We get it. You go in for your routine check-up, expecting a quick once-over. You’re given a clean bill of health on the cavities front, only to be told to go and book a hygienist appointment for another £80.

It might feel like overkill. It is easy to wonder: Is my dentist just trying to book up the hygienist? Is this just a business trying to sell more appointments?

To answer that, we have to ignore the business side for a moment and look at what is actually happening biologically.

How it Starts: The "Silent Destruct"

The perception in the UK is often that bleeding gums are normal or just a bit of bad luck. But the reality is that gum disease is a "silent destruct."

It starts with bacteria. You can brush and floss, but there are areas where calculus and bacteria build up that you simply cannot remove at home. This buildup causes your immune system to react, leading to inflammation. Initially, this is just gingivitis; annoying, perhaps, but manageable.

Crossing the Rubicon

However, if left untreated, especially in susceptible people (about 1 in 10 of us), the disease progresses. This is the point where you "cross the Rubicon."

You move from minor gingivitis, which is reversible, to periodontitis, which involves actual bone loss. Once you cross this line, the infection destroys the foundations of the teeth. Even though periodontal therapy has improved massively during my career, it is very hard—in fact, often impossible—to come back to where you started once the support for the tooth is lost.

The Leaky Gateway

The risk doesn't stop at tooth loss. Our bodies are generally very well sealed by skin or mucosa; however, the margin between our teeth and gums is potentially a "chink in our armour."

When your gums are diseased, they become "leaky." This ulcerated surface area allows bacteria to travel through the blood (bacteremia) or sends inflammatory signals (cytokines) spreading system-wide like a fire. This is where the mouth becomes the gateway to the body. The surface area of the inflamed surface can be the size of the palm of you hand!

The Specific Risks

There is significant evidence connecting this oral inflammation to major systemic issues:

• Diabetes (The Two-Way Street): The connection here is critical. Gum disease can make controlling blood sugar harder, and high blood sugar worsens gum disease. Studies show periodontal therapy can actually reduce HbA1c levels by around 0.4%; that’s a clinical improvement similar to adding a new medication.
• Heart Health: We are now finding bacterial DNA from the mouth inside artery plaque.
• Brain Health: Even scarier, recent links have been found between P. gingivalis (a gum bacteria) and Alzheimer’s disease. We are talking about long-term, chronic exposure to inflammation.

A Note on Causation vs. Correlation

We must be scientifically honest here: establishing a direct "causal" link is difficult. Does gum disease cause heart disease, or do people with poor health habits simply suffer from both? It is a complex area of research, and we have to be careful not to make wild claims.

However, the evidence is getting stronger by the day. The biological mechanisms of the "leaky" gum margin allowing bacteria into the bloodstream are undeniable facts, even if the exact scale of the impact is still being mapped out.

The Verdict

This is why that £80 appointment isn't just an upsell. A comprehensive hygienist appointment is with a well-trained, diligent clinician who does so much more than just "clean." Their primary role is to intervene before you cross the Rubicon.

So, are we trying to sell you something? Yes, we are selling you a future where you keep your teeth and protect your heart.

Don’t wait for it to hurt. Treat the mouth to heal the body.

For more information and source so information visit our Research Summary

Next Steps:

• Daily: Floss or use interdental brushes (it’s tedious, but necessary).
• Professional: If you have risk factors, that 3-month hygiene cycle isn't a sales tactic; it's a medical necessity. If you don't, then hopefully a 6 monthly hygiene appointment will be enough.
• Book an appointment with one of our Expert Dental Hygienists.