Periodontics

1. Stage 1Reversible

   Gingivitis

   Gum inflammation. Red, swollen gums that bleed when brushing. Fully reversible with proper treatment.

2. Stage 2

   Mild Periodontitis

   Periodontal pockets 4-5mm deep. Beginning bone loss. Non-surgical treatment usually effective.

3. Stage 3

   Moderate Periodontitis

   Pockets 6-7mm deep. Significant bone loss. May need surgical treatment for regeneration.

4. Stage 4

   Advanced Periodontitis

   Pockets >7mm. Severe bone loss. Tooth mobility. Risk of tooth loss without immediate intervention.

Gingivitis is the only fully reversible stage. Don't ignore bleeding gums, it's a warning sign that shouldn't be dismissed. Schedule a periodontal evaluation today.

• Early Stage (Gingivitis)

  Gingivitis begins with inflamed, bleeding gums and persistent bad breath that make eating uncomfortable. The good news is that this stage remains fully reversible with proper professional treatment and improved oral hygiene.

• Moderate Stage (Periodontitis)

  As the disease progresses, deep periodontal pockets form and bone loss begins. Gum recession becomes irreversible, and teeth may start to feel slightly loose or unstable.

• Advanced Stage

  Without intervention, advanced periodontitis leads to the loss of multiple teeth and severe bone destruction. Patients often require implants or dentures, facing significant aesthetic and functional challenges.

• Cardiovascular Risk

  Research shows that periodontal disease increases the risk of heart disease by two to three times and raises stroke probability. Oral bacteria can enter the bloodstream, triggering chronic systemic inflammation throughout the body.

• Diabetes Connection

  Diabetes and periodontal disease share a bidirectional relationship, each worsening the other. Diabetics face three times the risk of developing periodontitis, while treating gum disease often improves blood sugar control.

• Pregnancy Complications

  Pregnant women with periodontal disease face up to seven times higher risk of preterm birth and low birth weight babies. Pregnancy gingivitis is common, but the reassuring news is that periodontal treatment is safe during pregnancy.

1. Step 01

   Complete Anamnesis

   Detailed medical and dental history, risk factors (tobacco, diabetes, genetics), current medications.

2. Step 02

   Periodontal Clinical Examination

   Visual gum inspection, probing of all periodontal pockets, assessment of tooth mobility and gum recessions.

3. Step 03

   Periodontal X-rays

   Complete radiographic series (periapical or panoramic) to assess bone loss and destruction pattern.

4. Step 04

   Diagnosis and Staging

   Classification of periodontal disease (gingivitis, periodontitis stage I-IV), identification of modifiable risk factors.

5. Step 05

   Personalized Treatment Plan

   Presentation of treatment plan, therapeutic options, number of sessions needed, prognosis and costs.

6. Step 06

   Scheduling and Start

   Scheduling treatment sessions and immediate start of optimized oral hygiene instructions.

What is periodontal disease (gum disease)?

Periodontal disease is an infection of the tissues supporting the teeth - gums, periodontal ligament, and alveolar bone. It starts with bacterial plaque buildup that, if not removed, hardens into tartar. Bacteria cause inflammation (gingivitis) that can progress to periodontitis, destroying bone and potentially leading to tooth loss. It affects about 50% of adults over 30.

What are the symptoms of gum disease?

Symptoms include: red, swollen, or tender gums; bleeding when brushing or flossing; persistent bad breath (halitosis); gums pulling away from teeth (recession); teeth appearing longer; tooth sensitivity; loose or shifting teeth; change in bite; pus between teeth and gums. Important: periodontal disease can be silent in early stages, so regular check-ups are essential.

What is the difference between gingivitis and periodontitis?

Gingivitis is the initial and reversible stage of the disease - it only affects the gums, causing inflammation, redness, and bleeding. There is no bone loss. With proper treatment (professional cleaning and good hygiene), gums fully recover. Periodontitis is the advanced stage - the infection extends below the gum line, destroying bone and supporting tissues. It forms periodontal pockets (spaces between tooth and gum) that accumulate more bacteria. Bone damage is irreversible, but treatment can stabilize the disease.

What is scaling and root planing (deep cleaning)?

Scaling and root planing (SRP) is the standard non-surgical treatment for periodontal disease. Performed with local anesthesia, it consists of: scaling - removal of plaque and tartar above and below the gum line; root planing - smoothing root surfaces to remove bacterial toxins and allow the gum to reattach to the tooth. Usually done in 2-4 sessions, by quadrants. For early cases, it may be the only treatment needed.

Can periodontal disease be cured?

Gingivitis (early stage) can be completely cured with proper treatment. Periodontitis (advanced stage) cannot be cured but can be controlled and stabilized. Lost bone does not regenerate naturally, but treatment can: stop disease progression; reduce pocket depth; in some cases, regenerative techniques can recover some lost bone. Long-term success depends on rigorous maintenance - regular visits and impeccable oral hygiene.

What are the risk factors for periodontal disease?

Major risk factors include: smoking (the biggest modifiable risk factor); poorly controlled diabetes; genetics/family history; chronic stress; medications that reduce saliva; hormonal changes (pregnancy, menopause); poor oral hygiene; nutrient-poor diet; diseases affecting the immune system; teeth grinding (bruxism); crowded or misaligned teeth that make cleaning difficult.

Is there a connection between periodontal disease and other diseases?

Yes, studies show important associations. People with periodontal disease have 2-3 times higher risk of heart attack and stroke. Chronic gum inflammation can contribute to cardiovascular diseases. There is a bidirectional relationship with diabetes - each worsens the other. Other associations include: rheumatoid arthritis, Alzheimer's disease, pregnancy complications (premature birth, low birth weight), and respiratory diseases. Treating periodontal disease may improve control of other conditions.

What is gum recession and how is it treated?

Gum recession occurs when the gum pulls away from the teeth, exposing the root. Causes include: aggressive brushing, periodontal disease, bruxism, genetics, or orthodontics. Treatment depends on cause and severity: mild cases can be managed with changes in brushing technique and monitoring; moderate to severe cases may need gum graft (tissue transplant from palate) or pinhole technique (minimally invasive procedure without cuts). Gums do not naturally regrow once lost.

Is periodontal treatment painful?

With modern techniques and adequate anesthesia, periodontal treatment is generally well tolerated. Deep scaling is done with local anesthesia, so you feel no pain during the procedure. After treatment, there may be sensitivity in teeth and gums for a few days to a week. This sensitivity is normal and progressively decreases. We recommend analgesics if needed and warm salt water rinses. Minimally invasive techniques, like pinhole technique and GBT therapy, cause even less discomfort.

How often should I have periodontal maintenance?

Frequency depends on disease severity and response to treatment. Generally, patients with a history of periodontal disease need maintenance appointments every 3-4 months, instead of standard semi-annual cleanings. These appointments include: periodontal pocket measurement; removal of plaque and tartar above and below the gum; oral hygiene evaluation; treatment plan adjustments. Regular maintenance is essential to prevent disease reactivation.

Can gums bleed even if I brush my teeth well?

Healthy gums should not bleed. If they bleed when brushing, even with good technique, it may indicate: developing gingivitis or periodontitis; overly aggressive brushing technique; hard-bristled brush; incorrect flossing; hormonal changes (pregnancy, menstruation); certain medications (anticoagulants); nutritional deficiencies. Persistent bleeding should always be evaluated by a professional. Do not stop brushing or flossing because of bleeding - this worsens the situation.

What can I do at home to prevent periodontal disease?

Home prevention is essential: brush teeth 2 times a day with fluoride toothpaste, for 2 minutes, using gentle circular motions; use dental floss daily to clean between teeth; consider using interdental brushes; use an antibacterial mouthwash if recommended; do not smoke - it is the biggest modifiable risk factor; maintain a balanced diet rich in vitamins C and D; manage stress; if you grind your teeth, use a night guard; have regular check-ups (at least twice a year).