A common question. The answer is not simple. How loose is the tooth? Is it just the gum that’s holding it or is it the bone? Has the bone retracted evenly around the entire circumference of the tooth, or is the bone pocket deeper in some places? Is there a general health problem, medication, osteoporosis or not?

These are just the most basic questions, we have not yet gone into the depths of gum treatment diagnosis. As you can see, there is no clear answer, there are as many possible solutions as there are cases.

One thing is certain, and it is true for all gum treatments in general! Gum decay, even if it cannot be stopped, can be slowed down in most cases. Time is working against you. The sooner you act, the more options you have and the more bone you have that can be saved. The question with gum treatment is not whether it can be saved, but when to start!

There can be reasons for bleeding gums, from the most minor to the most severe. So the first step is always diagnosis. Fortunately, in more than half of the cases, a thorough ultrasonic scaling is perfectly sufficient to eliminate bleeding gums. This basic gum treatment removes the tartar and therefore the bacteria that cause inflammation.

If there are more serious gum pockets around some teeth or several teeth, a gum brushing or laser treatment may be needed after the ultrasonic scaling. If there is a serious recurrent gum infection without serious tartar build-up, then antimicrobial photodynamic therapy may be necessary, which kills 99% of the pathogenic bacteria without drugs or side effects!

A thorough oral examination, X-ray and in some cases 3 D CBCT scan is required before gum treatment. The first step is always to make a diagnosis. The oral examination can determine the cause of the bleeding gums, the presence and approximate depth of any gum pockets and the mobility of the teeth. A two-dimensional panoramic X-ray gives a general overview of the situation and can be used to determine whether there is generalised periodontal disease, i.e. destruction of the entire tooth. If the process involves only one tooth, an intraoral X-ray is taken of that tooth, allowing a more thorough examination. If a more serious diagnosis is required, a 3-dimensional CBCT of the tooth may be performed.

Dental curettage is gum treatment under dental anaesthesia. It is therefore not painful. Before the treatment, an ultrasonic scaling is performed, during which the larger and supra-gingival calculus is removed. Dental curettage is used to remove calculus deposited in the deeper gum pockets and on the root surfaces. These are the places where the ultrasonic device can no longer reach, so it cannot remove fine build-up. The curette is essentially a sharp instrument in the shape of a speculum, which the dentist or dental hygienist works with by stroking the surface of the root deep inside the pouch. The aim of curettage is to make the root surface completely smooth. A smooth surface allows regeneration to begin. In many cases, laser gum treatment is recommended after curettage to tighten loose tissue.