ENGums bleed, teeth look longer and feel loose, and the dentist at home says nothing can be done or suggests removing everything for dentures. Periodontitis treatment in Germany follows a step-by-step scheme whose aim is to stop the inflammation and keep the teeth as far as possible.
Below: what happens to the gums, diagnosis, treatment steps, supportive therapy, who treats the disease, costs and arrangements. There are no promises here to “grow gums back”: treatment aims to stop the disease and keep what is left.
Gum disease explained: what happens in periodontitis
What is often called “gum disease” or “receding gums” is in most cases periodontitis: chronic inflammation of the tissues holding the tooth — gum, bone and the fibres anchoring the root. Pockets form under the gum, bacteria collect in them and the bone around the root is gradually lost.
The main cause is plaque and tartar below the gum line. Smokers fall ill more often and more severely and respond worse to treatment. The link with diabetes works both ways: poorly controlled blood sugar worsens periodontitis, and untreated periodontitis makes blood sugar harder to control, so diabetes treatment in Germany and gum care are best coordinated. Heredity plays a part too. The disease rarely hurts and progresses slowly, so it is often noticed only when teeth loosen.
Diagnostics: measuring the pockets and imaging
The diagnosis rests on a periodontal chart covering every tooth. With a thin graduated probe the dentist measures pocket depth at several points around each tooth, notes bleeding and checks mobility. In plain words: deeper pockets mean more advanced disease, bleeding means active inflammation, mobility means lost support.
X-rays show how much bone remains; where needed, a cone beam CT adds a three-dimensional image of the jaw. The findings set a stage and a grade: the stage (I to IV) reflects how far the damage has gone and how complex the case is, the grade (A, B or C) how fast the disease progresses, and smoking or poorly controlled diabetes raise it. Both shape the plan. Bring existing X-rays: they show how fast bone was lost.
How periodontitis is treated: step-by-step therapy
Periodontitis is treated in steps, each building on the last. Step one is professional cleaning, home-care instruction and tackling risk factors: stopping smoking, controlling blood sugar. Step two is cleaning the root surfaces below the gum under local anaesthetic, often called deep scaling: plaque and tartar are removed without incisions, and the gum itself is not deliberately scraped. German dentists follow the clinical guideline of the German Society of Periodontology (DG PARO).
Step three is for deep pockets that remain after healing: gum surgery, opening the gum under local anaesthetic to clean the roots under direct vision. In selected cases, such as bone lost in a narrow crater along the root or an affected area between a molar’s roots, tissue regeneration with membranes or an enamel matrix protein gel is used. Surgery makes sense only with thorough cleaning at home, and regained tissue is not promised in advance.
Antibiotics are only an add-on where indicated, for example in severe disease in young patients, taken alongside root cleaning, never instead of it. Nor do lasers or “miracle pastes” replace the core treatment, mechanical cleaning.
Supportive therapy and what happens to lost teeth
Periodontitis is chronic, so active treatment is followed by regular check-ups for life: supportive periodontal therapy, UPT in German. The dentist checks the pockets, cleans professionally and sets the frequency of visits by risk. At home: brushing twice a day and daily cleaning between the teeth with interdental brushes or floss; mouthwash does not replace the brush. Without supportive therapy the disease returns.
If teeth are already lost, prosthetics and implants are discussed only once the inflammation is under control; the options are covered on the page about dental treatment in Germany.
Who treats periodontitis in Germany and what it costs
Periodontitis is treated by dentists with advanced training in periodontology and by university centres. The German Society of Periodontology (DG PARO) awards the title of specialist in periodontology (DG PARO-Spezialist für Parodontologie®) after several years of training and an examination before a society committee. Charité Berlin has a Department of Periodontology, Oral Medicine and Oral Surgery; the University Hospital Hamburg-Eppendorf and the University Hospital Dresden have dental centres (Zentrum für Zahn-, Mund- und Kieferheilkunde) with periodontology units.
No price can be quoted before an examination: for self-paying patients the bill follows the official dentists’ fee schedule (GOZ) and depends on the number of teeth and pockets, any surgery and follow-up visits. A written plan with a cost estimate comes first: if insurance does not cover the costs, the dentist must by law state the expected costs in writing beforehand. How dental prices in Germany work is explained separately.
Frequently asked questions
Can periodontitis be cured?
It can be stopped, but not cured for good: periodontitis is chronic. Treatment can halt tissue destruction and clearly improve the gums, but damage already done does not reverse on its own, and regeneration helps only in selected cases. Supportive therapy and home care keep the result.
Do teeth with periodontitis have to be extracted?
Not necessarily: treatment aims to keep the teeth, and the decision is made tooth by tooth. The dentist weighs pocket depth, bone loss, mobility and, finally, how the tooth responds to treatment. A tooth that cannot be saved may be extracted; replacements come once the inflammation is under control.
Is periodontal treatment painful?
Usually not: root cleaning and gum surgery are done under local anaesthetic, so the procedure itself should not hurt. Afterwards the gums need time to heal and may be sensitive; the dentist explains how to brush and what to eat in those days. Mention any fear of treatment beforehand.
How AlenMed arranges periodontitis treatment
AlenMed starts before the trip: X-rays and reports are translated and sent to the dentist with photos of the teeth. The dentist then estimates how many visits are needed: healing time passes between root cleaning and assessing the result, so treatment is planned over several trips or a longer stay.
Then come appointments, the clinic’s cost estimate, a visa invitation, accommodation and an interpreter. AlenMed’s office is in Munich; how arranging treatment in Germany works is described separately.
Afterwards the patient receives records in their own language and a supportive therapy plan to continue with their dentist at home; contact with the German dentist stays open.
This material is for information only and is not an offer. The treatment plan is set by the dentist at an in-person appointment.