Periodontal disease treatment starts without surgery, with a professional cleaning for gingivitis and a deep cleaning below the gumline for periodontitis. Gingivitis is reversible. Periodontitis can’t be reversed, but professional treatment can slow it down and manage it. It’s also common. In CDC figures from survey data for 2009 to 2014, about 4 in 10 U.S. adults aged 30 and older had periodontitis.
Written by Dr. Kris Owens, DDS, MS, Periodontist at Optima Dental Surgery Center
Dr. Owens is board certified in both periodontology and dental implant surgery and has held an active membership with the American Academy of Periodontology since his residency. He practices at our Round Rock office and serves patients from across the Austin area.
Deep cleaning is the first step for periodontitis and the treatment of choice in American Dental Association guidance. Will it hurt? You can be numbed with a local anesthetic while it’s done.
With the cleaning done, surgery comes later, if at all. After a deep cleaning, many patients need no further treatment, the American Academy of Periodontology reports, though most still need ongoing maintenance.
Left untreated, periodontitis deepens the pockets around your teeth and destroys bone, until teeth can loosen and may fall out or need removal. Treatment can slow that process down.
At Optima Dental Surgery Center in Round Rock, our periodontal disease treatment options run from deep cleaning to laser therapy and periodontal surgery.
Not sure which stage you're in? Dr. Kris Owens can examine your gums and explain your options at a free consultation.
What Each Stage of Gum Disease Means for You
Gum disease begins as gingivitis, the stage that can still be reversed. Plaque left on your teeth can inflame the gums, which turn red and swollen and may bleed easily. A professional cleaning followed by daily brushing and flossing can usually stop gum disease at this stage, according to the ADA’s MouthHealthy site.
Bleeding gums, gums pulling away so teeth look longer, loose or sensitive teeth, and bad breath that lingers are all reasons to get checked. Each appears on NIDCR’s symptom list and gets more detail in our guide to the early warning signs of gum disease.
Periodontitis is the later stage, when the disease spreads to the bone that supports your teeth. It’s staged from I to IV under the 2017 classification the ADA describes, mainly by how much attachment and bone has been lost. A grade is added for how fast the disease is moving, with smoking and diabetes among the factors weighed. For you, a periodontitis diagnosis at any stage means slowing the disease and keeping it stable.
Non-Surgical Gum Disease Treatment Comes First
For periodontitis, the non-surgical first step is scaling and root planing, often called a deep cleaning. Scaling clears the plaque and hardened tartar below the gumline. You can’t brush tartar away, the CDC notes, so this part takes professional instruments. Root planing then smooths each root so plaque and toxins have a harder time sticking to it.
Cleaning every tooth surface often takes several sessions, the ADA says. Because inflamed gums can make the work uncomfortable, you may get a local anesthetic before scaling and root planing begins. I also try to save my questions for the moments when your mouth is free to answer them.
Laser periodontal therapy, another non-surgical option at our office, gave results similar to scaling and root planing alone in controlled studies, the AAP notes.
When Gum Surgery Becomes Part of the Plan
The decision about surgery comes when your gums are measured again after the deep cleaning. For pockets of 4 to 5 mm that remain, the European clinical guideline suggests another round of cleaning. Deep pockets of 6 mm or more in stage III periodontitis are a different case, and for those the guideline suggests access flap surgery.
Periodontitis itself can’t be reversed, yet some of the bone and tissue it destroyed can be rebuilt. Regenerative procedures use membranes, bone grafts or tissue-stimulating proteins for that, and the AAP says they can reverse some of the damage. The disease still needs managing afterward. Where gums have pulled back from a root, a gum graft can cover it.
I perform bone grafting and periodontal surgery at our Round Rock office, so if surgery joins your plan, your care stays with the same team. You won’t have to get to know a new waiting room, either.
What Your Exam Looks At
At your exam, I look at the bone around your teeth and at your health history. Bone lost to gum disease shows on an x-ray. In my office, cone-beam CT adds a three-dimensional map of bone levels and pocket depth, which I use alongside the pocket measurements. I enjoy these scans more than you will, so I’ll stick to what yours show. Healthy pockets usually measure 1 to 3 mm, according to NIDCR.
Want a periodontist to read your x-rays? Book a free consultation with Dr. Kris Owens, or call (512) 341-2321.
Your First Month After a Deep Cleaning, and the Years After
Pain after a deep cleaning could last 1 to 2 days, and teeth may stay sensitive for up to a week, according to a Humana guide that cites the ADA. Bleeding and tenderness should go away within 3 to 4 weeks, says MedlinePlus.
By about 4 weeks your gums show the full effect of the cleaning, per the ADA, so that’s when measuring them again tells you the most. In my reading of the guideline, pockets that have tightened by then may keep you on the non-surgical path. If some stay deep, the next step depends on how deep. No one can promise which way your gums will go before that measurement.
Once active treatment ends, maintenance visits continue for life, because a periodontitis patient remains one even after successful therapy. The guideline links irregular attendance with more tooth loss than regular visits. The interval falls between 3 and 12 months, set by your risk and how your gums look after treatment. At home, brush twice daily and floss every day, as the CDC advises. You get to do that part of the plan on your own schedule, and nobody hands you a bib.
What a Deep Cleaning Costs and How Insurance Pays
You’ll get exact pricing at your free consultation, based on the plan your exam supports. For a sense of scale, Humana’s pricing tool for Orlando, Florida, put scaling and root planing at $235 to $303 per quadrant. A quadrant is one of four equal sections of your mouth. Humana’s tool was last accessed on Oct. 11, 2025. One insurer’s figure for one city is no substitute for your quote.
When scaling and root planing is medically necessary, Humana says a dental plan may cover some of the cost. Gum disease treatment sits under basic care in Humana’s guide to dental coverage, a tier many plans pay at 80%, against 50% for major care. Many plans still cap annual benefits at $1,000, while some now allow $2,000 or more, ADA News reported in December 2025. For major procedures, most insurers set a waiting period of 6 or 12 months after you enroll.
We verify your insurance benefits before your appointment. At the consultation we go over out-of-pocket costs and financing, including our partners Cherry and CareCredit.
Dental Implants After Gum Disease
If you’ve lost a tooth to periodontitis, implants may be an option, the AAP notes, though your history raises the risk of peri-implantitis. Peri-implantitis is an inflammation of the tissue around an implant, with progressive loss of the bone supporting it. The AAP’s ideal candidate has gums free of periodontal disease, one factor in who can get dental implants.
Before an implant goes in, the European guideline on implant care advises treating gum disease to a stable state, with supportive care in place. An implant also needs enough jawbone to hold it. Where bone is missing, the ridge can be built up with bone or a bone substitute before placement.
Find Out What Your Gums Need
At a free consultation at Optima Dental Surgery Center, Dr. Kris Owens will examine your gums and go over each option and its cost with you. You can ask every question on your list before anyone asks you to open wide. Call (512) 341-2321 or book online.
