Gum disease treatment ranges from a professional deep cleaning to surgery, depending on how far the disease has progressed. More than 42% of U.S. adults over 30 have some form of periodontitis, and that number climbs to nearly 60% for adults 65 and older. The good news is that most cases respond well to non-surgical treatment, especially when caught early.
Deep Cleaning: The First Line of Treatment
For mild to moderate gum disease, the standard treatment is a procedure called scaling and root planing. Think of it as a more thorough version of a regular dental cleaning. Your dentist or hygienist numbs your gums with a local anesthetic, then uses hand instruments or ultrasonic tools to scrape away plaque and hardite tarite (tartar) both above and below the gum line. The second step, root planing, smooths the surface of your tooth roots so bacteria have fewer places to cling to and your gums can reattach more snugly.
The procedure is typically done one or two quadrants of your mouth at a time, which means you may need two to four appointments to complete a full course. Cost runs roughly $185 to $444 per quadrant, with a national average around $242. Full-mouth treatment generally falls between $500 and $1,200, though dental insurance often covers a significant portion.
After a deep cleaning, your gums will feel tender and possibly bleed for a few days. Starting the day after your appointment, gently rinsing with warm saltwater (half a teaspoon of salt dissolved in half a cup of lukewarm water) three times a day helps the area heal. Avoid mouthwash on the day of the procedure itself, since it can prolong bleeding.
Localized Antibiotics Placed in the Pocket
Sometimes scaling and root planing alone isn’t enough to fully control infection in deeper pockets. In those cases, your dentist may place a tiny amount of antibiotic directly into the space between your gum and tooth. Two common options are a small chip containing an antiseptic and a powder containing a low-dose antibiotic. Both dissolve on their own over days to weeks, delivering medication right where the bacteria live. This targeted approach avoids the side effects of taking oral antibiotics and keeps a steady concentration of the drug in the pocket.
Pocket Reduction Surgery
When gum disease is moderate to severe and the pockets around your teeth are too deep for non-surgical cleaning to reach effectively, a periodontist may recommend pocket reduction surgery (also called osseous surgery or flap surgery). During this procedure, the surgeon folds back the gum tissue, removes bacteria and damaged bone, then repositions the gums so they fit more tightly around the teeth. The goal is to shrink those pockets so daily brushing and flossing can actually keep the area clean going forward.
Recovery from gum surgery takes longer than a deep cleaning. You’ll typically have stitches that dissolve within about a week. Warm saltwater rinses or a prescription mouth rinse, starting the day after surgery, help keep the surgical site clean during healing. Expect some swelling and discomfort for several days, and plan on eating soft foods while the tissue recovers.
Bone Grafts and Tissue Regeneration
Advanced gum disease destroys the bone that supports your teeth. Once that bone is gone, it doesn’t grow back on its own. Regenerative procedures aim to reverse some of that damage. In a bone graft, the surgeon places bone material (from your own body or a donor source) into the area where bone has been lost. This gives your body a scaffold to build new bone around.
A related technique called guided tissue regeneration takes things a step further. The surgeon places a thin membrane between the gum tissue and the bone graft. The membrane acts as a barrier that blocks fast-growing gum tissue from filling in the space before slower-growing bone cells have time to rebuild. Without that barrier, soft tissue would win the race and you’d end up with gum filling a space that should be bone.
Laser Treatment
Laser-assisted treatment is a newer alternative to traditional scalpel-and-suture gum surgery. Instead of cutting the gum tissue with a blade, the periodontist uses a specialized laser to remove diseased tissue and bacteria from the pocket. Early research shows that laser treatment can stimulate the formation of new connective tissue attachment to the tooth root, along with new bone growth. Because there’s no cutting or stitching, many patients experience less pain and swelling during recovery. Laser treatment isn’t appropriate for every case, and not all periodontists offer it, so it’s worth asking whether you’re a candidate.
What Happens After Active Treatment
Treating gum disease isn’t a one-and-done event. Once you’ve had periodontitis, you’re at higher risk of it returning. Clinical guidelines recommend supportive periodontal care visits every 3 to 12 months after active treatment, with the exact schedule tailored to your risk level. Most patients with a history of moderate or severe disease start with visits every three months. Over time, if your gums stay stable, your periodontist may space those visits out further.
These maintenance appointments are more involved than a standard dental cleaning. Your provider will measure the depth of your gum pockets, check for new areas of inflammation, and clean below the gum line in any spots that show early signs of relapse. Skipping or stretching out these visits is the single biggest factor in gum disease coming back after successful treatment.
Daily Care That Supports Treatment
Professional treatment handles the bacteria and damage that have already accumulated, but your daily habits determine whether the disease stays under control. Brushing twice a day with a soft-bristled brush cleans the surfaces of your teeth, but the real difference-maker is cleaning between your teeth once a day with floss, interdental brushes, or a water flosser. Bacteria colonize the spaces between teeth and just below the gum line faster than anywhere else in your mouth.
If you smoke, quitting is one of the most effective things you can do for your gums. Smoking restricts blood flow to gum tissue, slows healing after any procedure, and makes treatment outcomes significantly worse across the board. Patients who quit smoking before or during periodontal treatment consistently have better long-term results than those who continue.