Most people are able to keep their gums healthy by brushing and flossing regularly and seeing the dentist once or twice a year for scaling. Scaling is a harmless and easy procedure where the teeth are cleaned with an instrument to remove any tartar (also known as calculus or tooth stones). Tartar is a hard substance that forms naturally on the teeth. It's not harmful however it causes a problem as it allows bacteria to live underneath it next to the gums and patients are not able to brush underneath it and clean the bacteria away properly. It's this bacteria that can go on to cause gum and periodontal disease. 

At each visit your gums will be examined and if you are showing any worrying signs that gum disease may be affecting you, your options will be discussed. 

If basic scaling is required that will be provided as part of the NHS treatment but not necessarily on the same day as your examination. 

The basic NHS scaling does not include removal of heavy staining there are private cleaning options available which can remove heavy stains and brighten up your smile should you wish. 

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Gum disease/ periodontal disease

Gum disease is the process that causes disappearance of the tissues that hold the teeth in. The end result of this process is tooth loss. Certain individuals are genetically predisposed to this condition and certain lifestyle factors & medical conditions such as diabetes, poor oral hygiene and smoking can exacerbate the condition. In individuals that are suffering from gum disease there are treatment options available to help slow down or even stop the condition from progressing however it's usually not possible to reverse the damage that has already happened. 

The health service provides some treatment for this condition. Usually this involves an initial visit to identify the extend of the condition and discuss the causes and follow up visits to clean in targeted areas that the condition has affected. Often this is done using local anesthetic to numb these areas. In less severe cases this may achieve good results when combined with excellent oral hygiene at home and regular visits for gum treatment (usually every 3 months)  however in advanced cases you will achieve much more reliable results by seeing a periodontal specialist. Usually this will need to be arranged privately. Speak to your dentist about your options and potential referral.