Almost one third of Dutch adults have chronic gum inflammation. Ten to fifteen percent have it at an advanced stage, known as periodontitis, often without knowing it. And periodontitis is the leading cause of tooth loss among adults in the Netherlands.
Yet in the early stage, it is remarkably quiet. It does not hurt and gives no warning. At most, you see a little pink in the sink.
This is what is happening under your gumline all that time.
The biofilm below your gumline
The space between your tooth and your gum harbors an active community of bacteria held together in a chemical film: a biofilm. It is invisible to the naked eye, but thick enough to keep much of your immune system out.
Your body responds the way it responds to any infection: it sends immune cells to the site. Those cells cannot get through the biofilm layer to reach the bacteria. What they can do, out of pure biological logic, is damage the surrounding tissue during the attack.
First, the fibers that hold your tooth in place are affected. Then the jawbone itself is next: specialized cells slowly break it down under the ongoing inflammation.
And you do not feel that process. Not at the start, often not even halfway through. Usually only when a tooth begins to shift, or when bone loss is visible on an X-ray.
Between reversible and irreversible: there is a threshold
As long as it remains inflammation of the gums, with bleeding and sensitivity but without jawbone loss, it is fully reversible. With the right care, it disappears and the gums recover. Once bone has broken down, that changes. From that point, progression can still be stopped, but bone that is already gone cannot be rebuilt.
The question is which phase you are in now, and how much time you still have before crossing that threshold.
The four stages of periodontitis
Periodontitis is internationally classified into four stages, defined by how much jawbone has been lost around a tooth:
- Stage I: up to 15% jawbone loss. Visible bleeding on probing, small pockets. Still manageable.
- Stage II: 15 to 33%. Deeper pockets, permanent tissue loss. Treatable, but the damage already present remains.
- Stage III: 33 to 50%. Significant jawbone loss, sometimes first tooth mobility, exposed root surfaces.
- Stage IV: more than 50%. Teeth become loose, some have already fallen out or are surgically removed. Replacement with implants or a denture.
The threshold lies before Stage I. Stage I begins by definition only when measurable jawbone has already disappeared, and that bone cannot be rebuilt.
Periodontitis causes more tooth loss among Dutch adults than cavities or accidents. It is the silent inflammation that goes unnoticed for years.
Have you ever wondered why older people often no longer have a full set of teeth? For the vast majority, it started like this: bleeding gums that grew into bone loss and periodontitis that, by then, was no longer reversible.
What this path costs
Dental care for adults is almost entirely outside basic health insurance in the Netherlands. Supplementary dental insurance usually reimburses between €250 and €1,500 per year. The rest you pay yourself.
- First gum treatment: €400–€1,500
- Full periodontology pathway: about €1,600
- Implant per tooth: about €2,100
- KNMT example Max in his most expensive year: €3,461.97
"Unfortunately, the lost supporting tissue recovers little or not at all."
— Mondzorg Minke
Until January 2026, there were practically two options: go through one of those treatment pathways, or accept the progression.
In January 2026, a third option appeared.
What changed in January 2026
In the largest European study on periodontitis care to date, HOPE-CP with 200 patients, the results were published in the January 2026 issue of the Journal of Periodontology.
What was tested: a Finnish medical device, CE-marked Class IIa, that combines a light-activated mouth rinse with dual-light therapy. It works through photodynamic therapy, a principle periodontologists have used in the treatment room for years, but now at home, in ten minutes.
It is called Lumoral.
The Lumorinse rinse contains a light-sensitive molecule that attaches to bacteria in the biofilm. The mouthpiece then illuminates your oral cavity with blue (405 nm) and red (810 nm) light for ten minutes. The light activates the molecule, and it attacks bacteria below the gumline where your toothbrush cannot reach.
200 patients with stage I to III periodontitis were randomly assigned. One half received standard care: professional cleaning, a 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.
Published in the Journal of Periodontology, peer-reviewed by the American Academy of Periodontology (DOI: 10.1002/jper.70082).
Frequently asked questions
What Lumoral costs
Lumoral costs €249. One time. You pay for the device once and that is it.
Compared with the list above:
- €249 · Lumoral
- €400–€1,500 · first gum treatment
- €1,600 · full periodontology pathway
- €2,100 · implant per tooth
- €3,461.97 · Max in his most expensive year
Lumoral is the smallest line item on this list. And the only one you use before the damage instead of after it.
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.
— Lumoral clinical editorial team