trials, flap surgery achieved 0.6 mm more pocket reduction at 12 months in pockets deeper than 6 mm, while in shallow 1-3 mm pockets non-surgical treatment caused 0.5 mm less attachment loss (PubMed 12787211).
Periodontology
Tartar Cleaning
Tartar cleaning (scale and polish) removes hardened plaque that brushing cannot lift, using an ultrasonic scaler and hand instruments, then polishes.
Explore→02Gum Disease
Gum disease is two conditions: gingivitis stays in the gum and reverses with plaque control; periodontitis adds tissue and bone loss that does not reverse.
Explore→03Pink Aesthetics
Pink aesthetics corrects how much gum shows, its symmetry and colour; more than 2 mm of gum above the upper incisors at maximum smile counts as excessive.
Explore→04Periodontal Flap Surgery
Periodontal flap surgery lifts the gum, cleans the root under direct vision and stitches it back to close deep pockets that non-surgical cleaning left open.
Explore→05Gum Surgery
Gum surgery rebuilds lost soft tissue: it covers an exposed root, moves a receded gum margin back up and widens the band of keratinised tissue.
Explore→06Gingivectomy
Gingivectomy cuts away excess or diseased gum tissue; it is used to correct a gummy smile, eliminate periodontal pockets and recontour an irregular gum line.
Explore→Speak with your doctor about this treatment.
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