Many patients reach the dental office when periodontal disease is already advanced, although the first signs appeared long before.
Most of the time, symptoms are ignored or considered normal:
- gums that bleed during brushing,
- receding gums,
- persistent bad breath,
- in severe cases, teeth that start to become loose
When these signs finally lead the patient to see a doctor, the disease is already advanced. Treatment becomes more complex, longer, and requires a careful, step by step approach.
I am Dr. Diana Elena Anușca, specialist periodontist. I want to explain why periodontal diseases are diagnosed late, what the early signs are, and when you should see a periodontist, before the problem becomes difficult to control.
Why is periodontal disease so dangerous?
Many patients find it hard to understand that periodontal disease evolves differently from other dental conditions. Unlike tooth pain, which appears suddenly and is intense, periodontal damage often has mild or silent symptoms.
Inflammation develops in the tissues that support the tooth, the gums and the bone. These tissues can stretch. Because of this, pain is minimal or absent in the early stages. This creates the false impression that nothing serious is happening. The lack of obvious symptoms often delays the visit to the specialist.
Routine dental check-ups and professional cleanings every 6 to 12 months are essential for:
- early detection of periodontal changes
- prevention of bone loss
- long-term tooth preservation
When diagnosed early, periodontal disease can be controlled effectively and teeth can be kept healthy long term.
In complex dental rehabilitations, prosthetic, orthodontic, or implant treatments cannot begin if the supporting tissues are unhealthy.
For dental work to last, look natural, and function properly, the periodontium must be stable before any final stage. This is why complex treatments often require an interdisciplinary approach, which may include:
- the periodontist,
- the prosthodontist,
- the orthodontist,
- the implantologist,
- the general dentist
In this case, the rehabilitation of the upper arch was achieved through collaboration between me, as the periodontist, and my colleague, Dr. Bogdan Gligor, specialist in prosthodontics.
To complete the final prosthetic work, several stages were required:
- evaluation of periodontal status,
- periodontal treatment of affected teeth,
- extraction of non-restorable teeth,
- a healing period,
- long-term provisional prosthetic work.
These steps ensure stability, health, and durability of the final results.
What does periodontal treatment involve at Smile Vision clinic?
1. First visit, evaluation and professional cleaning
We usually start with Guided Biofilm Therapy.
This means more than simple cleaning:
- removal of bacterial biofilm,
- explanation of correct brushing techniques for your situation
- recommendation of auxiliary tools such as dental floss, interdental brushes, oral irrigators,
- identification and control of periodontal risk factors
2. Periodontal evaluation and imaging investigations
Least one week after cleaning:
- A complete periodontal evaluation is performed,
- Imaging investigations are requested, OPG or CBCT, if not already available,
- A definitive periodontal diagnosis is established.
3. Periodontal treatment
After removing factors that maintain inflammation, such as incorrect prosthetic work or defective fillings, treatment continues with:
- subgingival instrumentation,
- adjunct antimicrobial therapies:
- chemical, antimicrobial agents,
- physical, laser therapy
4. Reevaluation and periodontal stabilization
After initial treatment and a healing period, periodontal reevaluations and professional cleanings are performed at 1 month and 3 months after subgingival instrumentation.
After the 3-month reevaluation, two situations may occur:
if some areas do not respond adequately to root instrumentation, they will require surgical periodontal therapy, to allow access for subgingival treatment or for regeneration or resection of complex lesions;
• if therapeutic goals are achieved, patients enter supportive periodontal therapy, aimed at maintaining periodontal stability for all treated patients, through preventive and therapeutic measures defined earlier, tailored to personal needs, at regular intervals.
What results can you expect from periodontal treatment?
Regardless of the initial stage, the goals are clear:
- improved periodontal health,
- preservation of teeth on the arch,
- improved quality of life positive,
- impact on general health.
Untreated periodontal disease affects more than teeth. It is associated with systemic conditions such as diabetes, cardiovascular disease, and chronic inflammation.
What do I want as a periodontist?
“I want periodontal examination to become routine. I want to intercept many more cases in early stages and see far fewer cases where I must give a guarded prognosis for teeth affected by advanced disease.”
The best time to evaluate your periodontal health is now. A simple check-up can prevent complex treatments and tooth loss.
A healthy periodontium is the foundation of a stable smile and long-term oral health.
