The most important thing to understand about gum disease is that there are two very different stages, and the treatment goal is different for each.
Gingivitis, the early stage, can be fully reversed.
Periodontitis, the advanced stage, cannot be reversed, but it can be stopped from progressing further.
Why Gum Disease Is Easy to Miss
The Australian Dental Association notes that periodontitis does not usually cause pain.
That means someone can have significant bone loss around their teeth without feeling anything uncomfortable.
The signs that do appear are easy to dismiss: gums that bleed when brushing, a little puffiness, the occasional bad breath.
The Australian Institute of Health and Welfare reports that around 11 percent of Australian adults aged 18 and over said they had gum disease in the 2021 National Dental Telephone Interview Survey.
- Gums that bleed during brushing or flossing
- Red, swollen, or tender gum tissue
- Persistent bad breath that does not resolve with brushing
- Gum recession (teeth appearing longer than they used to)
- A noticeable gap between the gum and the base of the tooth
- A loose tooth or a change in how the teeth fit together when biting
Gingivitis: What Reversal Actually Means
Gingivitis is inflammation of the gum tissue caused by plaque build-up along the gum line.
At this stage, the bone and connective tissue that anchor the teeth have not yet been damaged.
A professional clean to remove plaque and hardened tartar, combined with consistent brushing and flossing at home, can allow the gum tissue to return to a healthy state.
The key word is consistent: plaque reforms every day, so the habits have to be maintained.
Periodontitis: What Cannot Be Reversed and What Can Be Controlled
When gum disease is not treated at the gingivitis stage, infection progresses below the gum line.
Pockets form between the gum and the tooth root, giving bacteria a sheltered environment to accumulate.
The bone supporting the teeth begins to break down.
As Healthdirect Australia describes it, periodontitis cannot be cured, but it can be controlled. The aim of treatment is to stop the infection, reduce the pockets, slow further bone loss, and reduce the risk of eventually losing teeth.
What a Periodontal Assessment Involves
Before any treatment, the dentist or hygienist needs to understand exactly how far the disease has progressed.
A periodontal examination involves measuring the depth of the pocket around each tooth using a small probe.
Pocket depths of 1 to 3 mm are generally healthy. Depths of 4 mm or more suggest the disease has progressed below the gum margin, and depths of 5 mm or greater indicate significant involvement.
Dental X-rays may be taken to assess bone levels, which cannot be measured by probing alone.
The Real Difference Between a Regular Clean and a Deep Clean
A routine scale and clean removes plaque and tartar from the surfaces of the teeth above and at the gum line.
A deep clean, known clinically as scaling and root planing, goes further.
It removes bacterial deposits from the root surfaces inside the periodontal pockets, and smooths the root surface to make it harder for bacteria to reattach.
| Procedure | What is removed | Where it works | Anaesthetic |
|---|---|---|---|
| Scale and clean | Plaque and tartar above and at the gum line | Above-gum surfaces and the gum margin | Usually not needed |
| Deep clean (scaling and root planing) | Bacterial deposits and biofilm from root surfaces inside pockets | Below the gum line, inside periodontal pockets | Local anaesthetic typically used |
A deep clean is done in sections, often one or two quadrants of the mouth at a time, to give the tissue time to heal and respond between visits.
Some tenderness and sensitivity is normal in the days after a deep clean. Most people manage this with over-the-counter pain relief.
Maintenance Is Part of the Treatment
After active treatment, the pockets need to be reassessed.
If they have reduced and the inflammation has settled, the next phase is maintenance: regular cleaning visits at an interval your dentist recommends based on your response to treatment.
For most people with periodontitis, this is every three to four months rather than the standard six months, at least in the early maintenance period.
This is not a commercial choice. Bacterial deposits in the pockets rebuild in weeks, and regular professional removal keeps the infection below the threshold where bone loss continues.
Our gum disease treatment page has more detail on what to expect from a full assessment at Perfect Dental Fairfield.
Home Care Between Appointments
Professional treatment controls the infection, but what happens at home between visits determines whether it stays controlled.
- Brush twice daily with a soft-bristled brush, spending at least two minutes and reaching the gum line
- Clean between teeth daily with floss, interdental brushes, or a water flosser, because plaque between teeth is one of the main drivers of gum disease
- If you smoke, reducing or stopping is the most significant lifestyle change you can make for gum health, as smoking impairs the immune response and reduces the effectiveness of treatment
- If you have diabetes, managing blood glucose levels is closely linked to gum disease control, and the relationship works in both directions