Gum disease care.

Gingivitis or periodontitis?

Gingivitis is inflammation of the gums alone. The gums look red or puffy and bleed easily, but the bone underneath hasn’t been affected. With thorough cleaning at home and a professional clean, gingivitis can usually be reversed within a few weeks.

Periodontitis is what can follow when inflammation persists. The gum starts to come away from the tooth, forming a pocket that collects bacteria, and the bone and fibres holding the tooth in place are slowly broken down. Lost bone doesn’t usually grow back, so treatment aims to halt the process and keep what remains.

Signs your gums need attention

Gum disease is easy to miss because it’s rarely painful. Book an assessment if you notice any of these:

• Bleeding when you brush, floss or bite into an apple
• Gums that look red, swollen or shiny rather than pale pink and firm
• Bad breath or a sour taste that keeps coming back
• Teeth that look longer, or new gaps appearing between them
• Teeth that feel loose, have shifted, or bite together differently
• Pus or a pimple-like spot on the gum

Smoking, diabetes, pregnancy and other risk factors

Smoking is one of the strongest risk factors. It also reduces blood flow to the gums, which can hide bleeding, so smokers sometimes have advanced disease with very few warning signs. Healing after treatment tends to be slower too.

Diabetes and gum disease seem to affect each other. Poorly controlled blood sugar raises the risk of periodontitis, and some research suggests that treating gum inflammation may help with blood sugar control. If you have diabetes, let your dentist know your most recent results.

During pregnancy, hormonal changes can make gums swell and bleed more easily, a condition often called pregnancy gingivitis. Other risk factors include a family history of gum disease, some medicines that cause dry mouth or gum overgrowth, stress, and crowded teeth that are hard to clean.

Measuring your gums

To work out what’s going on, your dentist gently slides a thin, blunt probe with millimetre markings between each tooth and its gum, usually at six points around every tooth. Healthy gums typically measure around one to three millimetres. Deeper readings, bleeding when probed, recession and any looseness are all recorded. Probing can feel a little tender where gums are inflamed, and an area can be numbed if needed.

X‑rays then show how much bone is left around each tooth. Together, these measurements become a baseline that later visits are compared against, so you can see whether things are improving, stable or changing.

How deep cleaning and root planing work

Deep cleaning, also called root planing or debridement, removes tartar and bacteria from the root surfaces at the bottom of the pockets, below where a routine clean reaches. The roots are left smooth and clean so the gum can tighten around them as the inflammation settles.

The area is numbed with local anaesthetic first. Depending on how many teeth are involved, treatment may be done in one long visit or spread over two to four shorter ones, often a quarter or half of the mouth at a time. Occasionally your dentist may suggest an antiseptic rinse or, in some situations, antibiotics alongside the cleaning.

Around six to twelve weeks later, your gums are measured again to see how they’ve responded. Many pockets shrink, but some may stay deep, which helps your dentist decide what comes next.

Recovery and realistic expectations

Your gums may feel tender and your teeth sensitive to cold for a few days after deep cleaning. Over‑the‑counter pain relief and a toothpaste for sensitive teeth usually help. As the swelling goes down, gums often sit a little lower, so teeth can look longer and small gaps may appear between them.

For a day or so, chew on the other side if you can and avoid very hard or crunchy food. Keep cleaning gently even if the gums bleed at first, as bleeding usually lessens as they heal.

How well your gums respond depends a lot on daily cleaning between your teeth, whether you smoke, and conditions such as diabetes. Treatment can’t always save every tooth, and your dentist will tell you plainly about any that are unlikely to respond.

Maintenance visits and when we refer

Periodontitis is managed rather than cured. Once your gums are stable, maintenance visits every three to four months are common, because the bacteria involved can recolonise deep pockets within that time. Each visit includes re‑measuring key areas and cleaning below the gum line where needed. Letting these visits lapse is a common reason gum disease becomes active again, often without obvious warning signs.

If the disease is advanced, progressing quickly, or not responding as expected, your dentist may refer you to a registered specialist in periodontics. They can offer treatments such as gum surgery or grafting, and you can often continue general care and some maintenance visits with us.

Health funds classify gum treatment differently, sometimes under general dental and sometimes under major, so it’s worth checking the item numbers with your fund before you start.

Gum health and your general health

Researchers have found associations between periodontitis and conditions including diabetes, heart disease and some pregnancy complications. An association doesn’t prove that one causes the other, and the research is ongoing. What’s reasonable to say is that healthy gums are one part of looking after your overall health, and that it helps to tell us about any medical conditions and medicines.