You brush. You probably floss, at least sometimes. And every three months you sit in my chair and we clean up what has built up since the last visit. By the next appointment, it has built up again. That is the loop.
Honestly, it is not about effort. Brushing reaches the tooth surface. Floss reaches between teeth. Mouthwash rinses what is in solution. None of those reach where periodontitis actually lives, which is below the gumline, in a structured bacterial biofilm that toothbrush bristles cannot physically touch.
Here is what that means in practice. Day one of a clean visit: gums calmer, plaque cleared, bleeding down. Day fourteen: bacteria have re-colonized the spots your brush cannot reach. Day sixty: the inflammation is back to where it was. Three months later: I see you again, and we restart the cycle.
For someone with periodontitis, this loop does not end with more discipline. It ends with a different kind of intervention.
Why the standard routine cannot close the gap
The recommendation is the same one you have heard since childhood. Brush twice a day. Floss daily. Use interdental brushes. Add a mouthwash. The recommendation is not wrong. It is incomplete.
Research consistently shows that the overwhelming majority of people who start flossing daily stop again within one to two weeks. With inflamed gums, flossing hurts, it makes you bleed, and it feels as if the problem is getting worse instead of better. The habit does not fit the body it is asked of.
And even the patients who do keep it up have the same physical problem: floss does not reach below the gumline. Neither does the brush. Neither does mouthwash. The biofilm that drives periodontitis sits in a pocket between tooth and gum that none of these tools physically enter.
Four hours per year. 8,756 hours at home.
Four hygienist appointments per year means your hygienist sees you for four hours a year. The remaining 8,756 hours, you are on your own. If the only thing in those hours is brushing and flossing, the math does not work. The system was never designed to keep periodontitis in check at home. It was designed to clean up after it.
The question is therefore not whether you can floss harder. You probably already do as much as a human reasonably can. The question is what else you can add to those 8,756 hours that actually reaches under the gumline, where the disease lives.
That is the gap HOPE-CP, the largest European periodontitis study to date, set out to test in January 2026. One specific addition to standard home care, in 200 patients with stage I to III periodontitis. Below: the numbers, the mechanism, and what it means for the loop you are currently in.
The bill you already know
Honestly, you probably know the following numbers by heart. But for the conversation that follows, I will put them in one place.
A combined appointment, dentist + dental hygienist, runs around €100 per visit in practice: €20 for the dentist, €80 for the hygienist. That appointment four times a year, and you are at €400 per year for routine visits alone.
Those are the normal costs. In a more complex periodontal situation, it rises to €115 to €200 per consult (T042 / T043 / T044), bringing the annual total toward €600–€800.
What insurance does and does not cover
Basic insurance reimburses €0 for adult periodontology. Supplementary dental insurance runs about €15–€20 per month (€180–€240 annual premium) and usually reimburses between €250 and €1,500 per year. In practice, that covers at most one treatment pathway.
A quote I often see on Dutch forums:
"You can only insure yourself for silly treatments up to about 500 euros. Once you get to serious procedures, you have to cough it up yourself."
Cynical. And broadly true. For implants (€2,100 per element), extensive aftercare pathways or a repeat of the initial pathway, you pay almost entirely yourself.
What cannot be recovered
"Unfortunately, the lost supporting tissue recovers little or not at all."
— Mondzorg Minke
Lost jawbone does not come back. What you still have now is what you have. Every aftercare cycle is aimed at preservation: holding on to what you still have, and delaying new progression as long as possible.
For most older people with dentures, it started somewhere with the same complaint. The goal of preservation, for you, is for it to go differently. For you to still have your own teeth at 80.
So this conversation is not about whether you need to do something. You already do something. It is about what else fits, for the least extra money.
What 200 patients added
In January 2026, the results were published of the largest European periodontitis study to date, HOPE-CP, n=200, in the Journal of Periodontology. The study tested one concrete addition to standard periodontal care: a Finnish medical device patients could use at home alongside their regular visits.
It is called Lumoral.
You rinse your mouth with the Lumorinse rinse. It contains a light-sensitive molecule that attaches to the bacteria in the biofilm below the gumline: exactly the same place your toothbrush, floss and mouthwash physically cannot reach.
You click the mouthpiece into your mouth. For ten minutes it emits blue (405 nm) and red (810 nm) light. 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 periodontitis patients (stage I to III) were randomly divided into two groups. One group received standard periodontal care. The other 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 users were still using Lumoral daily after six months.
Important note for anyone worried about this: the general oral flora remained undisturbed (Nikinmaa et al., 2021). Unlike chlorhexidine, Lumoral targets the bacteria in the biofilm, not everything in your mouth.
Published in the Journal of Periodontology, peer-reviewed by the American Academy of Periodontology (DOI: 10.1002/jper.70082).
A frequently asked question
What it costs
Lumoral costs €249. One time. No subscription.
That is a little more than two combined appointments together: a one-time investment on top of a routine you already have anyway.
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 ask people to try it consistently for six weeks before judging. Many people already see a difference during that period.
— Sanne de Vries, dental hygienist