Gingivitis & periodontitis · Perivale, Ealing
A clear, step-by-step plan for bleeding, swollen or receding gums: an accurate diagnosis, treatment matched to what’s actually happening below the gumline, and long-term care to keep your gums stable.
Bleeding gums assessed, without a referral.
Marisa Lennie · GDC 252605
The short answer
Gum disease is inflammation of the gums caused by a build-up of plaque. In its early stage (gingivitis), the gums may bleed and look swollen. If it progresses to periodontitis, the tissue and bone that support the teeth can be damaged.
Common signs include gums that bleed when you brush or floss, swollen or sore gums, bad breath, and gums that shrink back from the teeth. Smoking and diabetes increase the risk. Early gum disease can usually be managed with professional cleaning and better daily cleaning at home; more advanced gum disease needs cleaning below the gumline.
Treatment follows an internationally recognised, step-by-step approach, explained below. It starts with the foundations, then targets the areas that need more, and finishes with long-term maintenance to keep your gums stable.
From healthy to periodontitis
Gum disease is caused by plaque building up along the gumline. Caught early it’s reversible; left alone, it can damage the bone that holds teeth in place.
Pink and firm, no bleeding when you brush or clean between your teeth.
Keep it that way with daily cleaning and regular check-ups.
Red, swollen or sore gums that bleed when you brush, floss or eat hard foods.
Reversible: better cleaning at home and a professional clean usually settle it.
Bad breath, shrinking gums, deeper pockets, and in time loose teeth.
Bone loss can’t be reversed, but treatment can stop it progressing.
Get an urgent dental appointment for very sore and swollen gums, loose or falling-out teeth, or a lump, ulcer or red patch in your mouth. If you can’t get one, call 111.
Source: NHS (opens in a new tab) and HSE (Ireland’s health service) (opens in a new tab).
Your appointment
Gum treatment is a plan rather than a single appointment. Every stage is explained before it starts.
Book a gum assessmentFull periodontal charting
Pocket depths are recorded around every tooth, along with bleeding, recession and risk factors such as smoking, diabetes and medicines.
02Foundations
Home care & risk factors
We work on brushing and interdental cleaning and talk through risk factors, because treatment below the gumline only works well when daily plaque control is good.
03Treatment
Cleaning below the gumline
Hardened deposits and bacteria are removed from the root surfaces under local anaesthetic, usually over 2–4 appointments.
Re-measuring at 8–12 weeks
We re-measure pockets and bleeding to see how the gums have responded, and decide whether any areas need more treatment or a specialist referral.
05Maintenance
Keeping gums stable
Regular maintenance visits keep the result, every 3 months at first, extending once your readings stay stable.
From the chair
Hearing “gum disease” can be worrying, so I try to explain early on what it means and what we can do about it.
“Will I lose my teeth?”
That’s the first fear for most people. Gum disease can be brought under control with the right treatment and good care at home, and the earlier it’s treated the better. I’ll show you your readings so you can see exactly where things stand, and we’ll make a plan together.
Related: Early gum disease
“My gums don’t hurt, so is it really that serious?”
Gum disease often isn’t painful, which is why it can go unnoticed. Bleeding when you brush is the most common early sign. The pocket measurements tell us what’s happening below the gumline, where you can’t see or feel it.
Related: Bleeding gums
“I smoke. Does that make a difference?”
Yes, it’s one of the biggest risk factors for gum disease, and it can also mask bleeding, so the gums can look healthier than they are. I won’t lecture you, but I’ll explain how it affects your gums and point you to support if you’d like to stop.
Related: Bad breath
Choosing the right visit
Not sure? Book an assessment. Your pocket readings decide the right treatment, and I’ll explain them before anything starts.
Healthy or early
£9545 min
Routine cleaning above the gumline for gingivitis, where the gums are inflamed but no deep pockets have formed.
Best for
Bleeding gums with healthy pocket depths, picked up early.
About Hygiene CleanPeriodontitis
£130per quadrant · 60 min
Cleaning of the root surfaces below the gumline, under local anaesthetic, for periodontitis with pockets deeper than 4 mm.
Best for
Gum disease confirmed at your assessment, treated one quadrant at a time.
Book this visitAfter treatment
£9545 min
Regular supportive care once treatment has settled your gums, so they stay that way.
Best for
Anyone who has completed deep cleaning and reached stable readings.
About Periodontal MaintenancePeriodontal therapy
UK guidance on treating periodontitis, from the British Society of Periodontology, describes four steps. Your plan follows the same structure.
Source: SDCEP (opens in a new tab) and British Society of Periodontology (opens in a new tab).
Explaining your diagnosis, coaching brushing and interdental cleaning, reducing risk factors such as smoking and diabetes, and professional cleaning above and below the gumline.
Targeted cleaning of the root surfaces in deeper pockets, usually under local anaesthetic, with ongoing support for home care.
Any deep pockets that haven’t healed are treated again, or referred to a specialist where that’s the better option.
Regular supportive care to keep gums stable and catch early signs of change, with intervals based on your gum health and risk.
Honest expectations
Gum treatment is very effective when it’s followed through. Being honest about its limits helps you get the most from it.
Cleaning below the gumline is carried out with local anaesthetic, so treatment stays comfortable throughout.
Expect tenderness and sensitivity for a few days, and gums that look slightly shrunken as swelling settles, which is a sign of healing. Lukewarm salt-water rinses help.
Aftercare drawn from SDCEP (opens in a new tab) and NHS (opens in a new tab).
After active treatment, maintenance is usually every 3 months at first. See the NHS for urgent symptoms such as very swollen gums or loose teeth.
Gum Disease Treatment FAQs
Can’t see your question? Email me or call 020 8997 0933.
Bleeding gums when brushing or flossing, swollen or sore gums, bad breath and gums that shrink back from the teeth. In more advanced gum disease, teeth can become loose.
Early gum disease (gingivitis) usually settles with professional cleaning and good daily cleaning at home. Periodontitis can be brought under control and kept stable with treatment and regular maintenance, but bone that has been lost does not grow back.
A deep clean (root surface debridement) is £130 per quadrant, 60 minutes per quadrant. Periodontal maintenance afterwards is £95 per 45-minute visit.
A course of 2–4 appointments, then a review at 8–12 weeks to measure how the gums have responded.
Periodontal therapy is the treatment of gum disease. In the UK it follows four steps: building the foundations of good home care, cleaning below the gumline, managing any areas that haven’t responded, and long-term maintenance.
If your gums are very sore or swollen, a tooth is loose, or you have ulcers or a lump in your mouth, contact a dentist urgently or call NHS 111.
No. You can book a gum assessment with me directly. If you need specialist care, such as gum surgery, I’ll explain why and refer you to a periodontist.
Marisa qualified through the Royal College of Surgeons of England, training clinically at King’s College Hospital, London, and is an Approved Education Supervisor for trainee hygienists & therapists. Diagnosing and treating gum disease without surgery is within the GDC scope of practice for dental hygienists and therapists, and is the work Marisa does most at Bilton Road Dental Practice.
This page is general information about gum disease. Book an urgent appointment, or call NHS 111 if you can’t get one, for very sore and swollen gums, loose teeth, ulcers or red patches that don’t heal, or a lump in your mouth.
Call the practice or send an email to book your appointment.
Bilton Road Dental Practice · 56 Bilton Rd, Perivale, Greenford, London, UB6 7DH
Gum disease treatment in Perivale (UB6), Ealing, for patients from Greenford, Alperton, Sudbury, Hanwell and Northolt.
Can I use analytics cookies?
With your permission, Google Analytics helps me see which pages are useful. It stays off unless you accept, and you can change your choice any time under “Cookie settings” in the footer. Privacy and cookie policy (PDF, opens in a new tab)