Gum care and periodontics at Victorian Dental Group

Gum disease is the leading cause of tooth loss in Australian adults, and in its early stages it is usually painless. Common, serious and quiet is a difficult combination — which is why we assess your gums at every check-up, not only when something hurts.

This page explains how we assess gum health, what treatment actually involves, what it costs, and when you would be referred to a specialist.

Signs it is time to have your gums looked at

Book an appointment if you notice:

• Bleeding when you brush or floss. This is the most commonly ignored sign. Gums that bleed are inflamed — healthy gums do not bleed with normal brushing
• Red, swollen, sore or tender gums
• Gum recession — teeth appearing longer, or new sensitivity at the gumline
• Persistent bad breath or a bad taste that does not clear with brushing
• Gums pulling away from the teeth, or food packing into new spaces
• Loose teeth, teeth that have drifted, or a bite that feels different
• Pus around a tooth or gum — see us promptly

Most people with early gum disease have no pain at all. Absence of pain is not evidence of health.

What is actually happening

Plaque is a living film of bacteria that reforms on teeth within hours of brushing. Along the gumline it provokes an immune response, and it is that response — not the bacteria directly — that does most of the damage to the tissue.

Left undisturbed, plaque mineralises into calculus, a hard deposit that cannot be brushed away and that gives new plaque a rough surface to colonise. The deposit sits below the gum where no toothbrush reaches, so the inflammation becomes self-sustaining. That is why professional removal is not optional once calculus has formed.

Gingivitis and periodontitis are not the same thing

Gingivitis is inflammation confined to the gum tissue, caused by plaque sitting along the gumline. It is common, and it is genuinely reversible — with professional cleaning and an improved home routine, gums can return to health with no lasting damage.

Periodontitis is what gingivitis can become if it is left. The inflammation reaches the bone and the fibres anchoring the tooth in the jaw, and those structures are progressively destroyed. The important distinction: bone that has been lost does not grow back on its own. Treatment aims to halt progression and keep what remains, rather than restore what has gone. This is why early assessment matters so much.

Not everyone with gingivitis develops periodontitis. Susceptibility varies considerably between individuals, largely for reasons of immune response and genetics that are outside anyone's control. Two people with identical hygiene can have very different outcomes, which is worth knowing if you have been made to feel it is entirely your fault.

Gum health and general health

There are well-documented associations between periodontitis and diabetes, cardiovascular disease, rheumatoid arthritis and adverse pregnancy outcomes.

The diabetes link is the best established and works in both directions: poorly controlled diabetes makes gum disease worse, and active gum disease makes blood glucose harder to control. Treating the gums can help the diabetes.

For the others the evidence shows association rather than proven cause, and we will not tell you that treating your gums will prevent a heart attack. What is fair to say is that chronic inflammation anywhere in the body is worth reducing, and gum disease is a treatable source of it.

What a gum assessment involves

Before we manage anything periodontal, we need the full picture:

Periodontal charting. Using a fine probe, your practitioner measures the depth of the crevice between gum and tooth at several points around every tooth, and records where bleeding occurs. Healthy readings are shallow. Deeper pockets indicate attachment has been lost and that the area can no longer be cleaned by brushing alone. It is not painful, though inflamed areas can feel tender.

Radiographs. X-rays show the bone level around each root — something no visual examination can reveal. Our digital X-ray and OPG equipment is on site, so results are immediate.

Risk factors. Smoking is the single largest modifiable risk factor for periodontal disease. Diabetes, some medications, pregnancy, stress and family history all influence how your gums respond, and they shape the plan we build with you.

Treatment

The mainstay of periodontal treatment is thorough removal of calculus from the tooth and root surfaces above and below the gumline. Calculus cannot be brushed off; it has to be instrumented away.

Depending on how much there is and how deep it sits, this may be completed in a single appointment or staged across several, working through the mouth in sections. Where pockets are deep or roots are sensitive, local anaesthetic is used so the area can be cleaned properly without discomfort.

Review is part of the treatment, not an optional extra. Some weeks after cleaning, we re-chart the same points to see which areas have responded and which have not. That comparison is what tells us whether the disease is stabilising.

Maintenance intervals are shorter. Patients with a history of periodontitis are usually seen more frequently than the standard six months, because the bacteria repopulate deep sites faster than a routine recall can manage. Three-monthly is common.

What to expect afterwards

Gums are often tender for a few days, and sensitivity to cold is common because root surfaces that were covered by calculus are now exposed. A sensitivity toothpaste helps, and it usually settles over a few weeks.

Gums may appear to recede after treatment. They have not shrunk; the swelling has resolved and the true position is now visible. Gaps between teeth may open up for the same reason. This is a sign the treatment worked, though it is worth being warned about beforehand rather than discovering it in the mirror.

Bleeding should reduce steadily over the following weeks. If it does not, the area needs re-examining.

Will it hurt?

A routine clean on healthy or mildly inflamed gums is generally comfortable. Where gums are significantly inflamed or pockets are deep, we use local anaesthetic — there is no reason to endure a difficult clean. Tenderness and some sensitivity for a few days afterwards is normal, and gums may look worse briefly before they look better as swelling settles.

If you have had an uncomfortable experience elsewhere, tell us before we start. It changes how we approach the appointment.

When you would be referred to a periodontist

Most gum disease is managed successfully in general practice. We refer to a registered specialist periodontist when disease is extensive or progressing rapidly, when deep pockets have not responded to thorough non-surgical treatment, when surgical procedures such as pocket reduction or grafting are indicated, or where there are complications around a dental implant.

Victorian Dental Group is a general practice and none of our practitioners holds specialist registration. We work with a local network of specialists and will explain why a referral is being made and what it involves.

Smoking

Smoking roughly multiplies the risk of periodontitis, worsens the response to treatment, and masks the disease by reducing bleeding so the gums look healthier than they are. It is also the factor most within your control.

Stopping improves treatment outcomes measurably, and it does so within months rather than years. We will raise it because it matters clinically, not to lecture you, and we can point you to support if you want it.

Keeping gums healthy between visits

• Brush twice daily for two minutes with a soft-bristled brush, angled into the gumline. Hard brushing causes recession rather than preventing it
• Clean between the teeth daily. Brushing reaches roughly three of the five surfaces of a tooth
• Interdental brushes clean better than floss where there is space for them, and your practitioner will size them for you. The right size matters more than the brand
• An electric brush with a pressure sensor helps if you press too hard, which many people do
• Mouthwash is optional and does not replace mechanical cleaning. Chlorhexidine rinses are useful short-term after treatment, but stain teeth with prolonged use
• Keep your recall interval, particularly if you have been treated for periodontitis

What it costs

Fees depend on how much treatment is required, which is not known until your gums have been assessed. You will be given the item numbers and the cost in writing before treatment begins.

We claim on the spot through HICAPS — bring your health fund card and you pay only the gap, which depends on your level of cover. Periodontal treatment usually falls under major dental, and annual limits are often reached partway through a course, so ask us to check before starting. Afterpay and Zip are available for larger treatment plans. See payment options.

Questions we are asked

Will my gums grow back? Gum tissue that has receded does not return on its own. Grafting can cover exposed roots in selected cases and is a specialist procedure.

Is it too late? Rarely. Even advanced periodontitis can usually be stabilised, and keeping teeth for decades after diagnosis is a realistic aim.

Is gum disease hereditary? Susceptibility has a genetic component. The disease itself is caused by bacteria, so your habits still matter a great deal.

Can I catch it from my partner? The bacteria can transfer, but whether disease develops depends on the individual's own response and hygiene.

Do I need antibiotics? Usually not. Cleaning removes the source; antibiotics are reserved for specific aggressive or non-responding cases.

Why do I need cleans every three months? Because deep sites recolonise faster than six months allows. The interval is set by your charting, not by policy.

Book an assessment

Victorian Dental Group — 291 Wattletree Road, Malvern East VIC 3145

Phone (03) 9088 5808 · Monday to Friday, 8:00am–5:00pm · closed weekends and public holidays

Book online at any hour.

This page is general information and does not replace advice from a registered dental practitioner about your own circumstances. Please see our Disclaimer.