The honest answer
The honest medical answer is: it depends on which stage of the disease you have.
Gingivitis — inflammation of the gums without bone loss — is fully reversible. With a single professional cleaning and a consistent daily oral hygiene routine, the gum tissue returns to its normal, healthy state within two to four weeks. There is no permanent record of having had it.
Periodontitis — disease that has destroyed the bone around the teeth — is not curable in the strict sense of restoring everything that was lost. The bone that has been resorbed will not regrow spontaneously. But the active disease process can be stopped, the inflammation eliminated, and the remaining tissues stabilised. With proper ongoing care, the teeth that were affected can be kept in service for the rest of the patient's life. We sometimes call this "arrested" periodontitis.
The reason the distinction matters is what each implies for the patient:
- Gingivitis: a course of treatment, then you're done. No further specialist follow-up.
- Periodontitis: a course of treatment, then a maintenance programme for life.
What "control" looks like in practice
Treated periodontitis is a chronic condition managed in the same way that chronic conditions are managed in general medicine — high blood pressure, asthma, type 2 diabetes. The active disease is brought under control, then the patient is reviewed at regular intervals to keep it that way.
For periodontitis, the maintenance interval is usually every three to four months. At each visit, a periodontal hygienist:
- Re-measures the pockets and bleeding indices.
- Removes the early calculus that has reformed below the gum line.
- Re-instructs on home care if technique has drifted.
- Flags any site that is showing recurrence so it can be addressed before it becomes another round of treatment.
The evidence base for periodontal maintenance is among the stronger in dentistry. The most-cited long-term observational study — Axelsson and colleagues' 30-year follow-up of a Swedish cohort enrolled in a maintenance programme — reported very high tooth retention and stable periodontal attachment in patients who attended regular maintenance, contrasted with substantial tooth loss in patients who discontinued.2 The cohort was unusual: well-motivated patients in a structured programme, in a Scandinavian healthcare setting. Outcomes in other settings vary. The direction of effect — that compliance with maintenance is decisive for the long-term outcome — is consistent in subsequent reviews.
More recent systematic reviews put numbers on the same point. In treated, well-maintained patients, the survival of the most vulnerable teeth — the back molars — is roughly 82% over a mean of about 15 years (Chen et al., 2024),3 and whole-mouth tooth loss during supportive periodontal care is low, on the order of 3% over roughly a decade (Saleh et al., 2023).4 These are averages across studies, not a promise for any one patient, but they show why the realistic goal is durable control rather than a cure.
The practical point: maintenance is not a soft "if-you-can-make-it" suggestion. It is the work that determines whether the rest of the treatment holds.
Can the bone come back?
In limited cases, yes. Modern periodontal surgery includes a family of regenerative procedures designed to coax bone to regrow in well-defined defects:
- Bone grafts — using the patient's own bone, donor bone, or synthetic bone substitutes.
- Enamel matrix derivative (commonly known by the trade name Emdogain) — a protein product that mimics the signals present during natural tooth development, encouraging the formation of new ligament fibres and bone.
- Growth factors — recombinant human platelet-derived growth factor (rhPDGF-BB) and similar agents that stimulate tissue regeneration.
- Guided tissue regeneration — using a membrane to selectively allow bone-forming cells, not gum tissue, to repopulate the defect during healing.
These work best in intrabony defects — vertical pockets where bone has been lost on one side of a tooth root. They work less well, or not at all, in horizontal bone loss where the bone level has dropped evenly across multiple teeth.
A specialist consultation will tell you whether regeneration is realistic for your specific case. The honest framing: regeneration recovers a portion of what was lost in selected sites. It does not restore the dentition to its 25-year-old state.
What undermines control
Three behaviours move a stable periodontitis patient back towards active disease:
- Smoking. Continuing to smoke after treatment will eventually undo it. The single most powerful change a patient can make for their periodontal prognosis is to stop smoking.
- Missing maintenance visits. Patients who skip more than 6 to 9 months between visits begin to accumulate subgingival calculus that the hygienist can no longer reach with routine instruments — and bleeding scores rise sharply.
- Drifting oral hygiene technique. Without re-instruction, most patients revert to brushing the same sites well and missing the same sites. The missed sites are where recurrence happens.
If a patient does all three of these, the disease comes back. If they do none of them, in most cases the disease stays controlled for life.
The framing we use with patients
When a patient is first diagnosed with periodontitis, the most honest framing is:
This is a chronic condition. We can stop it. We cannot undo it. With three or four maintenance visits a year, the published evidence supports excellent long-term tooth retention in patients who keep up with the programme.
That is not as cheerful as "you will be cured", but it is what the evidence supports. The implication — that a patient who is on top of their disease can reasonably expect to keep their teeth into old age — is more reassuring than the alternative, and it is more honest than an outcome guarantee that no specialist can give.
This article is general educational content. The right treatment for your specific case depends on a clinical examination and a discussion with a registered specialist.