Gum Disease: Gingivitis, Periodontitis, Stages and Treatment
This page is general information and does not replace an examination.
Gum disease is inflammation of the gums caused by plaque. In its early form, gingivitis, the gums are red, swollen and bleed when you brush; it can be reversed with good cleaning[1][2]. Untreated, it can progress to periodontitis, which destroys the tissue and bone that hold the teeth and is described in stages I–IV[3][4]. Treatment goes step by step: daily cleaning and risk-factor control, professional cleaning under the gums, surgery where needed, then supportive care[5]. At Ulubey Dental Clinic in Antalya, a deep cleaning costs €80 and periodontal curettage €100 per quadrant.
- 1. What is gum disease?
- 2. Gingivitis vs periodontitis
- 3. Symptoms and when to see a dentist
- 4. Stages and grades of periodontitis
- 5. Causes and risk factors
- 6. How gum disease is treated
- 7. What you can do at home
- 8. Gum disease, implants and bridges
- 9. Gum treatment prices in Antalya
- 10. How we treat gum disease at our clinic
- 11. Frequently asked questions
- 12. Sources
What is gum disease?
Gum disease is caused by a build-up of plaque, the sticky film of bacteria on the teeth. If plaque is not removed by brushing and cleaning between the teeth, it builds up and irritates the gums[1]. The gums become red, swollen and sore, and they bleed[1].
Dentists separate two conditions. Gingivitis is inflammation limited to the gums. Periodontitis is the destructive form: the attachment of the gum to the tooth and the bone around the root are lost[3]. The 2017 World Workshop classification groups forms once called “chronic” and “aggressive” periodontitis under one name, periodontitis, described by stage and grade[3].
Gum health can be restored after gingivitis and after periodontitis has been treated. But a person who has had periodontitis remains at higher risk of it returning, even when the gums look healthy again, and needs to be monitored[2].
If your main worry is gums that bleed, swell or feel sore, our symptom guide to bleeding gums explains the possible causes and when to act.
Gingivitis vs periodontitis
| Gingivitis | Periodontitis | |
|---|---|---|
| What is affected | The gums only[2] | Gums, the fibres that attach the tooth and the bone around the root[3] |
| Typical signs | Red, swollen gums that bleed on brushing[1][2] | Bleeding, gums shrinking back, bad breath, loose teeth[1] |
| Can it be reversed? | Yes: gum health can be restored after treatment[2] | The gums can be healthy again, but on a reduced support; the person stays at higher risk and needs monitoring[2] |
| How it is assessed | Mainly bleeding on probing[2] | Probing depths, attachment loss, X-rays; described by stage (I–IV) and grade (A–C)[4] |
| Main treatment | Better daily cleaning and professional cleaning[1] | Stepwise therapy: cleaning under the gums, surgery where needed, supportive care[5] |
Symptoms and when to see a dentist
The NHS lists these symptoms of gum disease[1]:
- gums that bleed when you brush, floss or eat hard foods such as apples;
- gums that are swollen, red and sore.
Gum disease can lead to bad breath and a bad taste in the mouth, gums shrinking, teeth becoming loose or falling out, and a dental abscess[1]. Early gum disease is often not painful, which is why it is easy to ignore.
Ask for an urgent appointment if gum disease comes with very sore and swollen gums, teeth becoming loose or falling out, ulcers or red patches in your mouth, or a lump in your mouth or on your lip[1].
Book a routine appointment if your gums bleed when you brush or eat hard foods, your gums are painful and swollen, or you have bad breath[1].
A red or white patch that does not heal is not treated as gum disease: at our clinic we refer such lesions to a university faculty of dentistry for further examination.
A painful swelling on the gum with pus can be a periodontal abscess: an acute collection of pus in the gum pocket with rapid tissue destruction[3]. It needs prompt dental care.
Stages and grades of periodontitis
Since the 2017 classification, periodontitis is described in two dimensions[4]:
| Dimension | What it describes | Based on |
|---|---|---|
| Stage I–IV | How severe the disease is and how complex it is to manage | Loss of support relative to root length, teeth lost to periodontitis, pocket depth, bone defects, furcation involvement, tooth mobility and chewing problems[4] |
| Extent | Localised or generalised | How many teeth are affected[4] |
| Grade A–C | How fast it is progressing: slow, moderate or rapid | Direct or indirect evidence of the progression rate; risk factors are used to modify the grade[4] |
Stage and grade are set by the dentist from the examination, pocket measurements and X-rays. A higher stage means a more complex treatment plan, not a hopeless one.
The staging also guides treatment: the EFP guideline covers stages I to III with a stepwise approach that becomes more intensive with the stage[5].
Causes and risk factors
Plaque is the cause. Plaque that is not removed irritates the gums[1]. Other factors change how strongly a person reacts to plaque and how fast the disease progresses[2][4]:
- Smoking: pooled data from prospective studies show smoking raises the risk of periodontitis by about 85%[7].
- Diabetes: the NHS recommends regular check-ups especially for people with type 2 diabetes[1]. The two-way link between diabetes and gum disease is explained in our guide to oral health and medical conditions.
- Pregnancy: the NHS also advises regular check-ups especially when you are pregnant[1].
- Age: severe periodontitis rises steeply between the third and fourth decades of life, with incidence peaking around age 38[6].
Worldwide, severe periodontitis was the sixth most prevalent condition in the Global Burden of Disease 2010 data, with an age-standardised prevalence of 11.2%[6].
How gum disease is treated
How gum disease is treated depends on how severe it is[1]. The European Federation of Periodontology (EFP) S3 guideline sets out a stepwise approach[5]:
Step 1: cleaning habits and risk factors
Better daily cleaning, removal of plaque and tartar above the gum line, and control of risk factors such as smoking and diabetes[5].Step 2: cleaning under the gums
Instrumentation below the gum line (often called deep cleaning or root surface debridement), with or without additional therapies[5].Step 3: surgery where needed
Different types of periodontal surgery, depending on the stage and the sites involved[5].Step 4: supportive care
Regular supportive periodontal care to keep the results over time[5].
For early gum disease, the NHS describes advice on cleaning (for example interdental brushes), stopping smoking and a professional clean. For serious gum disease it lists deep cleaning under the gums, antibiotics, removal of some teeth and gum surgery[1]. Antibiotics are used only if a dentist prescribes them after an examination.
What you can do at home
The NHS advice for preventing gum disease[1]:
- brush with fluoride toothpaste at least twice a day; spit after brushing, do not rinse;
- clean between your teeth every day with floss or interdental brushes;
- do not use mouthwash straight after brushing;
- do not smoke;
- have regular check-ups.
Between the teeth. A Cochrane review of 35 trials found low-certainty evidence that flossing in addition to brushing may reduce gingivitis, and that interdental brushes may reduce gingivitis more than floss[8]. Where interdental brushes fit, they are a good first choice; floss suits tight contacts.
Electric or manual? A Cochrane review of 56 trials found that powered toothbrushes reduced plaque and gingivitis slightly more than manual ones (for gingivitis, about 6% in the short term and 11% in the long term), but the clinical importance of this is unclear[9]. The technique and the habit matter more than the brush.
Gum disease, implants and bridges
Implants can develop a similar problem. In peri-implant mucositis the main sign is bleeding on gentle probing; plaque is its cause. Peri-implantitis adds progressive loss of the bone around the implant[10].
People who lost teeth to gum disease can still have implants, but the gum disease must be treated and under control first; see who can get dental implants. Cleaning around implants and bridges is shown step by step in how to clean implants and bridges, and the warning signs of a failing implant are covered in dental implant failure.
Gum treatment prices in Antalya
| Treatment | When it is used | Price |
|---|---|---|
| Consultation and panoramic X-ray | First examination of teeth and gums | No separate fee |
| Deep cleaning (scaling + polish) | Plaque and tartar removal, gingivitis, before or alongside further gum treatment | €80 |
| Periodontal curettage | Cleaning under the gums in pockets, per quadrant (a quarter of the mouth) | €100 per quadrant |
| Periodontal flap surgery | Surgical access to clean deep pockets, per quadrant | €250 per quadrant |
| Free gingival graft | Selected cases of gum recession (the name describes the graft technique, not the fee) | Written quote only |
- Included: the treatment listed for the stated area.
- No separate fee: the consultation and the panoramic X-ray taken at the examination.
- Itemised in your quote only if needed: fillings, extractions or other treatment found at the examination.
Prices are indicative; your final written quote follows the examination and X-rays and is valid for 30 days. Unless the treatment plan changes, the written price does not change.
All fees are on our dental treatment prices page; the cleaning visit itself is described on professional teeth cleaning in Antalya.
How we treat gum disease at our clinic
Dr. Ali Cem Ulubey and Dr. Surur Ulubey examine and treat patients themselves; there are no rotating dentists.
- Examination: gums, pockets and teeth are checked, with a panoramic X-ray for every patient and periapical X-rays in the clinic when a tooth needs a closer look.
- Deep cleaning: scaling and polishing in one visit; there is no flight restriction after a cleaning. Guided Biofilm Therapy (Airflow) is also done in the clinic.
- Under the gums: periodontal curettage per quadrant; flap surgery per quadrant where pockets remain.
- Smoking: before periodontal surgery we ask you to stop smoking as early as possible, ideally at least 4 weeks before; if you cannot, cut down as much as possible (we ask for a maximum of 6–8 cigarettes a day); and not to smoke for at least 1 week after the procedure, until the wound has closed.
- Home care: we show you which interdental brushes fit, and where floss works better.
- Follow-up: we send WhatsApp check-ins at 30, 90 and 365 days after treatment; check-up intervals are set with you at the examination.
- Before implants or crowns: gum disease is treated first, so that new work starts on a stable base.
Visiting Antalya on holiday? A deep cleaning fits into one appointment; walk-in patients are seen Monday to Saturday, 09:00–19:00. See dentist in Antalya on holiday.
Frequently asked questions
Can gingivitis be reversed?
Yes. Gingivitis is inflammation limited to the gums, and gum health can be restored once the plaque that causes it is removed and kept under control. That means brushing twice a day with fluoride toothpaste, cleaning between the teeth every day and a professional cleaning. Bleeding usually lessens as the inflammation settles; if it does not, see a dentist.
Can periodontitis be cured?
Periodontitis can be treated and stopped, and the gums can become healthy again. The support already lost stays reduced, and a person who has had periodontitis stays at higher risk of it returning, so supportive care and regular check-ups are part of the treatment, not an optional extra.
Will gum disease make my teeth fall out?
It can. The NHS lists loose teeth and teeth falling out among the consequences of gum disease. Treatment aims to stop the loss of support so that you keep your teeth. How much can be saved depends on the stage of the disease, which the dentist assesses from pocket measurements and X-rays.
How much does gum disease treatment cost in Antalya?
At our clinic a deep cleaning (scaling and polish) costs €80, periodontal curettage €100 per quadrant and flap surgery €250 per quadrant. The consultation and panoramic X-ray have no separate fee. Your written quote, valid for 30 days, lists exactly which quadrants need treatment after the examination.
Can I have gum treatment while on holiday in Antalya?
A deep cleaning fits into one appointment, and there is no flight restriction after a cleaning. Cleaning under the gums is done per quadrant, so the number of appointments depends on how many quadrants need it. After the examination we tell you what can be done during your stay and what should be followed up at home.
Can I get dental implants if I have gum disease?
Often yes, but not before the gum disease is treated and under control. A history of periodontitis raises the risk of peri-implantitis, the inflammation and bone loss that can affect implants. Treatment of the gums, good cleaning at home and regular check-ups come first; the dentist decides at the examination when implant treatment can start.
Does an electric toothbrush help with gum disease?
It can help a little. A Cochrane review found powered toothbrushes reduced plaque and gingivitis slightly more than manual brushes, but the clinical importance is unclear. Brushing well twice a day and cleaning between the teeth every day matter more than the type of brush.
Sources
- NHS. Gum disease (page last reviewed 20 April 2026; accessed 26 October 2026). www.nhs.uk/conditions/gum-disease
- Chapple ILC, Mealey BL, Van Dyke TE, et al. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: consensus report of workgroup 1 of the 2017 World Workshop. J Periodontol. 2018;89 Suppl 1:S74-S84. PMID 29926944. pubmed.ncbi.nlm.nih.gov/29926944
- Papapanou PN, Sanz M, Buduneli N, et al. Periodontitis: consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol. 2018;89 Suppl 1:S173-S182. PMID 29926951. pubmed.ncbi.nlm.nih.gov/29926951
- Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: framework and proposal of a new classification and case definition. J Periodontol. 2018;89 Suppl 1:S159-S172. PMID 29926952. pubmed.ncbi.nlm.nih.gov/29926952
- Sanz M, Herrera D, Kebschull M, et al.; EFP Workshop Participants. Treatment of stage I-III periodontitis: the EFP S3 level clinical practice guideline. J Clin Periodontol. 2020;47 Suppl 22:4-60. PMID 32383274. pubmed.ncbi.nlm.nih.gov/32383274
- Kassebaum NJ, Bernabé E, Dahiya M, et al. Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression. J Dent Res. 2014;93(11):1045-1053. PMID 25261053. pubmed.ncbi.nlm.nih.gov/25261053
- Leite FRM, Nascimento GG, Scheutz F, López R. Effect of smoking on periodontitis: a systematic review and meta-regression. Am J Prev Med. 2018;54(6):831-841. PMID 29656920. pubmed.ncbi.nlm.nih.gov/29656920
- Worthington HV, MacDonald L, Poklepovic Pericic T, et al. Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal diseases and dental caries. Cochrane Database Syst Rev. 2019;4:CD012018. PMID 30968949. pubmed.ncbi.nlm.nih.gov/30968949
- Yaacob M, Worthington HV, Deacon SA, et al. Powered versus manual toothbrushing for oral health. Cochrane Database Syst Rev. 2014;(6):CD002281. PMID 24934383. pubmed.ncbi.nlm.nih.gov/24934383
- Berglundh T, Armitage G, Araujo MG, et al. Peri-implant diseases and conditions: consensus report of workgroup 4 of the 2017 World Workshop. J Periodontol. 2018;89 Suppl 1:S313-S318. PMID 29926955. pubmed.ncbi.nlm.nih.gov/29926955
This article is general patient information and does not replace a clinical examination or X-rays.
Editor contact: [email protected] · ulubeydental.com/contact-us
