What Is Gum Disease?
Gum disease is an infection of the tissues that hold your teeth in place. It is caused by bacteria in dental plaque, a sticky film that forms on teeth throughout the day. When plaque is not removed through regular brushing and flossing, it hardens into tartar (calculus) and triggers inflammation in the gums.
Gum disease develops in two stages. Gingivitis is the early stage, marked by red, swollen gums that may bleed when you brush or floss. At this point, the damage is limited to the gum tissue and is usually reversible with professional cleaning and better oral hygiene. Periodontitis is the advanced stage. The infection spreads below the gumline, creating pockets between the teeth and gums. Over time, these pockets deepen, and the bacteria destroy the bone and connective tissue that support your teeth.
Gingivitis vs. Periodontitis
The difference between gingivitis and periodontitis is the extent of damage. Gingivitis affects only the gum tissue. There is no bone loss, and the condition can be fully reversed with treatment. Periodontitis involves bone loss and tissue destruction that cannot be fully undone, though it can be stopped and managed.
Not all gingivitis progresses to periodontitis. With prompt treatment, most cases of gingivitis resolve completely. However, if left untreated, gingivitis can advance to periodontitis in some patients, particularly those with risk factors like smoking, diabetes, or a family history of gum disease.
Stages of Gum Disease
Understanding the stage of your gum disease helps determine the right treatment. Your dentist or periodontist will measure the depth of the pockets around your teeth using a small probe. Healthy gums typically have pocket depths of 1 to 3 millimeters.
- Gingivitis: Gums are inflamed and may bleed, but there is no bone loss. Pocket depths are typically 1 to 3 mm. Treatment involves professional cleaning and improved home care.
- Early periodontitis: Pockets measure 4 to 5 mm. There is mild bone loss visible on X-rays. Scaling and root planing is usually the first treatment recommended.
- Moderate periodontitis: Pockets measure 5 to 7 mm. Bone loss is more significant, and teeth may begin to shift. A combination of scaling and root planing, antibiotics, and possibly surgery may be needed.
- Advanced periodontitis: Pockets exceed 7 mm. Severe bone loss has occurred, teeth may be loose, and tooth loss becomes a real risk. Surgical treatment and ongoing maintenance are typically required.
Non-Surgical Gum Disease Treatments
Non-surgical treatment is the first approach for most cases of gum disease. The goal is to remove the bacterial infection and create conditions for the gums to heal and reattach to the teeth.
Scaling and Root Planing (Deep Cleaning)
Scaling and root planing is the standard non-surgical gum disease treatment. During scaling, your dental professional uses specialized instruments to remove plaque and tartar from the tooth surfaces and below the gumline. Root planing smooths the root surfaces so the gums can reattach more easily.
The procedure is typically done under local anesthesia and may be completed in one or two visits depending on how many areas of the mouth are affected. Most patients experience some sensitivity for a few days afterward, but recovery is straightforward.
Antibiotics and Antimicrobial Therapy
Your dentist or periodontist may prescribe antibiotics as part of your gum disease treatment. These can be systemic (pills taken by mouth) or local (placed directly into the periodontal pockets after scaling and root planing). Locally applied antibiotics, such as minocycline microspheres or chlorhexidine chips, deliver medication directly to the infected area over several days.
Antimicrobial mouth rinses may also be recommended as a supplement to treatment. These are not a substitute for professional treatment but can help reduce bacteria between visits.
Surgical Gum Disease Treatments
When non-surgical treatment does not fully control the infection, or when pockets are too deep to clean effectively, surgical options may be recommended. Surgery allows the periodontist to access the root surfaces directly, remove deep deposits, and in some cases regenerate lost bone.
Flap Surgery (Pocket Reduction)
Flap surgery is one of the most common periodontal surgical procedures. The periodontist lifts the gum tissue back, removes tartar and bacteria from deep pockets, and then sutures the tissue back into place so it fits more snugly around the teeth. This reduces pocket depth and makes it easier to keep the area clean going forward.
Bone and Tissue Grafts
When gum disease has destroyed bone around the teeth, bone grafting may be used to help regenerate lost tissue. The periodontist places graft material in the area of bone loss to serve as a scaffold for new bone growth. Guided tissue regeneration, which uses a special membrane to direct bone and tissue growth, is sometimes done alongside bone grafting.
Soft tissue grafts may also be used when gum disease has caused gum recession, exposing the tooth roots. Tissue is taken from the roof of the mouth or a donor source and attached to the affected area to cover exposed roots and prevent further recession.
LANAP Laser Gum Treatment
LANAP (Laser Assisted New Attachment Procedure) uses a specialized dental laser to remove diseased tissue and bacteria from periodontal pockets without cutting the gums with a scalpel. The laser energy selectively targets infected tissue while leaving healthy tissue intact. LANAP also stimulates the bone to regenerate around the teeth.
LANAP is FDA-cleared for periodontal treatment and may be an option for patients who want a less invasive surgical approach. Recovery is typically faster than traditional flap surgery, with less swelling and discomfort. However, not all cases are suitable for laser treatment, and your periodontist will advise whether LANAP is appropriate for your situation.
How to Prevent Gum Disease
Preventing gum disease starts with consistent oral hygiene and regular dental visits. Most cases of gum disease are preventable with daily care.
- Brush twice a day for two minutes with a soft-bristled toothbrush and fluoride toothpaste.
- Floss daily to remove plaque from between teeth where your toothbrush cannot reach.
- See your dentist for professional cleanings at least twice a year, or more often if recommended.
- Quit smoking or using tobacco products. Smoking is one of the strongest risk factors for gum disease and reduces the effectiveness of treatment.
- Manage underlying health conditions such as diabetes, which increases the risk of gum disease.
- Watch for early warning signs: bleeding gums, persistent bad breath, and red or swollen gum tissue.
Gum Disease Treatment Cost
The cost of gum disease treatment depends on the severity of your condition and the type of treatment needed. Costs vary by location, provider, and case complexity.
Scaling and root planing typically costs $200 to $300 per quadrant (the mouth is divided into four quadrants). A full-mouth deep cleaning may cost $800 to $1,200. Most dental insurance plans cover scaling and root planing when medically necessary, though coverage varies by plan.
Surgical procedures cost more. Flap surgery typically ranges from $1,000 to $3,000 per quadrant. Bone grafting and tissue regeneration procedures can add $500 to $3,000 depending on the extent of grafting. LANAP laser treatment typically ranges from $1,000 to $4,000 per quadrant. Many dental insurance plans cover a portion of periodontal surgery, but out-of-pocket costs can still be significant. Ask your provider about payment plans or financing options before starting treatment.
When to See a Periodontist for Gum Disease
A general dentist can diagnose and treat early gum disease, including gingivitis and mild periodontitis. However, moderate to advanced cases often benefit from the specialized training of a periodontist. A periodontist is a dentist who has completed 3 additional years of residency training focused on the prevention, diagnosis, and treatment of gum disease and the placement of dental implants.
Your dentist may refer you to a periodontist if your gum disease has not responded to initial treatment, if you have deep pockets or significant bone loss, or if surgical treatment is needed. You can also see a periodontist directly without a referral in most cases. Learn more about what periodontists do and how they can help on our [periodontics specialty page](/specialties/periodontics).
Find a Periodontist Near You
Every periodontist on My Specialty Dentist has verified specialty credentials. Search by location to find a periodontist in your area, review their experience, and schedule a consultation for your gum disease treatment.
Search Periodontists in Your Area