Last reviewed: March 2026 · Based on current clinical protocols at DenCos, Hoofddorp
Periodontal treatment encompasses the procedures used to stop gum disease, remove infection, and preserve the bone and teeth affected by periodontitis. Treatment ranges from non-surgical deep cleaning (scaling and root planing) for early stages to flap surgery and bone grafting for advanced disease. According to the Cleveland Clinic, non-surgical treatment successfully resolves the majority of early-to-moderate periodontitis cases when combined with good home care. At DenCos in Hoofddorp, the full spectrum of periodontal treatment is provided by Dr. Gang Wu — a registered periodontist and implantologist (BIG 29918905102) who manages everything from initial deep cleaning to complex surgical reconstruction.
This article explains the main periodontal treatment options, when each is used, what to expect during and after treatment, and how DenCos approaches periodontal care.
What is scaling and root planing?
Scaling and root planing — often called "deep cleaning" — is the first-line treatment for periodontitis stages I and II. It is a non-surgical procedure performed under local anaesthesia that targets bacteria and tartar below the gum line, where regular brushing and professional cleaning cannot reach.
The procedure has two components:
- Scaling — removing plaque and hardened tartar (calculus) from the tooth surfaces above and below the gum line using ultrasonic and hand instruments
- Root planing — smoothing the rough surfaces of the tooth roots so that bacteria cannot easily reattach and the gum tissue can heal against the root
According to the StatPearls periodontal disease reference, scaling and root planing reduces pocket depth by an average of 1–2 mm in moderate cases, allowing the gums to reattach and halting the progression of bone loss.
At DenCos, Dr. Gang Wu typically completes scaling and root planing in one or two sessions, depending on the extent of the disease. The mouth may be treated in quadrants (one quarter at a time) or as a full-mouth procedure in a single visit. After treatment, you return for re-evaluation in 6–8 weeks to assess healing and determine whether further intervention is needed.
What happens during and after scaling and root planing?
Understanding what to expect reduces anxiety and improves compliance with aftercare.
During the procedure
- Local anaesthesia numbs the treatment area — you should not feel pain
- Ultrasonic instruments break up tartar deposits; hand instruments refine the root surfaces
- The procedure takes 45–90 minutes per session, depending on the number of teeth involved
- At DenCos, Dr. Wu uses magnification and fibre-optic lighting for precision in deep pockets
After the procedure
- Day 1–2: mild sensitivity, tenderness, and slight bleeding are normal
- Week 1: gums begin to tighten around the teeth as inflammation resolves
- Week 6–8: re-evaluation appointment to measure pocket depths and assess healing
- Ongoing: maintenance cleanings every 3–4 months to prevent recurrence
| Recovery timeline | What to expect |
|---|---|
| Day 1–2 | Mild tenderness, possible sensitivity to hot/cold |
| Day 3–5 | Discomfort fades, normal eating resumes |
| Week 2–3 | Gums appear pinker and firmer |
| Week 6–8 | Re-evaluation: pockets measured, next steps determined |
At DenCos in Hoofddorp, patients receive written aftercare instructions including recommended mouth rinses (chlorhexidine), dietary guidance, and brushing modifications. Dr. Wu's team is available by phone during recovery if questions arise.
When is flap surgery needed?
Flap surgery — also called osseous surgery or open flap debridement — is recommended when periodontal pockets remain 6 mm or deeper after scaling and root planing, or when the disease has progressed to stage III or IV periodontitis. At this point, the pockets are too deep to clean effectively with non-surgical methods alone.
The Mayo Clinic explains that deep pockets harbour bacteria that continue to destroy bone despite non-surgical treatment. Flap surgery provides direct access to the root surfaces and underlying bone, allowing the periodontist to:
- Remove all remaining tartar and infected tissue from deep pockets
- Reshape irregular bone surfaces (osseous recontouring) to eliminate craters where bacteria accumulate
- Place bone graft material if significant bone has been lost
- Reposition the gum tissue snugly against the teeth to reduce pocket depth
At DenCos, Dr. Gang Wu performs flap surgery under local anaesthesia in the practice. The procedure takes 1–2 hours per area and is typically performed one quadrant at a time to allow comfortable recovery.
What does flap surgery recovery involve?
Recovery from periodontal flap surgery is straightforward but requires following post-operative instructions carefully.
First week
- Swelling: peaks at 48–72 hours, then gradually subsides. Ice packs help in the first 24 hours.
- Discomfort: managed with prescribed pain medication and over-the-counter anti-inflammatories.
- Diet: soft foods for the first 5–7 days. Avoid hot, spicy, or crunchy foods near the surgical site.
- Oral hygiene: do not brush the surgical area for the first week. Use a prescribed chlorhexidine rinse instead.
Second week
- Sutures are removed (or dissolve on their own) at 7–10 days
- Gentle brushing of the surgical area can resume
- Most patients return to normal daily activities within 2–3 days of surgery
Long-term
- Regular maintenance appointments every 3–4 months are essential to prevent disease recurrence
- Annual X-rays to monitor bone levels
At DenCos, Dr. Wu schedules a follow-up appointment at 1 week and again at 6–8 weeks post-surgery. The hygiene team then takes over with a personalised maintenance schedule. Because DenCos offers extended hours on Tuesday through Thursday until 18:30, follow-up appointments are accessible for working patients in Hoofddorp, Haarlemmermeer, and surrounding areas.
How do non-surgical and surgical treatments compare?
The choice between non-surgical and surgical treatment depends on the severity of your periodontitis, the depth of your pockets, and how your gums respond to initial treatment.
| Factor | Scaling & root planing | Flap surgery |
|---|---|---|
| Best for | Stages I–II, pockets 4–5 mm | Stages III–IV, pockets ≥6 mm |
| Anaesthesia | Local | Local |
| Duration | 45–90 min per session | 1–2 hours per quadrant |
| Recovery | 1–2 days | 1–2 weeks |
| Cost (NL) | €200–€500 per session | €400–€1,200 per quadrant |
| Follow-up | Re-evaluation at 6–8 weeks | Suture removal at 1 week, re-evaluation at 6–8 weeks |
At DenCos, Dr. Gang Wu always starts with the least invasive approach. Scaling and root planing is attempted first, and surgery is recommended only if pockets persist or the disease has advanced beyond what non-surgical treatment can address. This conservative philosophy ensures that patients receive only the treatment they need — nothing more, nothing less.
What role does maintenance play after treatment?
Periodontal treatment is not a one-time fix — it requires ongoing maintenance to keep the disease under control. Research cited by the European Federation of Periodontology shows that without regular maintenance, periodontitis recurs in the majority of treated patients.
A maintenance programme at DenCos includes:
- Professional cleanings every 3–4 months — more frequent than the standard 6-month interval for healthy patients
- Pocket depth measurements at each visit to detect early signs of recurrence
- Personalised home care instructions — updated as your condition evolves
- Annual X-rays to monitor bone levels
- Risk factor management — smoking cessation support, diabetes coordination with your GP
Dr. Wu emphasises that the long-term success of any periodontal treatment depends more on consistent maintenance than on the initial procedure itself. Patients who adhere to their maintenance schedule at DenCos retain more teeth and require fewer repeat surgeries.
The DenCos advantage: integrated periodontal and implant care
Not every tooth can be saved, even with the best periodontal treatment. When a tooth is beyond rescue, the transition to a dental implant must be carefully planned. At DenCos, Dr. Wu's dual qualification as periodontist and implantologist means this transition happens seamlessly — the same specialist who treated your gum disease also places and maintains the implant.
This integrated model also benefits patients who need orthodontic treatment. If gum recession or periodontitis is detected during orthodontic planning, Dr. Jing Guo (orthodontist) and Dr. Wu coordinate to ensure that periodontal health is stabilised before or during tooth movement.
For patients in Hoofddorp, Haarlem, Amsterdam, Amstelveen, and the broader Haarlemmermeer region, this one-stop approach saves time, reduces referrals, and delivers better outcomes.
Next step
Have you been told you have gum disease, or are you experiencing symptoms like bleeding gums or loose teeth? The sooner treatment begins, the more teeth and bone can be preserved.
Book a periodontal consultation at DenCos in Hoofddorp, or call us at 023-792 0463. Dr. Gang Wu will assess your condition, explain all treatment options, and create a personalised plan. Appointments available Tuesday through Thursday until 18:30.