Gum health
Gum disease treatment and deep cleanings: treatment options and what affects the cost
Treatment for gum disease ranges from a routine cleaning for healthy gums to scaling and root planing (deep cleaning) and ongoing periodontal maintenance. Which you need depends on gum measurements and X-rays, not preference.
No public price is listed for this treatment. Fees depend on your exam, and offices confirm whether they provide it.
What the treatment is
Gingivitis is inflammation of the gums, often with bleeding when brushing, without bone loss. It is usually reversible with professional cleaning and better home care.
Periodontitis is infection that has damaged the bone and attachment holding the teeth, creating pockets between the gums and teeth. It needs scaling and root planing: cleaning the root surfaces below the gumline, usually with local anesthetic, one or two quadrants at a time.
After treatment, patients with periodontitis usually move to periodontal maintenance visits, which are more involved than routine cleanings and often every three to four months.
Why it may be recommended
- Bleeding, swollen or receding gums, bad breath or loose teeth.
- Gum pocket measurements deeper than normal, with bone loss on X-rays.
- Gum disease is linked with diabetes and other health conditions, so controlling it matters beyond the mouth.
Treatment types and variations
Tap a type to see when it is used and what to weigh. Your dentist recommends options after examining you.
From healthy gums to periodontitis
Prophylaxis (routine cleaning)For healthy gums or mild gingivitis.
- Codes to ask about
- D1110
Gingivitis treatment with generalized inflammationA more involved full-mouth cleaning when inflammation is moderate or severe but there is no bone loss.
- Codes to ask about
- D4346
Full-mouth debridementGross removal of heavy tartar so the gums can be properly measured at a later visit.
- Codes to ask about
- D4355
Scaling and root planing, four or more teeth per quadrantDeep cleaning of a quadrant with widespread pockets.
- Codes to ask about
- D4341
Scaling and root planing, one to three teeth per quadrantDeep cleaning limited to a few teeth.
- Codes to ask about
- D4342
Local antibiotic placementMedicine placed into specific deep pockets after deep cleaning.
- Codes to ask about
- D4381
Periodontal maintenanceOngoing cleanings after periodontal treatment.
- Codes to ask about
- D4910
Gum surgeryFor pockets that do not respond to deep cleaning. See the gum surgery guide.
Materials and techniques
- Ultrasonic and hand instruments
- Remove tartar and bacteria from root surfaces.
- Local antimicrobials
- Placed in pockets in some cases.
Benefits, limitations and possible risks
Benefits
- Can stop or slow gum disease.
- Reduces bleeding and inflammation.
- Helps keep teeth longer.
Limitations
- Bone that has been lost does not usually grow back with cleaning alone.
- Results depend heavily on home care, smoking and health conditions.
- Periodontitis is managed, not cured; maintenance visits are ongoing.
Possible risks
- Tenderness and sensitivity for several days.
- Gums may appear to recede as swelling goes down.
- Temporary bleeding.
What happens during treatment
- 1
Periodontal exam
Pocket measurements, bleeding points and X-rays.
- 2
Numbing
Local anesthetic for deep cleaning.
- 3
Scaling and root planing
Usually one or two quadrants per visit.
- 4
Re-evaluation
Pockets are measured again after several weeks.
- 5
Maintenance
Regular periodontal maintenance visits.
Recovery and maintenance
- Soreness and sensitivity for a few days.
- Brush and floss gently but thoroughly; interdental brushes may be recommended.
- Do not skip re-evaluation and maintenance visits.
What affects the cost
- Diagnosis
- Routine cleaning, gingivitis treatment and deep cleaning have different fees.
- Number of quadrants
- Scaling and root planing is priced per quadrant.
- Local antibiotics
- Priced per tooth.
- Maintenance interval
- Every three to four months is common, which affects yearly cost.
Common additional charges
These are billed separately at many offices. Not every patient needs them.
| Comprehensive periodontal exam and X-rays | Needed for diagnosis. |
|---|---|
| Local antibiotic | Per tooth treated. |
| Re-evaluation visit | Sometimes billed. |
Procedure fee or total case cost?
A deep cleaning case is often four quadrant fees plus exam, X-rays and any local antibiotics, followed by ongoing maintenance visits. Ask for the first-year total.
Paying with insurance or without insurance
Most dental plans cover gum disease treatment as a basic service after the deductible, with frequency limits on maintenance. Without insurance, ask for per-quadrant fees and the maintenance fee.
Alternative treatments
Alternatives depend on your teeth and health. Ask your dentist to explain the trade-offs of each option, including doing nothing.
- Routine cleaning
- Not adequate for periodontitis; tartar below the gumline remains.
- Gum surgery
- For pockets that remain deep after non-surgical treatment.
Codes to ask your insurer about
Insurers price treatment by ADA CDT procedure code. The office confirms the exact code for your treatment; labels here are plain-English summaries.
| D1110 | Prophylaxis (routine cleaning), adult |
|---|---|
| D4346 | Scaling with generalized moderate or severe gum inflammation, full mouth |
| D4355 | Full-mouth debridement to allow an exam at a later visit |
| D4341 | Scaling and root planing, four or more teeth per quadrant |
| D4342 | Scaling and root planing, one to three teeth per quadrant |
| D4381 | Local delivery of antimicrobial agent, per tooth |
| D4910 | Periodontal maintenance |
| D0180 | Comprehensive periodontal evaluation |
Questions to ask your dentist
- What are my pocket measurements, and can I see the X-rays?
- How many quadrants need treatment?
- How often will I need maintenance visits afterwards?
- Is this done by the hygienist, dentist or a periodontist?
Frequently asked questions
Why do I need a deep cleaning instead of a regular cleaning?
When pockets and bone loss are present, tartar sits below the gumline on the roots, where a routine cleaning does not reach. Your gum measurements and X-rays show whether this applies.
Does insurance cover deep cleanings?
Most plans cover scaling and root planing as a basic service and periodontal maintenance with frequency limits. A pre-treatment estimate helps.
Related procedures
- Dental exam and cleaningA full exam checks your teeth, gums, bite and mouth tissues. A cleaning removes plaque and tartar that brushing misses. X-rays and the type of cleaning you need affect the total.
- Gum surgery and graftsGum surgery treats pockets that do not respond to deep cleaning, covers exposed roots with grafts, or exposes more tooth for a crown. Usually done by a periodontist and priced per tooth or quadrant.
- Dental implantsAn implant replaces a missing tooth root with a post placed in the jawbone, topped with an abutment and a crown, bridge or denture. It is usually priced as several parts, which is why quotes vary so much.