South Kensington
- 20 Old Brompton Road, London SW7 3DL
- Open seven days a week
- 020 7183 2362
Treatment comparison · Wimpole Street, Marylebone
Gum treatment or extraction: deciding whether a tooth loosened by gum disease can stay
Gum disease does its damage quietly, dissolving the bone that holds teeth in place until one day a tooth feels loose or an abscess appears. At that point there are two directions. Periodontal treatment cleans deep beneath the gum to halt the disease and give the tissues a chance to firm up around the tooth. Extraction removes the tooth, ends the infection at once and opens the way to a replacement. Neither is automatically right; the decision rests on how much bone remains, how the tooth is behaving and how well the rest of the mouth can be kept clean.
Decision guide
Which is right for you?
Choose Periodontal treatment if…
- The gum disease is at an early or moderate stage and the tooth is only slightly mobile.
- You are willing to attend several appointments and maintain a demanding cleaning routine.
- Keeping your own tooth matters more to you than a quicker resolution.
- The tooth is important for chewing or appearance and would be difficult to replace.
Choose Extraction if…
- X-rays show that most of the supporting bone has been lost.
- The tooth moves noticeably, is painful or has an abscess that keeps recurring.
- Previous gum treatment has not stabilised it.
- You would rather resolve the problem in one visit and then discuss an implant, bridge or denture.
At a glance
Side by side
| Feature | Periodontal treatment | Extraction |
|---|---|---|
| Aim | Control the disease and keep the tooth | Remove a tooth that cannot be reliably saved |
| Nature of procedure | Deep cleaning and root surface debridement under local anaesthetic; occasionally minor gum surgery | Surgical removal under local anaesthetic |
| Number of visits | Several, spread over weeks or months, plus maintenance | One, typically 30 to 60 minutes |
| Recovery | Mild tenderness for a few days | Socket heals over one to two weeks |
| Function afterwards | Your own tooth continues to work | Gap remains unless replaced |
| Fee at Wimpole Street | Periodontal treatment from £850 | Simple extraction from £250; complicated or surgical extractions more |
| Longer-term cost | Ongoing hygienist maintenance | Replacement with an implant, bridge or denture if desired |
| Effect on bone | Aims to halt further loss | Socket bone shrinks unless preserved or an implant is placed |
| Best suited to | Early to moderate disease where the tooth has a reasonable prognosis | Severe bone loss, hopeless mobility or unresolvable infection |
In the chair
What the treatment involves
Periodontal treatment
A full periodontal assessment measures pocket depths around every tooth and reviews X-rays to map bone levels. Treatment is then carried out in sections under local anaesthetic: ultrasonic and fine hand instruments remove hardened deposits and infected tissue from the root surfaces below the gum line, an area a routine scale does not reach. You are shown how to clean between the teeth effectively, since the result depends heavily on what happens at home. Around eight to twelve weeks later the pockets are measured again; most shrink as the gums tighten. Any areas that have not responded may be treated again or, occasionally, with small surgical procedures, and a maintenance schedule with the hygienist follows.
Extraction
After confirming with an X-ray that the tooth cannot be saved, the dentist numbs the area and loosens the tooth with gentle, controlled pressure before lifting it out. A simple extraction of an accessible tooth takes a matter of minutes; a broken-down or curved-rooted tooth may need to be sectioned or the gum lifted, which the fee schedule describes as complicated or surgical. Gauze pressure forms a clot, and you are given instructions on eating, rinsing and avoiding smoking. The socket closes over one to two weeks and the bone beneath remodels over several months. Options for replacing the tooth are discussed either beforehand or at a review.
Fees
Cost and longevity at Wimpole Street
Periodontal treatment at Wimpole Street will start from £850, reflecting the multiple sessions involved. A simple extraction starts from £250, with complicated extractions from £450 and surgical extractions from £650. Routine hygiene visits, which support both routes, are £89.
On the face of it extraction is the cheaper option, but it rarely ends there. Filling the gap with an implant starts from £2,950, a bridge from £995 per unit and a partial denture from £795, so the total commonly exceeds the cost of treating the gums. Where the tooth has a fair prognosis, the more economical path over time is usually to keep it.
All prices are indicative and are confirmed in a written treatment plan at your consultation. Fees are the same at every Medical & Dental clinic.
Weighing it up
Strengths and trade-offs
Periodontal treatment
Strengths
- Keeps your own tooth and its root
- Maintains bite and the position of neighbouring teeth
- Helps slow bone loss around the tooth
- Non-surgical in most cases
- Benefits the health of the whole mouth, not just one tooth
Trade-offs
- Several appointments and lifelong maintenance
- Success depends on daily cleaning between the teeth
- Higher initial fee than an extraction
- Advanced disease may not respond, and the tooth may still be lost later
Extraction
Strengths
- Ends pain and infection immediately
- Single, straightforward appointment
- Lower initial cost
- Protects adjacent teeth from spreading infection
- Clears the way for an implant, bridge or denture
Trade-offs
- The tooth is gone for good
- Replacement adds significant cost
- Bone at the site shrinks over time
- Neighbouring teeth may drift into the space
- One to two weeks of healing with some dietary limits
FAQ
Common questions
Three measures carry the most weight: how much bone remains on the X-ray, how far the tooth moves under gentle pressure, and whether infection persists after cleaning. A tooth with less than a third of its bone and marked mobility has a poor outlook; one with mild mobility and half its bone often responds well to treatment.
It is carried out under local anaesthetic, so the treatment itself is comfortable. Gums can feel tender and teeth sensitive to cold for a few days afterwards as the swelling settles, and exposed root surfaces may stay sensitive for a while.
Often, yes, if the looseness is due to inflammation rather than lost bone. As infection clears the gum reattaches and the tooth firms. Bone that has already gone does not regrow on its own, so a tooth with severe loss may remain somewhat mobile even after successful treatment.
Usually after the socket has healed for around three months, though in some cases an implant can be placed at the time of extraction. Where gum disease caused the loss, the surrounding tissues must be healthy first, which is why treating the remaining teeth still matters.
Research has linked chronic periodontitis with conditions such as diabetes and cardiovascular disease. The direction of cause and effect is still debated, but controlling gum inflammation is considered worthwhile for overall health as well as for keeping teeth.
Yes. Periodontal assessments and extractions are carried out now at South Kensington and St Paul’s, with the same fees and clinicians. Maintenance visits can move to Wimpole Street once the Marylebone diary opens.
Marylebone, W1
Wimpole Street opens 1 October 2026
Register your interest and we will contact you when the Marylebone diary opens. If you would rather not wait, the same clinicians can see you at South Kensington or St Paul's now.
Related treatments at Wimpole Street
Opening 1 October 2026
Wimpole Street is not yet seeing patients. Until then, please book or call our South Kensington clinic on 020 7183 2362 or our St Paul's clinic on 020 7183 3709. Questions about the new clinic: wimpolestreet@md.co.uk.
Until we open
Need an appointment before 1 October 2026?
The same clinical team already works from two other Medical & Dental clinics. Book at either one now and, if you prefer, move your ongoing care to Wimpole Street once the doors open.
St Paul's, City of London
- 5 Ave Maria Lane, London EC4M 7AQ
- Open Monday to Friday
- 020 7183 3709
