The average Dutch periodontitis patient has four appointments per year with the dental hygienist. Each appointment lasts about an hour. That equals four hours of professional periodontal care per calendar year.
A year has 8,760 hours. The remaining 8,756 hours, or 99.95% of the year, sit outside the practice. For care during that period, the standard instruction has been unchanged for years: floss daily, use interdental brushes, perhaps add mouthwash.
In practice, that instruction does not work for the majority of patients. Research consistently shows that the vast majority of people who start flossing daily stop again within one to two weeks. For people with already inflamed gums, flossing hurts, it bleeds and the perceived worsening of the problem undermines the motivation to continue.
The result is a systemic gap. The four hours in the chair are clinically effective. The 8,756 hours at home are, in practice, not filled with what they should be filled with. As a result, the work the dental hygienist does is less durable than it could be.
So the question is not whether something is needed at home. The question is what works for patients who demonstrably do not floss, and what it costs compared with what the system already costs.
The annual costs of existing maintenance care
A combined appointment, dentist plus dental hygienist, comes to about €100 per visit in practice: €20 for the dentist, €80 for the hygienist. Four appointments per year means a baseline of €400 per year for routine visits.
In a more complex periodontal picture, fees rise. The periodontal aftercare codes T042, T043 and T044 bring the amount per consult to €115 to €200. The annual total then comes to between €600 and €800.
What basic insurance does and does not cover
For adults, basic insurance reimburses €0 for periodontology. Supplementary dental insurance costs about €15 to €20 per month (€180 to €240 annual premium) and usually reimburses €250 to €1,500 per year. In practice, that reimbursement buys at most one treatment pathway.
For implants (€2,100 per element), extensive aftercare pathways or a repeat of the initial pathway, the patient pays almost entirely out of pocket.
What is not recovered
"Unfortunately, the lost supporting tissue recovers little or not at all."
— Mondzorg Minke
Lost jawbone does not return. What is still there now is what is there. Every aftercare cycle is aimed at preservation: holding on to what remains and delaying new progression as long as possible.
This is exactly the function of the 8,756 at-home hours. Not to replace the dental hygienist, but to extend the durability of the work. What actually works in those hours for patients who do not floss has, since January 2026, for the first time been empirically studied in a randomized trial of significant size.
What 200 patients did at home, randomized and published
In January 2026, the largest European periodontitis study to date appeared: HOPE-CP, n=200, published in the Journal of Periodontology (peer-reviewed by the American Academy of Periodontology, DOI: 10.1002/jper.70082).
The study design: 200 patients with stage I to III periodontitis, randomized across two arms. One arm received standard periodontal care (professional cleaning, sonic toothbrush, instructions). The other arm received the same standard care plus daily home use of a Finnish medical device, CE-marked Class IIa, that provides photodynamic therapy in ten minutes per session.
The device is called Lumoral.
The mechanism. The Lumorinse rinse contains indocyanine green (ICG), a light-sensitive molecule that attaches to bacteria in the biofilm. The mouthpiece emits blue (405 nm) and red (810 nm) light for ten minutes. The light activates the molecule, which produces reactive oxygen at the bacteria, in the place where toothbrush, floss and mouthwash physically cannot reach.
Results after six months:
- Clinically healthy gums (BOP below 10%, the European definition of healthy): 51% of the Lumoral group versus 23% of the standard care group. Twice as many patients.
- Good plaque control (plaque index below 10%): 63% versus 38%. One and a half times as many patients.
- Adherence: 85% of Lumoral users were still using it daily after six months.
Important clinical detail: the general oral flora remained undisturbed (Nikinmaa et al., Dental Journal 2021). Unlike chlorhexidine, Lumoral targets the bacteria in the biofilm, not the entire oral microbiome.
Frequently asked question
The cost position
Lumoral costs €249, one time.
In the context of the existing baseline:
- €249 Lumoral, one-time purchase
- €400 to €800 annual routine care (ongoing)
- €180 to €240 supplementary insurance premium (ongoing)
Lumoral equals a little more than two combined dental-hygienist appointments, paid once. The ongoing costs of the existing routine do not change.
30-day returns
If the experienced effect is insufficient, the device can be returned within 30 days. The purchase amount is refunded; return shipping costs are paid by the buyer. For clinical assessment of the effect, we advise a minimum use period of six weeks.
— Lumoral clinical editorial team