Gum Disease Treatment in Koramangala, Bengaluru

The disease nobody comes in for

Almost nobody books an appointment because their gums bleed. They book because a tooth hurts, and the bleeding gums get mentioned on the way out, as an afterthought, usually with the phrase “that is normal for me”.

It is not normal. Healthy gum does not bleed when a toothbrush touches it, any more than healthy skin bleeds when a towel touches it. Bleeding is inflammation, inflammation is a response to bacteria sitting undisturbed at the gum margin, and the process that follows is slow, painless and the single most common reason adults in India lose teeth that had nothing else wrong with them.

The painlessness is the problem. A cavity announces itself. Gum disease removes the bone that holds a tooth in place over ten or fifteen years without ever hurting, and then one day a molar is mobile and it is far too late to do anything useful.

Two stages, and only one of them is reversible

This is the most important thing on this page, so it comes before the treatment.

Gingivitis is inflammation of the gum only. The gums are red, puffy and bleed easily. No bone has been lost. It is completely reversible: a proper cleaning plus a change in daily technique returns the gum to health within a few weeks, with nothing permanently lost.

Periodontitis is what gingivitis becomes when it is left. The inflammation has moved past the gum into the bone, the fibres attaching the tooth to the bone have broken down, and a pocket has formed between the gum and the root. Bone that has gone does not come back. Treatment stops the loss and stabilises what is left, which is genuinely worth having, but it cannot undo what already happened.

Which of the two you have is not a matter of opinion, and it is not something anyone can tell by looking at your gums for five seconds. It is measured.

How we measure it, before we treat anything

At the first appointment we chart pocket depths at six points around every tooth with a graduated probe, and take X-rays that show the level of bone between the teeth.

A healthy sulcus measures one to three millimetres. Four is borderline. Anything at five or above is a pocket that a toothbrush has never cleaned in its life and never will, because the bristles do not go there.

You see the chart, and you see the X-rays. It takes about twenty five minutes, and it is the entire basis for what is recommended afterwards. A clinic that proposes gum surgery without doing this has not measured anything.

Deep cleaning, which is where most cases end

For the majority of patients, treatment is scaling and root planing, and nothing more.

This is not the six-monthly cleaning. That one cleans what is visible. This one cleans the root surface inside the pocket, below the gum, under local anaesthesia, with ultrasonic and hand instruments, removing the hardened deposit and the contaminated layer of root surface that the bacteria are living on. It takes around forty five minutes per quadrant, which is why we usually split it across appointments rather than asking you to sit through the whole mouth in one sitting.

Then we wait. Six to eight weeks later the pockets are charted again, and in most cases the numbers have come down, the bleeding has stopped and the gum has tightened back against the teeth. That is the end of active treatment, and you move onto a maintenance interval.

Flap surgery, for the pockets that do not respond

Some pockets are too deep for any instrument to clean properly without being able to see the surface it is cleaning. If the re-charting shows those, flap surgery is what solves it.

Under local anaesthesia, the gum is lifted back a few millimetres so the root surface and the bone defect underneath are directly visible. They are cleaned under vision rather than blind, any granulation tissue is removed, and where a defect is the right shape a graft material can be placed in it. The gum is then repositioned and closed with fine sutures, which come out after about a week.

It is done at the clinic, under the same local anaesthesia used for a filling, and it takes around an hour per area. The decision to do it is always made from re-charted numbers after the cleaning, never on the first day, because a large number of pockets that look surgical at the first appointment are not surgical at the second.

The laser

We have a soft tissue laser, and it is useful here: less bleeding during soft tissue work, and a more comfortable first few days afterwards than a blade. It is a tool inside the treatment, not a treatment of its own. Nobody should be sold “laser gum treatment” as a substitute for cleaning the root surface, because the cleaning is what works.

Maintenance is the actual treatment

Gum disease is managed, not cured. Someone who has had periodontitis is someone whose gums will do it again if the plaque is left undisturbed, so the interval between cleanings is set from your own re-charted numbers rather than from the standard six months. For some patients that is three-monthly for a year, then longer.

We will also size interdental brushes to your actual gaps and show you how to use them. This is not filler advice. Between-tooth cleaning is where gum disease begins and ends, and a brush sized in a chemist by guesswork is usually the wrong one.

Where we are

Tooth District is in S.T Bed Layout, Koramangala 4th Block, on Koramangala 1st Main Road just off 80 Feet Road. Patients come to us from across Koramangala, Ejipura, Jakkasandra, Adugodi, HSR Layout and BTM Layout, and regularly from Indiranagar, Domlur and HAL.

If your gums have been bleeding for months, or a tooth has started to feel loose, that is worth an appointment this week rather than at your next cleaning.