How Gum Disease Progresses (Stages)
Gum disease starts as gingivitis, inflammation confined to the gum tissue around the teeth, and can progress to periodontitis, where the infection spreads into the ligament and bone that hold the teeth in place. The two stages are clinically different, not just a difference of degree: gingivitis affects only the soft tissue and can be resolved, while periodontitis involves a loss of attachment and bone that does not grow back on its own.
Between those two points, a dentist tracks the disease by measuring the depth of the pocket between the gum and the tooth and by checking for bleeding on gentle probing. A healthy pocket is shallow and does not bleed; a deepening pocket with bleeding is the clinical sign that inflammation has moved past simple gingivitis. Radiographs are used to confirm whether the bone level itself has changed, since that is not something visible in a mirror.
The trigger for both stages is the same: plaque, a soft bacterial film that forms on the teeth continuously, and calculus, the hardened deposit plaque becomes once it has been left in place. Daily brushing and cleaning between the teeth removes plaque before it mineralises; once it has hardened into calculus, only professional instrumentation removes it, which is why the disease keeps progressing in the presence of calculus that has not been cleaned off.
Left untreated, periodontitis does not stay static. The bone loss it causes is progressive, meaning it continues if the underlying inflammation is not controlled, and it eventually shows up as the visible signs covered on the warning signs page: teeth that feel loose, gums that have moved down the root, and a bite that feels different than before. None of this happens overnight, which is why catching gum disease at the gingivitis stage, before any of that bone loss has occurred, gives a meaningfully better outcome than catching it later.
Gingivitis vs Periodontitis
Gingivitis can heal. Periodontitis cannot be reversed, only controlled. That is the single fact this page is built around, and it is worth stating plainly rather than softening it, since it changes what "treatment" is aiming for at each stage.
With gingivitis, removing the plaque and calculus that caused the inflammation, alongside better daily cleaning, allows the gum tissue to return to health, since no bone or attachment has been lost yet. With periodontitis, treatment (starting with the deep cleaning covered below) stops the disease progressing and manages the inflammation, but the bone and attachment already lost stay lost; a dentist's goal from that point is stability, not full reversal. Neither stage should be self-diagnosed: a dentist confirms which one is present from pocket measurements and, where periodontitis is suspected, radiographs.
This distinction is also why "my gums stopped bleeding so I'm fine" is not the same test at both stages. In gingivitis, resolved bleeding genuinely can mean the tissue has healed. In periodontitis, inflammation can settle down between flare-ups even while the underlying bone loss from an earlier active period remains, so the absence of bleeding on its own is not proof that no damage has occurred; that is confirmed by pocket depth and radiographs at a review appointment, not by symptoms alone.
Deep Cleaning: Scaling and Root Planing
Deep cleaning, known clinically as scaling and root planing, is the first-line treatment once periodontitis is diagnosed, and it is different from a routine scale and polish. It is carried out under local anaesthetic, since the instruments reach below the gum line into the periodontal pocket, an area that is otherwise sensitive to instrument themselves. Most patients feel pressure rather than sharp pain during the appointment itself, and some tenderness and cold sensitivity afterwards is common as the tissue settles.
Treatment is typically carried out in sessions covering one section of the mouth at a time, itemised under ADA item 222 (periodontal debridement, per tooth), with the gums re-assessed once they have healed from the initial rounds. There is no single published figure for how many sessions a given case needs or how often review should happen afterwards, since that depends on the individual response to treatment and the pocket depths recorded at review, so this page does not quote a fixed number of visits or a recall interval.
Working in sections rather than the whole mouth in one appointment serves two purposes: it keeps each session to a manageable length under local anaesthetic, and it lets the dentist compare how different areas of the mouth respond, which informs the review. A dentist who proposes treating the whole mouth's deep cleaning in a single long appointment without a stated clinical reason is worth asking about, since sectioned treatment is the more typical approach for a reason.
Surgical Options in Tasmania
Where deep cleaning alone does not bring the disease under control, surgical treatment becomes part of the plan, decided by the dentist or a referred periodontist based on how the tissue responds to the non-surgical stage. Gum grafting is one surgical option relevant where gum recession has left root surfaces exposed; see receding gums and gum graft options for the detail on that specific procedure.
Laser-assisted periodontal therapy is marketed in some practices as an alternative or addition to scaling and root planing. Scaling and root planing is the documented first-line treatment for periodontitis, and this page does not claim laser treatment is better, since no named systematic review comparing the two was found in the evidence base behind this site; treat any comparative claim for laser treatment with that gap in mind and ask the practice what evidence they are basing it on.
Periodontal surgery itself, when it is needed, covers a range of techniques a periodontist or general dentist may use to reduce pocket depth, regenerate lost tissue, or reshape the gum, and which technique applies is decided from the specific case rather than offered as a single standard procedure. A referral to a periodontist, one of the 13 dental specialties recognised by the Dental Board of Australia, is common where a case is more advanced or is not responding as expected to non-surgical treatment; check any claimed specialist title against the Ahpra public register, since "periodontist" is a protected title that requires that specific registration.
Cost, Public Dental and Health Fund Cover
Eligible concession-card adults pay $47 per appointment at Oral Health Services Tasmania's general dental care, capped at $188 for a course of care (fee schedule effective 26 March 2025). That is the only official Tasmanian figure for gum disease treatment; there is no official schedule of private dental fees, so a private practice sets its own fee for scaling and root planing, itemised under ADA item 222 per tooth.
| Payer | What applies | Item / figure |
|---|---|---|
| Oral Health Services Tasmania (eligible concession-card adults) | $47 per appointment, general dental care capped at $188 per course | Official Tasmanian government fee |
| Private practice | Fee set by the practice | ADA item 222, per tooth |
| Health fund extras | Part of the private fee, subject to the policy's waiting period and limit | Check the current Private Health Information Statement |
Many extras policies apply a shorter waiting period for general dental care (commonly around 2 months) than for major dental treatment, though this varies by product, so check the specific policy rather than assuming a figure.
Ask for a written, itemised quote before treatment starts, showing ADA item 222 per tooth or per section of the mouth being treated, and take it to a health fund for a benefit estimate if extras cover applies. That is also the only reliable way to compare quotes between two practices, since a single verbal figure can hide different inclusions.
Prevention and Maintenance
Daily plaque removal, thorough brushing and cleaning between the teeth, is the main thing within a patient's own control, since calculus (mineralised plaque) cannot be removed by brushing once it has formed and needs to be instrumented by a dentist. Smoking and uncontrolled diabetes are both recognised as factors that raise the risk of gum disease and can affect how well the gums respond to treatment, though the published evidence does not give a single percentage or odds figure for either that applies to every patient.
Technique matters as much as frequency. A soft-bristled brush angled toward the gum line, used without heavy pressure, cleans the area where gum disease starts without contributing to gum recession the way a hard brush used aggressively can. Cleaning between the teeth, with floss or an interdental brush sized to the gap, reaches the surfaces a toothbrush cannot, which is exactly where plaque tends to sit undisturbed between meals.
A dentist sets a maintenance and review interval based on an individual's own risk factors and how their gums have responded to treatment, not a fixed rule like "every six months for everyone": Ahpra's advertising guidance specifically warns against encouraging regular treatment where there is no clinical need. Ask the treating dentist what interval they recommend for your own case and why.
Once a patient has been treated for periodontitis, maintenance is not optional in the way a general check-up might feel for someone with healthy gums: the disease can become active again if plaque and calculus are allowed to build back up, and a dentist monitoring pocket depths over time is how a return of the disease is caught early rather than after further bone loss has already happened. For the early signs to watch for between visits, see gum disease signs.