If you are reading this, the appointment was probably today or yesterday.
Or you are Googling late at night, in bed, because once the word was said, it stayed with you.
Periodontitis. Maybe with a stage number next to it.
In my practice I have this conversation every week, sometimes several times. And I know roughly which two questions are in your head right now, because they are almost always the same. Nobody asks them out loud in the treatment room. Everyone asks them later at home on Google.
Here they are. Answered honestly, the way I would answer them in my chair.
"Can I still be cured?"
The short answer: no. Periodontitis is not cured, but stabilized.
I know that sounds harsh on the first day. In practice, it is a little more nuanced.
The bacterial inflammation below your gumline, the inflammation that breaks down the jawbone around your teeth, can be brought to a halt. The bleeding can stop. The gums can recover. Pockets can become smaller. What does not come back: jawbone that has already broken down. That remains gone.
What that means in one sentence: everything you still have now can be preserved. From today, the difference between "stopping where it is" and "further loss" depends on what you do from this week onward.
"Is it reversible?"
Partly, yes. And that is what I most want my patients to hold on to on the first day.
Inflamed, bleeding gums are reversible. With the right care, the inflammation disappears, the tissue heals back toward healthy, and pockets can become smaller in the first months after the treatment pathway.
What is not reversible: jawbone that has already broken down.
So the relevant question is not "can this go back?" but "what has not been lost yet?" And the earlier the diagnosis, the larger that part is.
What comes next, what the treatment plan involves, what it costs and what you can start at home this week, is not a small thing. But it is not opaque either. I explain it in the order my patients usually hear it from me.
Where you are now: the four stages
Periodontitis is internationally divided into four stages, defined by how much jawbone has been lost around a tooth. It is not a perfect system, but it gives an honest picture of where you stand:
- Stage 1: up to 15% jawbone loss. Bleeding on probing, small pockets. In my chair, this is the most hopeful moment to receive the diagnosis. Almost nothing has been lost yet.
- Stage 2: 15 to 33%. Deeper pockets, permanent tissue loss. Treatable, but what is there now remains.
- Stage 3: 33 to 50%. Significant jawbone loss, sometimes first tooth mobility, exposed root surfaces. This is where people often see for the first time that something is wrong: a tooth starts leaning, a molar feels different.
- Stage 4: more than 50%. Teeth become loose or have already fallen out. Replacement with implants or a denture.
In my practice, I see many patients diagnosed for the first time only in stage 3, often because there are already clear complaints before they come back. If you hear it in stage 1 or 2, you are hearing it at a favorable moment. That sounds strange, because a diagnosis is a diagnosis, but in practice the difference between early and late is big.
The treatment pathway: what I do in the chair
The standard periodontitis pathway is called the initial treatment. Four one-hour sessions, spread over three months. Each session is a deep cleaning below the gumline, scaling and root planing, done by me or by a periodontologist.
Honestly: it is not a pleasant pathway. I often work under anesthesia because otherwise it is too sensitive. Most patients describe sensitive spots afterwards, light swelling and a few days of bruised gums. The first week hurts more than they expected. Then it settles.
What I can say: it works. At the evaluation after session four, we usually see clearly fewer pockets, less bleeding and healthier-looking gums on the outside. Not all pockets, not for everyone, but enough to make the pathway worthwhile.
What it costs
A full initial treatment pathway in practice comes to about 1,600€ (Independer.nl, 2026 + KNMT fees). After that comes aftercare, every three months, lifelong, at 115€ to 200€ per consult.
- Initial pathway: about 1,600€
- Aftercare per quarter: 115€–200€ per consult
- Implant, if a tooth eventually cannot be saved: about 2,100€ per element
- KNMT example Max in his most expensive year: 3,461.97€
Dental care for adults is almost entirely outside basic insurance. Supplementary insurance usually reimburses 250€ to 1,500€ per year. At most, that buys you one pathway. The rest you pay yourself. That is the honest calculation I give my patients before they look it up themselves.
"Unfortunately, the lost supporting tissue recovers little or not at all."
— Mondzorg Minke
That is why early intervention makes the difference. The period in which the inflammation can still decrease and the tissue can still recover does not remain open forever.
What you do at home between those treatment appointments often determines whether the pathway holds in the long term. I want to be honest about that next. That is exactly where I see patients drop off.
What 200 patients did at home, alongside their treatment
I tell most people in my chair that the pathway is only half the work. The other half is what you do at home, between appointments. That does not mean flossing "a bit more often." In practice, I see floss back in the drawer by week three, and even those who do keep it up still do not reach below the gumline, where the bacteria sit.
In January 2026, the largest European periodontitis study to date, HOPE-CP, n=200, appeared in the Journal of Periodontology. The study tested one concrete addition to standard periodontal care: a Finnish medical device patients can use at home alongside their regular appointments. CE-marked Class IIa, photodynamic therapy at home in ten minutes.
It is called Lumoral.
You rinse your mouth with the Lumorinse rinse. It contains a light-sensitive molecule that attaches to bacteria in the biofilm: below the gumline, where toothbrush, floss and mouthwash physically cannot reach. You click the mouthpiece into your mouth and it emits blue (405 nm) and red (810 nm) light for ten minutes. The light activates the molecule, and it attacks the bacteria where they are.
Ten minutes. On the couch, while you watch an episode. The device does the work.
In HOPE-CP, 200 patients with stage I to III periodontitis were randomly divided into two groups. The exact same diagnosis you probably just received. One half received standard care: professional cleaning, sonic toothbrush, instructions. The other half received the same care plus daily Lumoral at home.
After six months:
- Twice as many patients in the Lumoral group reached clinically healthy gums (BOP below 10%, the European definition of healthy): 51% versus 23%.
- One and a half times as many patients achieved good plaque control (plaque index below 10%): 63% versus 38%.
- 85% of Lumoral users were still using it daily after six months. That is a different number from what I see with flossing.
Published in the Journal of Periodontology, peer-reviewed by the American Academy of Periodontology (DOI: 10.1002/jper.70082).
Frequently asked questions
What it costs
Lumoral costs 249€. One time. You pay for the device once and that is it.
Compared with the list from the previous section:
- 249€ · Lumoral
- 1,600€ · initial pathway
- 115€–200€ · aftercare per quarter
- 2,100€ · implant per tooth
- 3,461.97€ · Max in his most expensive year
Lumoral is the smallest item on this whole list.
30 days to experience it
Does it not work for you? Then return it within 30 days. You get your money back, minus return shipping costs. In practice, I usually ask my patients to try it consistently for six weeks before judging. In most people, we already see a difference in the bleeding index within that period.
— Sanne de Vries, dental hygienist