Periodontics & Gum Treatment

Healthy gums and jawbone are the foundation beneath every natural tooth, porcelain veneer, crown, and dental implant. Because gum disease typically progresses without sharp toothache, many adults dismiss bleeding when brushing or persistent bad breath until the supporting bone around the roots has already begun to recede. At COSDENT Smile Design in Bangkok, our periodontal clinicians diagnose and treat gum inflammation across every stage, from reversible gingivitis to advanced periodontitis, at our Siam and Rama 9 clinics.

Whether you need targeted deep cleaning (scaling and root planing), supportive periodontal maintenance, or gum stabilisation before starting cosmetic veneers or orthodontics, this guide explains how periodontal care works and what your treatment plan involves.

Table of contents

• Warning signs that your gums need a periodontal assessment

• Stages of gum disease: Gingivitis vs Periodontitis

• How our periodontists diagnose gum and bone health

• Non-surgical and surgical periodontal treatments at COSDENT

• Routine scaling vs Periodontal Root Planing (Deep Cleaning)

• Why gum disease must be stabilised before veneers, implants or braces

• Supportive periodontal maintenance and home care

• Frequently asked questions

Warning signs that your gums need a periodontal assessment

Healthy gum tissue is firm, pale pink (or evenly pigmented according to your natural complexion), and does not bleed when you brush or floss. Arrange a periodontal evaluation if you notice any of the following:

• Bleeding when brushing, flossing, or biting firm foods (even if there is zero pain).

• Red, puffy, swollen, or tender gum margins that have lost their firm knife-edge contour.

• Persistent bad breath (halitosis) or a metallic/unpleasant taste caused by anaerobic bacteria inside deep gum pockets.

• Gum recession making teeth look longer, exposing yellowish root surfaces, or creating dark triangular spaces ("black triangles") between teeth.

• Pus oozing from the gumline, shifting front teeth, or teeth that feel slightly loose when biting.

Stages of gum disease: Gingivitis vs Periodontitis

Understanding where your gums sit on the clinical spectrum explains why treatment differs between an early hygiene visit and specialist periodontal therapy:

• Stage 1, Gingivitis (Reversible Gum Inflammation): Plaque and tartar along the gumline irritate the superficial gingival tissue, causing redness, swelling, and bleeding. Crucially, the underlying bone and periodontal ligament fibres are still intact. Professional ultrasonic scaling, Airflow biofilm removal, and improved daily flossing can reverse gingivitis completely.

• Stage 2, Mild to Moderate Periodontitis: When subgingival tartar remains below the gumline, the body's chronic inflammatory response begins breaking down the periodontal attachment and alveolar bone. The normal 1–3 mm sulcus deepens into a 4–6 mm periodontal pocket where toothbrush bristles cannot reach, requiring quadrant or localized root planing.

• Stage 3, Severe / Advanced Periodontitis: Pocket depths exceed 6 mm with substantial vertical or horizontal bone loss, furcation involvement between molar roots, gum recession, and tooth mobility. Comprehensive periodontal therapy, splinting, or surgical pocket reduction is required to halt further tooth loss.

How our periodontists diagnose gum and bone health

At your COSDENT periodontal consultation, diagnosis goes beyond a quick visual glance:

1. 6-point periodontal charting: Using a calibrated millimetre probe, the clinician gently measures the pocket depth around six sites on every tooth, recording bleeding points, gum recession, and furcation areas.

2. Digital radiographic bone evaluation: Bitewing, periapical, or panoramic X-rays show the exact height and contour of the alveolar bone crest between every root.

3. Systemic & lifestyle risk review: Evaluating factors that accelerate periodontal breakdown, including smoking/vaping, diabetes, hormonal changes, night-time tooth grinding, and overhanging old fillings or crowns.

Routine scaling vs Periodontal Root Planing (Deep Cleaning)

Why gum disease must be stabilised before veneers, implants or braces

If you are visiting Bangkok for cosmetic dentistry, our clinicians always check your periodontal foundation first:

• Before Porcelain Veneers or Crowns: Placing veneers against swollen, bleeding gums prevents accurate digital scanning and moisture-free adhesive bonding, and as inflamed gums later shrink or recede, the veneer margin can become exposed. Read our dedicated article on getting veneers when you have gum disease.

• Before Orthodontics: Moving teeth with Invisalign or braces while active periodontal inflammation is present can rapidly accelerate bone loss around the roots.

• Before Dental Implants: Periodontal bacteria from untreated natural teeth can colonise a newly placed dental implant and cause peri-implantitis.

Supportive periodontal maintenance and home care

After scaling and root planing, the gum tissue heals and tightens around the clean root surfaces over 4 to 6 weeks, reducing pocket depths. Because periodontal bacteria re-establish in deep crevices within 90 to 120 days, patients who have had periodontitis are typically placed on a 3- to 4-month Supportive Periodontal Therapy (SPT) schedule, paired with daily interdental brushes sized specifically to the spaces between their teeth.

Frequently asked questions

Can bone lost to periodontal disease grow back naturally?

Horizontal bone loss from chronic periodontitis does not grow back on its own once resorbed; the primary goal of root planing and periodontal maintenance is to stop the infection so bone loss halts and your gums re-attach firmly to the root. In specific localized vertical bone defects, your periodontist can assess whether regenerative bone grafting or guided tissue regeneration is an option.

Is deep cleaning (scaling and root planing) painful?

Because root planing reaches beneath the gumline along sensitive root surfaces, our periodontist numbs the area with local anaesthesia before starting so the procedure is comfortable. Mild root sensitivity to cold liquids and slight gum tenderness for a few days afterward are normal and managed with desensitizing toothpaste and warm saltwater rinses.

How many days do I need in Bangkok for periodontal treatment?

Initial periodontal charting, X-rays, and localized or half-mouth root planing can be completed within 2 to 5 days in Bangkok (often split across two appointments so your whole mouth is not numb at once). Long-term pocket re-evaluation takes place 4 to 6 weeks later either at COSDENT or with your local periodontist at home.

How do I book a periodontal assessment at COSDENT?

Contact COSDENT Smile Design to schedule a gum health and periodontal examination at our Siam or Rama 9 clinic in Bangkok, or check our pricing page for general fee guidance.

Periodontal diagnosis, number of root-planing sessions, prognosis and exact fees are confirmed after full-mouth pocket probing and radiographic assessment.