What you pay for gum disease treatment depends almost entirely on how far the disease has gone when it is found. Gingivitis is usually dealt with in a routine check-up and clean. Established periodontitis means several longer appointments, regular maintenance afterwards and sometimes surgery, so the bill grows with every stage. That is the practical case for having your gums measured before they start to hurt.
Gum disease is also far more common than most people assume. When the National Study of Adult Oral Health 2017 to 2018 examined Australian adults, about three in every ten had moderate or severe periodontitis (Ha and colleagues, Australian Dental Journal, 2020).
Two conditions with very different outlooks
Gum disease begins when plaque, the soft film of bacteria that forms on teeth daily, is left along the gum line. The gums become inflamed. Plaque that stays put hardens into tartar (calculus), which a toothbrush cannot remove.
Gingivitis is inflammation of the gums only. They look red or puffy and bleed when brushed, but the bone and attachment fibres are intact. It can be fully reversed.
Periodontitis is what happens when the inflammation reaches below the gum line and the fibres and bone holding the tooth start to break down. Pockets form between gum and tooth, bacteria collect in them, and the damage tends to continue until it is treated. Lost bone does not grow back by itself, so the aim of treatment is to stop the disease and keep the teeth stable.
How periodontitis is staged
Since 2018, dentists have used an international classification developed at the World Workshop on periodontal diseases (Tonetti and colleagues, Journal of Periodontology, 2018). Periodontitis is given a stage from I to IV, describing how much support has been lost and how complex treatment will be, and a grade from A to C, describing how quickly it appears to be progressing.
- Stage I is early disease: a small amount of lost attachment and bone, shallow pockets, no teeth lost.
- Stage II is moderate: more bone loss and somewhat deeper pockets, but still no teeth lost to gum disease.
- Stage III is severe: deep pockets and substantial bone loss, sometimes between the roots of back teeth, and some teeth may already have been lost.
- Stage IV is advanced: extensive loss of support that affects chewing and the bite, with several teeth loose, drifting or lost.
The grade is shaped by your history. Smoking and diabetes, for example, push the grade toward faster progression and usually mean shorter gaps between maintenance visits.
Who is more likely to develop it
Plaque is the trigger, but some people's gums break down much more readily than others'.
Smoking
Smoking is one of the strongest risk factors for periodontitis, and smokers often respond more slowly to treatment. It also reduces gum bleeding, which can hide the most obvious warning sign. Quitting improves the outlook at any age.
Diabetes
Diabetes and gum disease affect each other. Diabetes raises the risk of periodontitis starting and worsening, and treating periodontitis can modestly lower HbA1c. Our article on gum disease and diabetes covers the research.
Family history
Some people inherit a stronger inflammatory response. If a parent lost teeth to gum disease, your dentist or OHT may suggest more frequent maintenance even if your home care is good.
Hormonal changes
Pregnancy, puberty and other hormonal shifts make the gums react more strongly to plaque. Pregnancy gingivitis is common and usually settles after the birth.
Medicines and dry mouth
Some blood pressure medicines in the calcium channel blocker group, some anti-seizure medicines and some immunosuppressants can cause the gums to overgrow, creating areas that trap plaque. Many other medicines reduce saliva, which also favours plaque. Tell your dentist about everything you take.
Crowded teeth and stress
Overlapping or tilted teeth are harder to clean, so gum problems often start there first. Long-term stress is also thought to weaken the gums' response to plaque, and a painful form of gum infection called necrotising gingivitis is associated with stress, smoking and poor general health.
Signs that deserve a dental visit
Early gum disease is usually painless, so the signs are things you see rather than feel:
- bleeding when you brush or floss, even a little pink when you spit
- gum edges that look red, swollen or shiny rather than pale pink and firm
- bad breath or a bad taste that keeps coming back; see our guide to bad breath
- teeth that look longer because the gums have shrunk back, covered in our receding gums guide
- sensitivity near the gum line, which our article on sensitive teeth explains
- a change in your bite or a tooth that feels loose
Pus, a throbbing ache or a tender swelling beside a tooth may be a gum abscess and should be seen promptly. Healthdirect advises seeing a dentist if your gums still bleed after three to four days of good brushing and flossing.
What a gum assessment involves
A dentist or OHT uses a thin, marked probe to measure the gap between gum and tooth at several points around each tooth. Healthy gaps are shallow, usually up to about 3 mm, and do not bleed when measured. Deeper pockets and bleeding point to active disease. X-rays show how much bone remains, and the dentist also records recession and any looseness. These findings give your stage and grade, and they become the baseline for checking whether treatment has worked.
Treatment at each stage, and what drives the cost
Fees for gum treatment are charged per item, using the item numbers in the Australian Dental Association's schedule of dental services, so the total depends on how much needs to be done. The main items are below. As a typical market range, not a Lumi fee, a routine check-up and clean in Sydney costs about $200 to $400. Deeper treatment is priced per tooth or per procedure, so it is best quoted after an examination.
| Treatment | Usual ADA items | When it is used | What changes the cost |
|---|---|---|---|
| Examination and X-rays | 011, 022, 037 | Baseline assessment | Number and type of X-rays |
| Periodontal charting | 221 | Measuring and recording the pockets around every tooth | Usually charged once per assessment |
| Scale and clean | 114, with 121 if fluoride is applied | Gingivitis and routine care | Amount of tartar |
| Periodontal debridement (deep clean) | 222, charged per tooth | Periodontitis, stages I to III | Number of teeth with pockets |
| Treatment of an acute gum infection | 213 | A gum abscess or flare-up | Number of appointments |
| Periodontal surgery, regeneration or gum grafts | Surgical periodontal items | Deep pockets that do not respond to cleaning, selected bone defects, recession | Number of teeth, type of procedure and materials |
| Supportive periodontal therapy | Usually 221, 222 or 114 | Maintenance after active treatment | How often you need it |
A whole course of active treatment for moderate or severe periodontitis therefore costs considerably more than a single clean, and surgery adds further. After your examination you will usually receive a written treatment plan with item numbers and fees, often by email, which you can take to your health fund for a quote. Our dental cleaning cost guide covers routine cleans in more detail.
Health funds and Medicare
Many extras policies include periodontal items, usually under general or major dental cover, with annual limits and waiting periods that vary between funds. Ring your fund with the item numbers before treatment. At Lumi Dental, health fund claims are processed on the spot through HICAPS.
Medicare does not cover routine adult dental care. Eligible children aged 0 to 17 may be covered under the Child Dental Benefits Schedule, which in 2026 provides a benefit cap of $1,158 over two calendar years for eligible families.
Gingivitis reverses; periodontitis can be stopped
Gingivitis usually clears after a professional clean removes the tartar and you keep up thorough brushing and cleaning between the teeth. Nothing permanent is left behind.
Periodontitis is different. Treatment removes the bacteria and deposits from the root surfaces so the gums can tighten and pockets can shrink, but the bone already lost does not return on its own. Regenerative surgery can rebuild some bone in selected defects. For most people the realistic goal is to stop further loss, and with good home care and regular maintenance many people keep their teeth for the long term.
Treatment usually runs over several visits, followed by a review a few months later to remeasure the pockets. After that come maintenance appointments, often more frequent than routine six-monthly check-ups, at an interval set by your dentist or OHT.
Daily habits that keep gums healthy
The routine that prevents gum disease is the same one that heals early gingivitis.
Brush twice a day for about two minutes with a soft brush, angling the bristles toward the gum line and using gentle, small movements. An electric toothbrush can help; a Cochrane review (Yaacob and colleagues, 2014) found that powered brushes reduced plaque and gingivitis modestly compared with manual ones.
Clean between your teeth once a day with floss, interdental brushes or a water flosser, whichever you will keep using. Use a fluoride toothpaste, and after brushing spit out the excess rather than rinsing with water so the fluoride stays on the teeth. Replace your toothbrush about every three months, or sooner if the bristles splay.
Keep your check-ups, avoid smoking, and work with your doctor on conditions such as diabetes. If you are anxious about dental visits and have been putting them off, our dental anxiety guide explains ways to make appointments easier.
Questions about gum disease and its cost
Can I fix gum disease at home?
Better cleaning can settle gingivitis, but any tartar has to be removed professionally first, because brushing cannot shift it. Periodontitis always needs professional treatment.
Is gum disease painful?
Usually not until it is advanced. Pain, swelling or pus can mean an abscess and needs prompt care.
Will I lose teeth?
Not necessarily. Early and moderate periodontitis that is treated and maintained often stays stable. The risk of tooth loss is higher in advanced disease, in smokers, in people with poorly controlled diabetes and in people who stop attending maintenance.
How can I keep the cost down?
Have your gums checked regularly so problems are found at the gingivitis stage, and keep up maintenance after treatment so you do not need to repeat a full course.
Getting a clear picture of your gums
If it has been a while since your last clean, or your gums have been bleeding and you have been hoping it will settle, one visit can show where you stand and what, if anything, needs doing. Lumi Dental at Melrose Central in Melrose Park offers gum assessments and hygiene-focused care with our dentists and oral health therapists. See our general dentistry page for more.
