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Gum disease and periodontitis: treatment and implants
Gum disease and periodontal treatment in Tunisia: gingivitis, periodontitis, grafts and implants

Gum disease and periodontal treatment in Tunisia: gingivitis, periodontitis, grafts and implants

In short: Bleeding gums are not a minor detail. Gingivitis, the reversible inflammation of the gums, can progress to periodontitis, a chronic infection that destroys the bone holding the teeth and is a leading cause of tooth loss in adults. Treatment starts with better cleaning at home and professional scaling and root cleaning, sometimes followed by gum surgery or grafts, and always continues with lifelong maintenance. Periodontitis must be under control before implants, crowns or veneers, because it increases the risk of implant failure and peri-implantitis. Gum health is also linked to diabetes and heart health. Dental treatment in Tunisia costs about 60% less than in Switzerland, which makes sense for the larger restorative work once the gums are stable, while regular maintenance belongs close to home. This guide explains how gum disease develops, how it is treated, and how to plan care between Switzerland and Tunisia.

Updated November 2026. This article is general information and does not replace an examination by a dentist or periodontist.

Contents

What changed in 2025 and 2026 for gum health?

Gum disease has not changed, but the way it is viewed has. Over the last two years, international bodies have pushed for oral health to be treated as part of general health rather than a separate, cosmetic matter. Several publications are worth knowing.

How common is gum disease worldwide?

Very common. In its fact sheet updated on 17 March 2025, the World Health Organization (WHO) estimates that oral diseases affect nearly 3.7 billion people, and that severe periodontal disease affects more than one billion. The main risk factors it lists are poor oral hygiene and tobacco use. The WHO also highlights the two-way relationship between diabetes and periodontal disease, and the fact that oral diseases share risk factors with other non-communicable diseases: tobacco, alcohol and a diet high in free sugars.

What did the European periodontists publish in 2026?

In September 2026, the European Federation of Periodontology (EFP) and the European Association of Dental Public Health launched a white paper, « Oral health and systemic health outcomes: a call for interdisciplinary action », published in Periodontology 2000. It states that periodontitis has the strongest evidence of links to general health, that treating it can improve blood sugar control in people with diabetes, and that evidence on major events such as heart attacks remains limited. It calls for oral health to be included in universal health coverage and in the training of all health professionals.

Do heart specialists now take gums seriously?

Increasingly. On 31 August 2026, the EFP and the European Society of Cardiology held their first joint session at the ESC Congress in Munich, titled « Does the mouth matter to the heart? Periodontitis as a cardiovascular risk factor ». The speakers discussed shared risk factors and inflammatory mechanisms and how oral health could be included in cardiovascular risk assessment. The question of whether the link is causal remains open, but the direction is clear: your gums are part of your health file.

Is there new guidance on gum emergencies?

Yes. On 18 September 2026, the EFP announced a new clinical practice guideline on acute periodontal conditions, published in the Journal of Clinical Periodontology and based on the 21st European Workshop on Periodontology held in November 2025. It covers necrotising periodontal diseases, periodontal abscesses and combined lesions of the gum and the tooth nerve, with a three-step approach: confirm the diagnosis, control pain and tissue destruction quickly, then treat the underlying problem to prevent recurrence.

Date Source What it means for you
17 March 2025 WHO, oral health fact sheet Severe gum disease affects over one billion people; hygiene and tobacco are the main levers
Oct. 2024 / 2025 Journal of Periodontal Research, meta-analysis A history of periodontitis increases implant loss and peri-implantitis
31 Aug. 2026 EFP and European Society of Cardiology First joint session on gums and heart health
Sept. 2026 EFP and EADPH white paper Treating periodontitis can improve blood sugar control in diabetes
18 Sept. 2026 EFP guideline on acute conditions Abscesses and necrotising disease need prompt treatment

Gingivitis or periodontitis: what is the difference?

Both are caused by the bacterial film (plaque or biofilm) that forms on teeth every day. The difference lies in what the inflammation has destroyed.

What is gingivitis?

Gingivitis is inflammation limited to the gums. They are red, swollen and bleed when you brush or floss. Crucially, the bone and the fibres attaching the tooth are intact. Gingivitis is reversible: with good cleaning and a professional clean, the gums return to health within a few weeks.

What is periodontitis?

Periodontitis is a chronic inflammatory disease in which the attachment of the tooth (the fibres and bone) is progressively destroyed. The gum detaches from the tooth and forms a « pocket » in which bacteria multiply out of reach of the toothbrush. Over years, the bone around the teeth is lost, teeth become mobile, can move and eventually fall out. The damage is not reversible on its own, but the disease can be stopped and kept under control, and in some cases lost bone can be partially regenerated.

Does gingivitis always become periodontitis?

No. Many people have gingivitis for years without progressing. But periodontitis is always preceded by gingivitis, and it is impossible to predict who will progress. Susceptibility depends on genetics, smoking, diabetes and other factors. Treating gingivitis is the simplest way to avoid periodontitis.

Gingivitis Periodontitis
What is affected Gums only Gums, fibres and bone
Signs Redness, swelling, bleeding Bleeding, pockets, receding gums, bad breath, mobile teeth
Pain Rarely Often painless until late
Reversible? Yes, completely Can be stopped; bone loss is permanent unless regenerated
Treatment Cleaning at home and professional cleaning Scaling and root cleaning, sometimes surgery, lifelong maintenance

Signs that should alert you

Periodontitis is often called a silent disease because it rarely hurts until it is advanced. These signs should lead you to a dentist or dental hygienist:

  • gums that bleed when brushing, flossing or eating, even slightly;
  • red, swollen or tender gums;
  • persistent bad breath or a bad taste in the mouth;
  • gums that seem to recede, teeth that look longer, or new gaps between the teeth;
  • sensitive tooth necks with cold drinks;
  • teeth that move, change position or feel loose;
  • pus between the teeth and gums;
  • a change in your bite, or a partial denture that no longer fits.

Why don’t smokers notice bleeding?

Because nicotine constricts the blood vessels in the gums, masking the bleeding that would otherwise warn of inflammation. A smoker can have advanced periodontitis with gums that look pale and healthy. For smokers, a regular periodontal examination is even more important.

Are bleeding gums during pregnancy normal?

Hormonal changes make the gums more sensitive to plaque, and pregnancy gingivitis is common. It usually settles after birth, but it should be treated, because a professional clean during pregnancy is safe and useful. Pre-existing periodontitis should be treated too.

Causes and risk factors

What causes periodontitis?

The starting point is the bacterial biofilm, but the disease is driven by the body’s inflammatory response to it. Some people react strongly and lose bone quickly; others have plenty of plaque and little damage. That is why the same hygiene habits do not produce the same results in everyone.

What are the main risk factors?

  • Smoking: the most important avoidable factor. It increases the risk and severity of periodontitis and reduces the response to treatment.
  • Diabetes: poorly controlled diabetes increases the risk and speed of periodontitis, and periodontitis makes diabetes harder to control.
  • Genetics and family history: if your parents lost teeth early through gum disease, your risk is higher.
  • Stress, poor sleep and poor nutrition, which affect immunity.
  • Some medicines that cause gum overgrowth (some antiepileptics, some blood pressure medicines of the calcium channel blocker type, ciclosporin) or dry mouth.
  • Dental factors: overhanging fillings, poorly fitting crowns, crowded teeth or a partial denture that traps plaque.
  • Obesity, associated with a higher risk in many studies.

Is gum disease contagious?

The bacteria can be transmitted, for example between partners, but whether they cause disease depends on each person’s response. It is not contagious in the usual sense.

Diagnosis: stages and grades

A periodontal diagnosis requires a full examination, not just a look in the mouth. It is often done by a dentist, a periodontist (a dentist specialised in gums) or a dental hygienist.

What does the examination involve?

  • Periodontal charting: a thin, graduated probe measures the depth of the pocket around each tooth, usually at six points per tooth. Healthy pockets are about 1 to 3 mm; deeper pockets indicate loss of attachment.
  • Bleeding on probing, recorded for each site, which shows active inflammation.
  • Recession and tooth mobility.
  • X-rays to see the level of bone around the teeth.
  • Medical history: smoking, diabetes, medicines, family history.

What are the stages of periodontitis?

Since the 2017 World Workshop on the classification of periodontal diseases, organised by the American Academy of Periodontology and the EFP, periodontitis is described by a stage and a grade. The stage, from I to IV, describes severity and complexity: stage I is initial periodontitis with little attachment loss; stage II is moderate; stage III is severe with a risk of further tooth loss; stage IV is severe with a risk of losing the dentition, often with chewing problems and teeth that have moved.

And the grades?

The grade, A, B or C, describes the speed of progression and the risk of future progression: grade A is slow, B moderate and C rapid. Smoking ten or more cigarettes a day and poorly controlled diabetes are grade modifiers that push the grade up. A young person with stage III grade C periodontitis has a very different outlook from an older person with stage II grade A.

Why does the stage matter for implants?

Because it predicts what will happen around future implants. As explained below, a 2024 meta-analysis found a particularly high risk of implant loss in people with a history of grade C (rapidly progressing) periodontitis.

Scaling and root cleaning: the core treatment

The EFP’s S3 clinical practice guideline for the treatment of stage I to III periodontitis, published in 2020 in the Journal of Clinical Periodontology, describes a stepwise approach. Each step builds on the previous one.

Step 1: what happens first?

The first step targets behaviour and the biofilm above the gum line: instruction in cleaning, especially between the teeth, removal of plaque and tartar above the gums, correction of factors that retain plaque (such as overhanging fillings), and control of risk factors, notably stopping smoking and improving diabetes control. This step is not a formality. Without it, the following steps fail.

Step 2: what is root cleaning?

The second step is the cleaning of the root surfaces below the gum line, often called subgingival instrumentation or « scaling and root planing ». Using ultrasonic instruments and fine hand instruments, under local anaesthetic if needed, the dentist or hygienist removes the hardened deposits and the biofilm from the pockets. It is usually done in one or several sessions. In selected cases, antibiotics or other adjuncts are added, but they are not routine.

Does it hurt?

Under local anaesthetic, it is generally not painful. Afterwards, the gums may be sore for a day or two and the teeth sensitive to cold for some weeks. As inflammation subsides, the gums shrink slightly and the teeth may look a little longer: this is a sign of healing, not a side effect of bad treatment.

When is the result assessed?

About two to three months after root cleaning, the gums are measured again. In many patients, pockets become shallower and bleeding decreases dramatically. Where deep pockets remain, step 3 is considered.

What is scaling, and is it enough?

A routine « scale and polish » removes tartar above the gum line. It treats and prevents gingivitis but is not enough to treat periodontitis, which requires cleaning deep in the pockets. If your gums bleed and pockets are deep, ask whether you need a periodontal treatment, not just a cleaning.

Cleaning at home

Home care decides the long-term result. Professional treatment removes what you cannot reach; you prevent it from coming back every day.

What is the right brushing routine?

Brush twice a day for about two minutes with a fluoride toothpaste, using a soft manual brush or an electric toothbrush, angling the bristles towards the gum line. Electric brushes, especially oscillating-rotating ones, make it easier to clean well for many people. Hard brushes and aggressive horizontal scrubbing damage the gums.

What about between the teeth?

This is where periodontitis usually starts, and a toothbrush does not reach. Interdental brushes in the right sizes (often several sizes for one mouth) are the most effective option for most adults with gum disease. Floss is suitable where the spaces are very tight. Water flossers can help, especially around bridges and implants, but do not fully replace brushes. Ask your hygienist to show you the right sizes and technique.

Do mouthwashes help?

They can complement mechanical cleaning but never replace it. Chlorhexidine mouthwash is sometimes prescribed for short periods, for example after surgery; long-term use stains the teeth and alters taste. Do not use antiseptic mouthwashes continuously without advice.

Does diet matter?

Yes. A diet low in free sugars, rich in vegetables and fibre, and stopping smoking all reduce inflammation. Blood sugar control is essential if you have diabetes.

Periodontal surgery

When deep pockets persist after root cleaning, surgery can give access to areas that cannot be cleaned otherwise. This is step 3 of the EFP guideline.

What is flap surgery?

The periodontist gently lifts the gum away from the teeth under local anaesthetic, cleans the roots and the bone defects under direct vision, sometimes reshapes the bone, and stitches the gum back. The aim is to reduce the depth of pockets so that they can be kept clean.

Can lost bone be regenerated?

In certain types of defect, yes, partially. Regenerative techniques use membranes, bone substitutes or biological products (such as enamel matrix derivatives) to encourage new bone and attachment. They work best in deep, narrow defects around individual teeth, in non-smokers with good hygiene. They are not possible everywhere.

What is recovery like after gum surgery?

Discomfort, swelling and some sensitivity for a few days, controlled with painkillers. You will be told how to clean the area, often with a soft brush and a mouthwash for a time. Stitches are removed after one to two weeks. Avoid smoking: it significantly impairs healing.

Receding gums and gum grafts

Gum recession means that the gum margin moves away from the crown, exposing part of the root. It can be caused by periodontitis, but also by aggressive brushing, thin gums, orthodontic movement, a lip or tongue piercing, or the position of the tooth in the bone.

Is recession always a problem?

Not always. Mild recession that is stable and not sensitive may only need monitoring and gentle brushing. Treatment is considered when recession progresses, causes sensitivity, makes cleaning difficult, increases the risk of root caries, or bothers you aesthetically.

What is a gum graft?

A gum graft covers exposed roots or thickens thin gums. In a connective tissue graft, a piece of tissue is taken from under the surface of the palate and placed under the gum around the exposed root. In a free gingival graft, a thin strip of surface tissue is taken from the palate to thicken the gum. Substitutes made of collagen can sometimes replace tissue from the palate.

Does the palate hurt after a graft?

The palate is often the most uncomfortable part. A 2025 systematic review in the Japanese Dental Science Review looked at 54 studies and 43 different interventions used to reduce pain at the palatal donor site, such as collagen sponges, platelet-rich fibrin and laser light therapy. Pain generally improved over time with these interventions, but the studies were too different to say which is best. In practice, a protective plate, a collagen dressing and good painkillers help, and pain usually decreases over a week to ten days.

Can recession be fully corrected?

It depends on how much bone and gum is left between the teeth. When the bone between the teeth is intact, complete root coverage is often possible. When it has been lost through periodontitis, coverage is usually partial.

Gummy smile and gingivectomy

A « gummy smile » shows a large band of gum above the upper teeth. The teeth may look short. The causes vary: excess gum over normal teeth, a short or very mobile upper lip, a vertically long upper jaw, or a combination.

What is a gingivectomy?

A gingivectomy removes excess gum tissue to reshape the gum line and reveal more of the tooth. It is done under local anaesthetic with a scalpel, an electrosurgical instrument or a laser, and takes from a few minutes to over an hour depending on the number of teeth. It also treats gum overgrowth caused by certain medicines. Medespoir’s page on gingivectomy in Tunisia (in French) describes the procedure.

Is gingivectomy always enough?

No. If the bone is too close to the edge of the gum, removing gum alone leads to it growing back, and a « crown lengthening » with bone reshaping is needed. If the cause is the lip or the jaw, other treatments (botulinum toxin for a very mobile lip, or orthognathic surgery in severe cases) may be discussed. A good diagnosis with measurements and X-rays comes before any cutting.

Should the gums be healthy before veneers?

Absolutely. Veneers, crowns and gum reshaping all depend on stable, uninflamed gums. If the gums are inflamed when impressions are taken, the margins may end up in the wrong place once the gums heal. Our guide to planning a smile makeover in Tunisia explains the steps for veneers and whitening.

Acute gum problems: abscess and necrotising disease

What is a periodontal abscess?

A painful swelling of the gum, often with pus, around a tooth with a deep pocket. It can appear suddenly, sometimes after a deep cleaning, if a pocket closes over bacteria. The new EFP guideline stresses the importance of rapid diagnosis and treatment, because abscesses can cause rapid tissue destruction. Treatment usually involves draining and cleaning the pocket; antibiotics are added when there are signs of spreading infection or general symptoms.

What is necrotising gum disease?

A rare, painful condition in which the tips of the gum between the teeth die and form grey ulcers, with bleeding and a very bad smell. It is associated with stress, smoking, poor nutrition, lack of sleep and weakened immunity. It needs prompt treatment by a dentist.

What if I have gum pain while travelling?

If it happens in Tunisia, the dental team can see you. If it happens in Switzerland, contact your dentist or a dental emergency service; many cities have a dental emergency number. Do not wait for a planned trip to treat an acute infection.

Planning dental work in Tunisia? Request your free personalised quote, sent within 48 hours. Send a recent panoramic X-ray and, if you have one, your periodontal chart: they show whether your gums are ready for the planned treatment.

Periodontitis and implants

Many people who lose teeth to periodontitis want implants. This is possible, but the history of gum disease changes the risk and the plan.

Does a history of periodontitis increase the risk of implant failure?

Yes. A meta-analysis of prospective cohort studies published in 2024 in Clinical Implant Dentistry and Related Research found a significantly higher risk of implant failure in people with a history of periodontitis, both within five years and beyond, and about four times the risk of peri-implantitis. Another meta-analysis in the Journal of Periodontal Research (online October 2024) confirmed a greater risk of implant loss, bone loss around implants and peri-implantitis, especially at ten years or more, in severe stages and in rapidly progressing (grade C) periodontitis. The evidence is of low to moderate certainty, but the direction is consistent.

What is peri-implantitis?

The equivalent of periodontitis around an implant: inflammation of the gum around the implant with loss of the bone that supports it. It can lead to implant loss and is harder to treat than periodontitis around a natural tooth. Its milder, reversible form is peri-implant mucositis, inflammation without bone loss. Our guide to dental implants in Tunisia covers implants in more detail.

Can I have implants if I had periodontitis?

Yes, provided that:

  • the periodontitis has been treated and is stable, with no deep, bleeding pockets around the remaining teeth;
  • you can clean well, including around the future implants;
  • you stop smoking or at least reduce it significantly;
  • diabetes, if present, is well controlled;
  • you commit to regular maintenance, usually every three to six months.

Should I keep or extract teeth with gum disease?

It depends on each tooth. A periodontally weakened tooth can often be kept for many years with treatment and maintenance. Extracting all teeth to place implants is not a solution to periodontitis: the susceptibility remains, and implants can be affected too. A good plan keeps what can be kept and replaces what cannot.

Situation Usual sequence
Gingivitis, no bone loss, implant planned Professional cleaning, then implant treatment
Stage I-II periodontitis Root cleaning, re-evaluation after 2 to 3 months, then implants or crowns
Stage III periodontitis Root cleaning, surgery if needed, stable maintenance before implants
Stage IV, many mobile teeth Complex plan: periodontal treatment, selective extractions, implant-supported or removable prosthesis
Inflammation around existing implants Diagnosis (mucositis or peri-implantitis), cleaning, sometimes surgery

Gums and general health

The link between the mouth and the rest of the body is one of the main reasons periodontists have become more vocal. The evidence varies by condition.

Is there a link with diabetes?

Yes, and it is the best-documented one. Diabetes increases the risk of periodontitis, and periodontitis makes blood sugar harder to control. An umbrella review published in Acta Diabetologica pooled 27 trials and found that non-surgical periodontal treatment reduced HbA1c by about 0.5 percentage points at three months and about 0.4 at six months in people with type 2 diabetes. The 2026 EFP white paper confirms that treating periodontitis can improve blood sugar control. If you have diabetes, a periodontal examination should be part of your annual check-up.

And heart disease?

Periodontitis is associated with a higher risk of cardiovascular disease, and the two share risk factors and inflammatory mechanisms, as discussed at the 2026 joint EFP and European Society of Cardiology session. Whether treating the gums reduces heart attacks or strokes has not been demonstrated. It is reasonable to treat periodontitis for its own sake and to see it as one more reason to stop smoking and control blood pressure and cholesterol.

What about pregnancy and other conditions?

Associations have been reported with complications of pregnancy, chronic kidney disease, rheumatoid arthritis and respiratory infections in frail older people. The strength of evidence varies. Good oral health is recommended in all these situations, but periodontal treatment is not presented as a cure for them.

Maintenance: care for life

Periodontitis is a chronic disease, like high blood pressure. Once treated, it needs regular follow-up to avoid relapse. This is step 4 of the EFP guideline: supportive periodontal care.

How often should I have maintenance?

Usually every three to six months, according to your risk. A smoker with a history of severe periodontitis may need appointments every three months; a person with stable, mild disease every six months or less. Each appointment includes measuring the pockets, cleaning, and reinforcing home care.

What happens if I skip maintenance?

The disease tends to come back, and the bone loss resumes. Many studies show that patients who follow maintenance keep their teeth far longer than those who do not.

Who provides maintenance in Switzerland?

Your dentist, a periodontist or a dental hygienist. In Switzerland, dental hygienists are trained professionals who carry out periodontal maintenance, often in a dental practice. Choose someone close to home: maintenance only works if it is regular.

Treatment in Tunisia: what makes sense

Dental treatment in Tunisia costs about 60% less than in Switzerland; the exact price is given in a free, personalised quote sent within 48 hours. But not every gum treatment is suited to a trip abroad. The logic is to separate what needs time and repetition from what can be grouped into one or two stays.

What is logical to do in Tunisia?

  • Larger restorative work once the gums are stable: implants, crowns, bridges, veneers. See our guides on crowns, bridges and dentures and implants.
  • A gingivectomy or gum reshaping as part of a smile makeover, once inflammation is controlled.
  • Other surgical procedures, if the quote confirms they can be done and how many stays they require.

What is better done in Switzerland?

  • The initial diagnosis and the first phase of periodontal treatment, which require several sessions and re-evaluation after two to three months, although they can also be organised in Tunisia if the treatment plan allows the time.
  • Lifelong maintenance every three to six months.
  • Emergencies such as an abscess.

How should I prepare a quote for implants if I have gum disease?

Send a recent panoramic X-ray, any 3D scan, your periodontal chart if you have one, and a list of your medical conditions and medicines, including diabetes and smoking. The dental team in Tunisia will need to know whether your periodontitis has been treated and is stable. If it is not, they may propose treating the gums first. Medespoir’s pages on the dentist in Tunisia and dental implants (in French) explain the general approach.

What is included in the Tunisian package?

The Medespoir package in Tunisia includes the consultation, examinations, the treatment, the hotel with full board for you and one companion, transfers and remote follow-up after your return. The flight, personal expenses, care received in Switzerland, travel insurance and bank charges remain at your own expense. Consultations and documents are in French.

And Turkey?

In Turkey, Medespoir confirms hair transplants. For dental treatment, your quote states whether it is possible and where. Both destinations remain considerably less expensive than Switzerland.

Insurance in Switzerland

Does basic insurance pay for gum treatment?

Generally not. Under article 31 of the Federal Health Insurance Act (KVG/LAMal), basic insurance covers dental treatment only when it is caused by a severe, unavoidable disease of the chewing system, or by a severe general disease or its consequences, or when it is necessary to treat a severe general disease. The Health Care Benefits Ordinance (KLV/OPAS), articles 17 to 19, lists these situations. Ordinary periodontitis caused by plaque does not usually qualify. In specific situations, for example periodontal treatment required because of certain serious illnesses, cover may be possible after a request to the insurer.

What about supplementary insurance?

Many people in Switzerland have supplementary dental insurance, which usually pays part of the cost up to an annual limit, often with waiting periods and exclusions for pre-existing conditions. Check whether it covers treatment abroad and under what conditions before you go.

Does basic insurance cover dental treatment in Tunisia?

No. Basic insurance does not cover planned treatment abroad, and dental treatment is mostly outside its scope anyway.

Four common situations

These scenarios are illustrations, not real patients.

Bleeding gums at 35

Julia, 35, from Basel, notices her gums bleed when she brushes. Her dentist finds generalised gingivitis, no bone loss. After a professional clean and instruction in interdental brushes, the bleeding stops within a month. She now sees a hygienist once a year.

Periodontitis before implants

Thomas, 52, a smoker from Geneva, has lost two molars and wants implants in Tunisia. His X-rays show moderate bone loss around several teeth: stage III periodontitis. The dental team recommends treating the gums first. He has root cleaning in Switzerland, reduces and then stops smoking, and is re-evaluated three months later. With the gums stable, he travels to Tunisia for the implants, then returns for the crowns. He continues maintenance every four months in Geneva.

Receding gums after orthodontics

Nina, 28, from Lausanne, has recession on two lower front teeth after braces. They are sensitive and look longer. A periodontist proposes a connective tissue graft. She is warned that the palate will be sore for about a week. The roots are covered and the gum is thicker.

Gummy smile and veneers

Karim, 40, from Zurich, wants veneers but shows a lot of gum when he smiles. The examination shows healthy gums with excess tissue over normal teeth. A gingivectomy on the upper front teeth is planned, followed by the veneers once the gums have healed and stabilised, in two stays in Tunisia.

Ready to plan your treatment? Request your free quote. The team will tell you whether your gums are ready and how many stays the treatment requires. For an overview of dental treatments, see our 2026 dental guide and Medespoir’s dental care guide (in French).

Sources

  • World Health Organization, oral health fact sheet, 17 March 2025: who.int
  • EFP, « New white paper calls for oral health to be integrated into general healthcare », September 2026: efp.org
  • EFP, « EFP and ESC join forces to explore links between periodontitis and cardiovascular health », September 2026: efp.org
  • EFP, new clinical practice guideline on acute periodontal conditions, 18 September 2026: efp.org
  • Sanz M. et al., treatment of stage I-III periodontitis, EFP S3 level clinical practice guideline, Journal of Clinical Periodontology, 2020: pubmed.ncbi.nlm.nih.gov
  • Serroni M. et al., history of periodontitis as a risk factor for implant failure and peri-implantitis, Clinical Implant Dentistry and Related Research, 2024: pubmed.ncbi.nlm.nih.gov
  • Annunziata M. et al., implant therapy in patients with and without a history of periodontitis, Journal of Periodontal Research, 2024-2025: pubmed.ncbi.nlm.nih.gov
  • Di Domenico G. L. et al., periodontal treatment and glycaemic control, umbrella review, Acta Diabetologica, 2023: pubmed.ncbi.nlm.nih.gov
  • Leite G. G. et al., morbidity of the palatal donor area after gum grafts, systematic review, Japanese Dental Science Review, 2025: pubmed.ncbi.nlm.nih.gov
  • Federal Health Insurance Act (KVG/LAMal), article 31: fedlex.admin.ch; Health Care Benefits Ordinance (KLV/OPAS), articles 17 to 19: fedlex.admin.ch
  • Medespoir (in French): gingivectomy, dental implants, dentist in Tunisia, prices

Frequently asked questions

Are bleeding gums serious?

They are a sign of inflammation. Most often it is gingivitis, which is reversible, but it can also be the first sign of periodontitis. Have it checked.

Can periodontitis be cured?

It can be stopped and kept under control with treatment and lifelong maintenance. Bone already lost does not grow back on its own, although some defects can be partly regenerated.

Is deep cleaning painful?

It is usually done under local anaesthetic and is not painful. The gums may be sore and the teeth sensitive for a few days afterwards.

Can I have implants if I have gum disease?

Yes, once the gum disease is treated and stable, with good home care and regular maintenance. The risk of implant problems is higher than in people without a history of periodontitis.

How often do I need maintenance?

Usually every three to six months, depending on your risk.

Does basic insurance pay for gum treatment?

Generally not, except in specific situations linked to severe disease. Supplementary dental insurance may cover part of the cost.

Is a gum graft painful?

The palate, where the tissue is taken, is usually sore for about a week. Painkillers and a protective plate help.

Does smoking affect gum treatment?

Yes. Smoking increases the risk and severity of periodontitis, hides bleeding and reduces the response to treatment and to implants.

Is a gingivectomy the same as treating gum disease?

No. A gingivectomy reshapes the gum line, often for aesthetic reasons. Periodontitis is treated by cleaning deep in the pockets and by maintenance.

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