Periodontal services are dental treatments focused on the gums, the bone that supports your teeth, and the tissues that hold everything in place. They range from deep cleanings that go below the gumline to surgical procedures that rebuild lost bone and reshape damaged gum tissue. Some periodontal services are performed by general dentists, but more complex cases are typically handled by a periodontist, a dentist with additional years of specialty training in gum disease and dental implants.
Deep Cleaning: Scaling and Root Planing
The most common periodontal service is scaling and root planing, often called a “deep cleaning.” It’s similar to a routine dental cleaning but reaches much further beneath the gumline to address plaque and tartar buildup that regular brushing can’t touch. During the procedure, your dentist or hygienist numbs the gums with local anesthesia, then uses hand scalers or ultrasonic instruments to remove hardened deposits from both above and below the gumline. The final step is smoothing (planing) the tooth roots so gum tissue can reattach more easily.
This is typically the first line of treatment for gum disease. If your dentist spots pockets forming between your gums and teeth, deep cleaning is usually recommended before considering anything surgical. As of 2024, the average cost runs about $242 per quadrant of the mouth, so a full-mouth deep cleaning often falls in the $800 to $1,000 range before insurance.
Pocket Reduction Surgery
When deep cleaning alone isn’t enough to control gum disease, pocket reduction (or “flap”) surgery may be the next step. In this procedure, a periodontist lifts the gum tissue away from the teeth to access and clean the bone underneath directly. Damaged bone is reshaped to eliminate the deep pockets where bacteria collect. The goal is straightforward: reduce the depth of those pockets so bacteria have fewer places to hide and the gums can heal tightly against the teeth again.
This type of surgery is reserved for cases where pockets remain deeper than about 4 millimeters after non-surgical treatment. It produces a significant reduction in pocket depth, which makes ongoing home care and professional cleanings far more effective.
Gum Grafting for Receding Gums
Gum recession, where the gum tissue pulls back and exposes more of the tooth root, is both a cosmetic concern and a health risk. Exposed roots are vulnerable to decay and sensitivity. Periodontal gum grafts replace that lost tissue, and there are a few different approaches depending on the location and severity.
A connective tissue graft is the most widely used technique. The periodontist takes a small piece of tissue from underneath the skin on the roof of your mouth and stitches it over the exposed root. This method produces a strong band of protective gum tissue and tends to hold up well over time.
A free gingival graft takes tissue directly from the surface of the palate instead of from underneath it. It’s highly predictable for building up a thicker band of gum tissue and can treat multiple teeth at once. The tradeoff is that the grafted tissue sometimes doesn’t match the color of surrounding gums perfectly, so it’s generally reserved for areas that aren’t highly visible when you smile. Recovery involves managing two healing sites: the donor area on the palate and the graft site itself.
The average cost for a single gum graft procedure is about $2,742, though this varies by location and complexity.
Bone Grafting and Tissue Regeneration
Advanced gum disease destroys not just soft tissue but the bone that holds your teeth in place. Bone grafting uses bone material or synthetic substitutes to fill in areas where bone has been lost. The graft material acts as a scaffold, encouraging your body to grow new bone into the damaged area.
A related technique called guided tissue regeneration takes this a step further. After placing the bone graft, the periodontist covers the area with a thin collagen membrane. This barrier prevents fast-growing gum tissue from filling the space before slower-growing bone has a chance to regenerate. Studies show that combining bone grafting with guided tissue regeneration leads to increased bone density and reduced defect size within about six months, along with measurable improvements in how tightly the gums attach to the teeth.
Dental Implant Services
Periodontists don’t just treat gum disease. They’re also trained to place dental implants, and their expertise with bone and soft tissue makes them particularly well suited for complex cases. Periodontal implant services often go beyond simply placing the implant post and include preparing the site to ensure success.
Sinus augmentation is one common preparatory procedure for upper jaw implants. The sinus floor is raised and bone is added beneath it, creating enough depth for an implant to anchor securely. Ridge modification addresses a different problem: when the jawbone has deteriorated or has an irregular shape, the periodontist lifts the gum, fills in areas of missing bone with graft material, and rebuilds the ridge to support an implant.
After implants are placed, periodontal care doesn’t end. Implants can develop their own version of gum disease called peri-implant disease, which causes the same inflammation and bone loss around an implant that periodontitis causes around natural teeth. Ongoing professional cleanings and monitoring are part of keeping implants healthy long-term.
Laser Periodontal Therapy
Some periodontists offer laser-assisted treatment as an alternative to traditional surgery. The most well-known protocol, called LANAP, uses a specialized laser that selectively targets diseased and inflamed tissue while leaving healthy tissue intact. The laser energy also kills pigmented bacteria in the pockets and promotes the formation of a stable blood clot that seals the treated area and supports healing from the inside out.
Recovery from laser therapy is generally faster and less painful than conventional surgery. However, the healing process still takes time. Periodontists typically avoid probing the treated areas for six months to a full year to let the tissues fully regenerate at the root surface. Follow-up visits are scheduled at one week, one month, and then every three months.
Cosmetic Periodontal Procedures
Not all periodontal services are about treating disease. Cosmetic procedures address the appearance of your gums and smile. Crown lengthening, for example, removes excess gum tissue to expose more of the tooth surface, correcting what’s sometimes called a “gummy smile.” This procedure can also be functional, exposing enough tooth structure for a crown or filling to be placed properly.
Gum contouring reshapes uneven gum lines for a more symmetrical appearance. These procedures are elective but can make a dramatic difference in how your smile looks.
Ongoing Maintenance After Treatment
Once active periodontal treatment is complete, the work shifts to keeping gum disease from coming back. Periodontal maintenance cleanings are more thorough than standard dental cleanings and include careful measurement of pocket depths, removal of plaque and tartar below the gumline, and monitoring for signs of recurring disease.
The American Academy of Periodontology recommends that most patients with a history of gum disease start with maintenance visits every three months. This schedule reduces the likelihood of disease progression compared to less frequent visits. Over time, your periodontist may adjust the interval based on how your gums respond. Some patients eventually move to visits every four to six months, while others do best staying on a quarterly schedule indefinitely. The right frequency depends on how aggressively your particular case tends to recur and how well you manage daily brushing and flossing at home.