Gum disease treatment in Skopje

What is gum disease treatment and what can it achieve?

Gum disease is caused by plaque, the sticky film of bacteria that builds up on your teeth. Dentists call it periodontal disease, and you may also come across the older name pyorrhoea. If you are looking into gum disease treatment in Skopje, it helps to know that the right approach depends on the stage:

Do you need gum treatment?

Gum disease does not usually hurt in the early stages, so it is easy to overlook. Book a check-up if you notice:

• bleeding gums when you brush, clean between your teeth or eat
• red, swollen or sore gums
• bad breath or an unpleasant taste in your mouth
• receding gums that make your teeth look longer
• loose or shifting teeth, new gaps or a change in your bite
• sensitivity to hot and cold, or pus around the gumline

Your risk is higher if you smoke, have diabetes, are pregnant, have a family history of gum disease or take certain medicines.

When treatment needs to be adapted

• Smoking: this speeds up gum disease and makes treatment less effective. A year after you stop smoking, your gums respond better to treatment.
• Diabetes: poorly controlled blood sugar raises the risk and slows healing.
• Pregnancy: in a high-risk pregnancy, some treatments may be postponed.
• Blood thinners: treatment is generally safe, but extra precautions against bleeding are needed.
• Medicines that can cause gum overgrowth (for example, some blood pressure or epilepsy medicines): this makes cleaning harder.
• Bone-strengthening medicines (such as bisphosphonates, as tablets or injections): these can carry a risk of jaw complications, mainly with surgery.

Please tell us about every medicine you take.

How gum treatment works, step by step

1. Assessment and plan (1 visit). We ask about your health, medicines and smoking, and measure the depth of your gum pockets with a thin probe: up to about 3 mm in healthy gums and 4 mm or more in periodontitis. X-rays show how much bone has been lost. Then we explain the diagnosis, your options and the risks.
2. Home care and controlling risk factors. You are shown how to brush and clean between your teeth properly, and plaque and tartar above the gumline are removed.
3. Deep cleaning below the gumline. The root surfaces inside the pockets are cleaned with hand or ultrasonic instruments (scaling and root planing). A session usually takes 1–2 hours: the whole mouth in one visit, or half at a time over two visits. More advanced disease may need more visits.
4. Healing and reassessment. After several weeks to about three months, the pockets are measured again. The aim is for no deep, bleeding pockets to remain.
5. Further treatment, only if needed. Where deep pockets remain, the deep cleaning is repeated, or gum surgery is advised, carried out by a dentist with additional training in gum disease (a periodontist). Surgery only makes sense if you keep up good daily cleaning at home.
6. Maintenance. Check-ups and professional cleaning every 3 to 12 months, depending on your risk, and usually every 3–6 months at first.

For gingivitis, professional teeth cleaning (a scale and polish) and better care at home are usually enough. Active periodontitis treatment typically takes several months, and longer if surgery is needed.

Does gum treatment hurt?

Deep cleaning is done under local anaesthetic, which numbs the area being cleaned. You can also ask for a local anaesthetic for an ordinary scale and polish.

Your gums may be sore for a few days afterwards. Over-the-counter painkillers, taken as directed, usually help, and most people get back to their normal routine the same day. After gum surgery, pain, swelling and some bleeding are possible, and healing takes about 1–4 weeks.

If you feel nervous, tell us at the start: we will explain each step beforehand, and you can ask for a break. Read what to expect at your first visit.

Recovery and caring for your gums after treatment

• Eat and drink whatever feels comfortable, and follow the instructions you are given.
• If your gums bleed a little more for the first few days, keep cleaning gently. This is common and soon settles.
• Brush your teeth twice a day for 2 minutes, using a fluoride toothpaste.
• Clean between your teeth every day, ideally with interdental brushes (small brushes for the gaps between teeth).
• After brushing, spit out the toothpaste but do not rinse with water.
• Use a mouthwash only if your dentist recommends one.
• Keep your check-up appointments: without them, gum disease can easily come back.

For more tips, read how to brush and clean between your teeth properly.

Risks, limitations and alternatives

Serious complications are rare. Possible side effects include:

• Sensitivity to hot and cold, which usually eases over a few weeks to a month or two.
• Receding gums as the swelling settles: your teeth may look longer, and gaps may appear between them.
• Temporary looseness of the teeth until the gums firm up.
• Soreness and bleeding for a few days and, less often, an infection.
• Gum disease coming back, especially without regular check-ups or if you carry on smoking.
• Tooth loss: with advanced disease, some teeth may be lost despite treatment.

Lost bone usually does not grow back with cleaning, although regenerative surgery can restore part of it in some types of bone defect.

On their own, antibiotics, lasers, gels and mouthwashes do not replace mechanical cleaning. No medicine or home remedy can remove tartar from the gum pockets.

How much does gum disease treatment cost?

The cost is worked out after an examination and depends on:

• the stage of the disease and how many teeth need cleaning
• X-rays, the number of visits and any anaesthesia
• whether surgery is needed after the reassessment
• how often you need maintenance visits
• other treatment, for example new fillings where old ones trap plaque, or replacing missing teeth

After the examination, and before treatment starts, you will receive a written plan with the stages and costs. Our prices page explains how pricing works.

Why choose Dr. Milanovski for gum disease treatment in Skopje?

‘Save the tooth’ is the practice’s motto: keeping your natural teeth comes first. Healthy gums are the foundation for this, because without the bone and gum around it, even a well-treated tooth will not last long.

• The practice has been open since 2015 and is in the Aerodrom district, near the Biser shopping centre.
• It has a contract with the Health Insurance Fund (FZO), so insured patients can register Dr Kiril Milanovski as their chosen dentist (izbran stomatolog).
• Before each step, we explain what we are doing, why, and what options you have.

Gum disease: frequently asked questions

If your gums bleed, are swollen or are receding, do not wait until it hurts. Book a check-up and we will agree the next step together.