Gum Disease Treatment Guide: Stages from Gingivitis to Gum Surgery and Korean Insurance Rules

Gum disease treatment removes plaque and tartar from around the teeth and manages periodontal tissue damaged by inflammation. Gingivitis, where inflammation is limited to the gums, can recover with scaling, but periodontitis, where the bone has started to dissolve, may also require root planing or gum surgery. In Korea, national health insurance covers scaling once a year for people aged 19 and over, while the cost of other periodontal treatment depends on the scope of treatment and the copayment rate for the type of dental institution.

Published 2026-11-08 · Updated 2026-11-08 · DentalStatics editorial team

Key facts

Scaling under national health insurance	Age 19 and over, once between January 1 and December 31 each year (source: National Health Insurance Service (NHIS, 국민건강보험공단))
Scaling beyond once a year	Not covered by insurance (source: NHIS)
Periodontal disease prevalence in adults	23.4% of those aged 19 and over (2018 Korea National Health and Nutrition Examination Survey, oral examination) (source: Korea Disease Control and Prevention Agency (KDCA, 질병관리청) National Health Information Portal)
Patients with gingivitis and periodontal disease	About 19.6 million, the most common outpatient diagnosis under health insurance in 2024 (source: KDCA National Health Information Portal (citing Health Insurance Review and Assessment Service statistics))
Scaling interval after periodontal treatment	Once every 3 to 6 months (source: KDCA National Health Information Portal)
Scaling when there is no periodontal disease	Once a year (source: KDCA National Health Information Portal)
Outpatient copayment at a dental clinic	30% of the total covered medical cost (source: NHIS)
Outpatient copayment at a dental hospital	40% in dong (urban) areas, 35% in eup/myeon (rural) areas (source: NHIS)

How does gingivitis differ from periodontitis?

Periodontal disease is a chronic bacterial inflammation affecting the gums, the periodontal ligament, the alveolar bone, and the surface of the tooth root. When inflammation stays in the soft tissue of the gums it is called gingivitis, and when it has resorbed the bone it is called periodontitis.

Gingivitis can return to normal gums once tartar is removed and brushing is corrected. In periodontitis, a gap opens between the tooth and gum to form a periodontal pocket, and bone that has dissolved is mostly hard to restore. For that reason the goal of periodontitis treatment is to stop or slow its progression.

Periodontal disease is common among Korean adults. In the 2018 Korea National Health and Nutrition Examination Survey oral examination, 23.4% of adults aged 19 and over had periodontal disease, and the rate rose sharply from age 50. The Korea Disease Control and Prevention Agency (KDCA, 질병관리청) says periodontal disease mostly begins in the mid-30s and recommends regular gum examinations starting in the 20s and 30s.

What are the signs that gum treatment is needed?

Early gum disease causes almost no pain, so it is hard to notice by yourself. The KDCA explains that by the time people visit a dentist after feeling symptoms like those below, the teeth often have to be extracted. If even one or two of them keep recurring, it is wise to have your gums examined.

Gum bleeding in particular is easy to put off because it does not hurt. When found at the gingivitis stage, it often ends with scaling and brushing correction, so being examined while there is no pain is the way to reduce both the scope of treatment and the number of visits.

Gums bleed when brushing
Gums are red and swollen or discharge pus
Gums recede and the teeth look longer
Food often gets stuck between teeth
Teeth are sensitive or loose, and chewing feels weak

What stages does gum treatment go through?

The dentist decides the treatment stage by looking together at pocket depth, gum bleeding, tooth mobility, and the bone height on X-rays. A diagnosis is not made from a single X-ray, and a clinical examination is always reviewed with it. The stages of periodontal treatment presented by the KDCA are as follows.

Scaling: removing plaque and tartar above the gumline
Root planing and subgingival curettage: scraping tartar from under the gums and smoothing the root surface
Flap surgery (open curettage): cutting the gum to remove deep tartar and diseased tissue
Bone grafting and guided tissue regeneration: attempting to regenerate collapsed bone and periodontal tissue

How is the extent of treatment decided?

Whether to move to the next step is decided by the re-examination results. If pockets are shallower and bleeding sites are fewer after root planing, care moves to regular maintenance, and gum surgery is considered only for sites where deep pockets remain.

A periodontal abscess, where pus collects in the gums, is treated first by incision and drainage, with antibiotics added if needed. The KDCA explains that antibiotics are only an adjunct for acute or severe periodontal disease and cannot treat periodontal disease on their own.

How does health insurance apply to gum treatment?

For people aged 19 and over whose treatment ends with tartar removal alone, national health insurance covers one scaling a year between January 1 and December 31. A second scaling in the same year, or tartar removal for bad breath, stain removal, or preparation for orthodontics or prosthetics, is not covered.

Root planing and periodontal curettage are also periodontal procedures with set insurance fees, and the Ministry of Health and Welfare adjusted the fees of these two procedures when it expanded scaling coverage in 2013. The patient's share differs by type of institution, such as 30% at a dental clinic and 40% at a dental hospital in a dong area. For items whose coverage varies by situation, such as gum grafts or regenerative materials, it is wise to check each one before treatment.

Scaling coverage was widened in July 2013 to include cases with no follow-up treatment, and since 2018 the reference period has been the calendar year. Unused sessions do not carry over to the next year, so it helps to check before the year ends.

What factors make gum disease worse?

The main cause is bacteria in the plaque on tooth surfaces and the tartar it hardens into. When smoking, diabetes, obesity (body mass index of 30 or more), or stress are added, gum disease develops more easily and the response to treatment can worsen. The KDCA explains that current smokers have a worse periodontal prognosis and less benefit from periodontal treatment than former smokers and non-smokers.

Hormonal changes such as puberty, menstruation, and pregnancy, and some blood pressure drugs, anticonvulsants, immunosuppressants, and oral contraceptives, can also affect gum inflammation or gum overgrowth. It is safer to tell the dentist about any medication you take before a gum visit.

How often is follow-up care needed after gum treatment?

The KDCA recommends scaling once a year even without periodontal disease. People who have had periodontitis treatment or who form tartar easily are advised to have a checkup and scaling every 3 to 6 months.

At home, brush with the bristles against the gums, starting from the line where tooth meets gum, and clean between the teeth with floss or interdental brushes at least once a day. Mouthwash is only a supplement and cannot remove tartar that has already hardened.

Periodontal treatment and regular care continue for months to years, so it matters to choose a dental office whose travel distance and hours suit you. Compare the information published as public data in the regional dental lists on DentalStatics first, then ask at the consultation about the number of visits per treatment stage and which items are covered or not covered, which makes comparing dental offices easier. If you have an implant, have the gums around it checked too.

Detailed guides

Frequently asked questions

Is gum treatment finished once I have scaling?

At the gingivitis stage, many cases recover with scaling and brushing correction. If periodontitis has deep pockets, additional treatment such as root planing may be needed, decided from the gum examination results. Wherever treatment ends, regular maintenance must follow for the benefit to last.

How can I tell whether I have already used this year's insured scaling?

You can check in the dental treatment information inquiry for tartar removal on the National Health Insurance Service (NHIS, 국민건강보험공단) website or The건강보험 app, which requires an identity certificate. If the result shows the scaling is covered, you still have a session left this year, and if not, it has been used. Dental offices can also look up your remaining count at registration.

Does gum treatment hurt a lot?

Scaling is usually done without anesthesia, but scraping tartar from under the gums and gum surgery are done under local anesthesia. Sensitivity or a feeling that the gums have receded can follow, and the KDCA explains that most symptoms after scaling disappear within 1 to 2 weeks.

Is scaling covered by insurance for people under 19?

Insured scaling for prevention starts at age 19. However, the NHIS says that even under 19, tartar removal as a step before periodontal surgery can be covered.

Does dissolved gum bone grow back?

Mostly it is hard to restore to its original state. Bone grafting or guided tissue regeneration can attempt partial regeneration, but the KDCA explains that cases where tissue can regenerate are extremely limited. That is why it matters to start periodontal treatment before more bone dissolves.

Is gum disease related to general health?

The KDCA explains that periodontal disease shares risk factors with chronic conditions such as cardiovascular disease and diabetes, and that they can affect each other. If you have diabetes or heart disease, tell the dentist at your gum visit.

References

Korean version →