Will my gum disease come back?

If untreated periodontitis bone loss does not return on its own — but with maintenance neglect, **inflammation can recur**. With 3- to 6-month follow-ups, recurrence rate is < 10 %; without follow-up, it can exceed 50 %. Maintenance is the most important step.

Can my gums grow back?

Mucosal recession does **not** spontaneously regrow. It can be reconstructed with **gum graft surgery** (CTG, FGG). Bone loss can be partially recovered with **bone grafts and GBR**.

Why do my gums bleed when brushing?

The most common cause is **gingivitis** (early gum disease). Hormonal changes (pregnancy, puberty), some medications (anticoagulants), and systemic conditions (diabetes, leukemia) can also cause it. Detail: [Bleeding gums causes](/en/blog/bleeding-gums-causes).

Is scaling harmful to teeth?

No. Scaling **does not damage tooth enamel** — it only removes calculus deposits. The mild sensitivity that follows is **normal** and resolves in a few days. Detail: [Dental scaling and cleaning](/en/blog/dental-scaling-cleaning).

How long does periodontal surgery take to heal?

For flap surgery, the gums close visibly in **1–2 weeks**, full healing takes **6–8 weeks**. With grafts, soft-tissue maturation may take **6 months**.

Does smoking affect periodontology?

Yes, **dramatically**. Smoking: - Triples the risk of periodontitis - Reduces healing rates by 40–60 % - Lowers regenerative procedure success - Increases peri-implantitis risk (5x) Detail: [Smoking and dental implants](/en/blog/smoking-and-dental-implants).

Will my teeth become loose?

In severe periodontitis, bone loss + tissue destruction can produce mobility. With early intervention, **mobility can be reduced or stabilized**. Splinting + occlusal adjustment + bone regeneration are part of the treatment.

Can periodontology save my tooth?

Yes — even with severe periodontitis, **70–80 % of teeth can be preserved** with the right protocols (combined with implants, one of the highest tooth-preservation success rates).

Can pregnant women receive periodontal treatment?

Yes. **Routine cleaning + non-surgical treatment** is safe in pregnancy. **Surgical procedures** are typically delayed until after delivery (unless urgent). Detail: [Dental X-ray during pregnancy](/en/blog/dental-xray-during-pregnancy).

Does diabetes affect periodontal treatment?

A two-way relationship — uncontrolled diabetes worsens periodontitis; periodontal infection raises HbA1c. **Glycemic control** is critical before treatment. Aim for HbA1c < 7 %.

How long does periodontal treatment take?

- Stage 1 (initial phase, non-surgical): **2–4 sessions** - Stage 2 (re-evaluation): 1 session - Stage 3 (surgical, if needed): **2–6 sessions** (case-dependent) - Total: **3–9 months**, including healing

How is the maintenance program structured?

- 3-month follow-ups (high-risk: smoking, diabetes, severe periodontitis) - 6-month follow-ups (low-risk: gingivitis history, mild periodontitis) - Each visit: pocket measurement, professional cleaning, instruction reinforcement

Is periodontal treatment painful?

With modern local anesthesia, scaling and most procedures are **painless**. Mild soreness is normal in the first 2–3 days post-surgery — typically managed with paracetamol. Severe pain is uncommon and warrants follow-up.

Is laser treatment effective?

Laser is a useful **supportive** tool — but not a stand-alone treatment. In randomized studies, laser-assisted SRP shows ~10–15 % more pocket-depth reduction than conventional SRP, with shorter-term benefit. Long-term outcomes are similar.

Can periodontology fix gummy smile?

Yes. **Gummy smile** has multiple causes: - Excessive gum display → **gingivectomy** - Short clinical crown → **crown lengthening** - Hyperactive upper lip → **botulinum toxin** (lip; not periodontology) - Skeletal upper jaw excess → **orthognathic [oral surgery](/en/blog/oral-surgery-guide)** Treatment is selected after detailed analysis. ---

Periodontal Treatment in Istanbul

✍️ Authored by: Dr. Aykut Gürel — Specialist in Oral, Dental and Maxillofacial Surgery 10+ years of clinical experience in periodontal surgery (bone grafts, sinus lifts, gum grafts) and peri-implantitis management. Multidisciplinary approach with periodontists in complex cases. Last updated: 7 May 2026

What Is Periodontology? — 60-Second Answer

Periodontology = the specialty that studies the gums, bone, and all the tissues holding teeth in place
Periodontist = a dentist with 3–4 years of additional specialty training (PhD or board specialty in Türkiye)
Gum disease = ~80 % of periodontology cases
Early diagnosis = critical for preventing tooth loss (periodontitis is the #1 cause of adult tooth loss in Türkiye)
Treatment range = from professional scaling to surgical bone and gum grafts

💡 Important: Periodontology is not only gum disease treatment; it also covers peri-implant tissue protection, gum aesthetics (gummy smile, pink aesthetics) and the systemic links between oral inflammation and diabetes / cardiovascular disease.

Periodontist vs General Dentist

Topic	General Dentist	Periodontist
Education	5-year dental school	5 years + 3–4 years periodontology specialty
Scope	Basic gum treatment, scaling	Advanced surgery, grafts, bone regeneration
Conditions	Gingivitis, simple curettage	Periodontitis, peri-implantitis, mucogingival surgery
Surgical approach	Limited	Flap surgery, bone graft, gum graft, laser

Routine gum care is performed by the general dentist; bone-loss + surgery cases are referred to a periodontist or oral surgeon.

Scope of Periodontology

1. Gum Diseases (Gingivitis & Periodontitis)

Gingivitis is the early-stage inflammation that affects only the gum surface. It is reversible — proper oral hygiene + a professional cleaning resolves it in 2–3 weeks.

If untreated, it progresses to periodontitis — inflammation that extends to bone, causing gradual bone loss and ultimately tooth mobility. Periodontitis is not fully reversible, but it can be controlled and stabilized.

Stage	Bone Loss	Symptoms
Gingivitis	None	Bleeding gums, redness, swelling
Mild periodontitis	< 15 %	Pocket depths 4–5 mm, mild bleeding
Moderate periodontitis	15–33 %	Pocket depths 5–7 mm, gum recession beginning
Severe periodontitis	> 33 %	Tooth mobility, deep pockets > 7 mm, abscesses

2. Peri-Implantitis

Inflammation around dental implants — analogous to periodontitis but on implants. It threatens implant longevity. Periodontology applies surgical decontamination + bone regeneration protocols.

3. Mucogingival Surgery

Gum recession treatment — connective tissue grafts, FGG (free gingival graft), CTG (connective tissue graft)
Crown lengthening — for "short tooth" appearance or pre-restorative purposes
Frenectomy — releasing high muscle attachments

4. Bone Regeneration

Bone grafts (autograft, allograft, xenograft)
GBR (Guided Bone Regeneration) — membranes + bone substitutes
Sinus lift — for posterior maxillary implant cases (detail)

5. Pink Aesthetics

Treatment of gummy smile (excessive gum display)
Smile-design support — gum contour symmetry
Botulinum toxin for high-lip-line gummy smile (in collaboration with maxillofacial surgery)

Periodontology Treatment Steps

Stage 1: Diagnosis

Clinical examination — pocket depth measurement at 6 sites per tooth
Bleeding on probing index
Mobility scoring
Periodontal X-ray (panoramic + periapical)
3D dental tomography (CBCT) for advanced surgical cases (detail)
Risk-factor screening: smoking, diabetes, family history

Stage 2: Initial Phase (Non-Surgical)

Professional scaling (supragingival)
Root planing / SRP (subgingival)
Local anesthesia if needed
Antibacterial irrigation (chlorhexidine)
Patient training: proper brushing technique, interdental brushes, flossing

80 % of patients respond fully to this stage and need no surgery.

Stage 3: Re-Evaluation (4–6 weeks later)

Pocket depths re-measured
Bleeding rate re-checked
Decision: maintenance program OR surgical phase

Stage 4: Surgical Phase (if needed)

Flap surgery — open access to root surfaces
Bone grafts — to fill defects with biocompatible material
GBR — guided bone regeneration with membranes
Connective tissue graft — for gum recession
Laser-assisted treatment — selected cases

Stage 5: Maintenance (Long-Term)

3-month checkups (high-risk patients)
6-month checkups (low-risk patients)
Lifelong follow-up

Periodontal Treatment Prices 2026 (Istanbul)

Procedure	2026 Price (EUR / USD)
Scaling (full mouth)	€60 – €120 / $65 – $130
SRP — Root planing per quadrant	€100 – €180 / $110 – $200
Gingivectomy (per region)	€110 – €220 / $120 – $240
Gum graft (per tooth)	€280 – €560 / $310 – $610
Bone graft (per region)	€330 – €670 / $360 – $730
Sinus lift	€560 – €1,400 / $610 – $1,520
Peri-implantitis surgery	€440 – €1,100 / $480 – $1,200
Crown lengthening	€170 – €340 / $185 – $370
Maintenance (3-month checkup)	€60 – €120 / $65 – $130

💡 Pricing factors: number of sites, graft material brand, regenerative membranes used, complexity, anesthesia type.

ℹ️ Insurance: SRP and routine cleaning may be partially covered by Turkish national insurance (SGK); surgical periodontology and grafts are typically self-pay. International private insurance varies — most aesthetic periodontal work is out of scope.

Periodontal Disease & Systemic Health

The mouth–body connection is well-documented in periodontology:

Systemic Condition	Periodontal Link
Diabetes	Bidirectional — uncontrolled diabetes worsens periodontitis; periodontitis worsens glycemic control
Cardiovascular disease	Chronic gum inflammation correlates with atherosclerotic risk
Pregnancy	Gum inflammation increases preterm-birth risk
Rheumatoid arthritis	Inflammatory crossover (P. gingivalis bacteria)
Alzheimer's	Recent studies show oral bacteria in the brain

Implication: Periodontology is not just dental care — it is an integral part of overall health.

When Should You See a Periodontist?

Bleeding gums when brushing
Visible gum recession (longer-looking teeth)
Bad breath (halitosis)
Pus from the gums
Tooth mobility
Family history of periodontitis
Diagnosis of diabetes
Existing implants — peri-implant maintenance

💡 Maintenance is critical: patients with treated periodontitis must continue 3- to 6-month follow-ups for life. Skipping this raises the recurrence rate from < 10 % to over 50 %.

Periodontology and Implant Treatment

Implant placement and periodontology overlap in three areas:

Pre-implant evaluation: Periodontal stability is mandatory before implants. Active inflammation is treated first.
Bone preservation: Bone grafts and sinus lifts prepare insufficient bone before implants.
Peri-implant maintenance: After implant placement, regular periodontal cleaning prevents peri-implantitis (the leading cause of late implant failure).

Academic References

The medical content in this guide draws on the following independent academic sources:

Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: framework and proposal of a new classification. Journal of Periodontology, 2018. https://pubmed.ncbi.nlm.nih.gov/29926951/
Renvert S, Persson GR, Pirih FQ, Camargo PM. Peri-implant health, peri-implant mucositis and peri-implantitis: case definitions and diagnostic considerations. Journal of Clinical Periodontology, 2018. https://pubmed.ncbi.nlm.nih.gov/29926496/
Sanz M, Marco Del Castillo A, Jepsen S, et al. Periodontitis and cardiovascular diseases: consensus report. Journal of Clinical Periodontology, 2020. https://pubmed.ncbi.nlm.nih.gov/32011025/
Sanz M, Ceriello A, Buysschaert M, et al. Scientific evidence on the links between periodontal diseases and diabetes. Diabetes Research and Clinical Practice, 2018. https://pubmed.ncbi.nlm.nih.gov/29209669/
Cobb CM, Sottosanti JS. A re-evaluation of scaling and root planing. Journal of Periodontology, 2021. https://pubmed.ncbi.nlm.nih.gov/33484158/
Berglundh T, Armitage G, Araujo MG, et al. Peri-implant diseases and conditions: consensus report of workgroup 4. Journal of Clinical Periodontology, 2018. https://pubmed.ncbi.nlm.nih.gov/29926495/

For a comprehensive periodontal evaluation and treatment plan (gum disease, bone loss, gum recession, peri-implantitis), contact Derya Dental Clinic in Maltepe, Istanbul. Get in touch or schedule via WhatsApp.

Last updated: 7 May 2026 — Medical review: Dr. Aykut Gürel.

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This content is for informational purposes only and does not replace medical diagnosis or treatment. Please consult a specialist for decisions about your oral and dental health.

Periodontal Treatment in Istanbul: Gum Disease, Bone Loss & Surgery (2026)