Nothing you build on inflamed gums stays where you put it. Healthy gums first. Then we stop the decay. Then we rebuild.
People usually come in wanting the last step: the crown, the veneers, the straighter smile. That's completely reasonable. But the order we do things in decides whether the result lasts, and it's the part patients are least often told. Here's the sequence, and why we stick to it.
Why the Gums Come First
Your gums and the bone beneath them are what everything else sits on. If they're inflamed, they bleed, swell and move. That makes it harder to take an accurate scan, harder to seal the edge of a filling or crown, and harder to judge the finished shape of a smile. Work placed on inflamed gums doesn't last as well.
There's a bigger reason too. If gum disease has reached the stage of periodontitis, bone has already been lost, and that bone doesn't grow back. Treatment can stabilise it. It can't undo it. So we find out where you stand with a BPE gum check at your first exam, and we get things stable before anything is built on top.
Then Decay
A filling deals with the damage. It doesn't deal with why the damage happened. Before we rebuild, we look at what's driving decay in your mouth: how often you eat and drink between meals, what's in your drinks, how well every surface is being cleaned, and whether fluoride is doing its job. Frequency matters more than quantity here, which we've written about separately. Skip this step and new fillings and crowns just become the next place decay starts.
Then We Rebuild
Once the gums are healthy and decay is under control, the rebuild is far more predictable. That covers crowns, composite bonding, veneers, Invisalign and implants. A healthy tooth whitens better, and a healthy gum line frames a cosmetic result properly instead of fighting it. For implants it matters even more: people who've had gum disease are more prone to problems around implants, which is exactly why we want things stable first.
What About Pain or Infection?
Anything painful or infected is dealt with straight away. The order above is for planned work. It's never an excuse to leave you hurting.
It Isn't a Delay. It's the Foundation.
This isn't about making you wait. For some people the gum phase is straightforward, and for others it takes longer. We'll tell you honestly which it is after your first exam. A hygiene visit is £77 for 20 minutes or £105 for 30. And once you're dentally healthy, our membership plan, from around £28 a month, covers your regular check-ups, hygiene visits and necessary restorative work, so the foundation stays in place.
If you've been told you need work and you're wondering why we're talking about your gums first, this is why. We'd rather build it once and build it to last.