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PreventionWellbeing2 min read · July 22, 2026

by Dr. Massimo Ferrara

Periodontitis: how to recognise it and what can be done

Periodontitis rarely hurts until it is advanced: the warning signs, the risk factors and how it is treated, according to WHO and EFP guidance.

Periodontitis is the inflammation that spreads from the gums to the bone supporting your teeth. It is one of the most widespread chronic diseases worldwide and, according to WHO, severe forms affect a substantial share of the adult population. The catch is that it rarely hurts, which is why it is often noticed late.

Signs you should not ignore

Do not wait for pain. The warning signs are different:

  • gums that bleed when brushing, or spontaneously;
  • persistent bad breath that does not clear up with cleaning;
  • receding gums and teeth that look «longer»;
  • the feeling that a tooth moves, or that your bite has changed;
  • gaps opening between teeth that used to touch.

Why it matters more than it seems

Periodontitis is not only a mouth problem. International literature documents a two-way link with some systemic conditions, diabetes first of all: gum disease can make glycaemic control harder, and poorly controlled diabetes worsens periodontal tissues. One more reason not to postpone.

How it is treated

The path always starts with an orderly diagnosis: periodontal probing to measure pocket depth, radiographs to assess the bone, and a clinical history (smoking, family history, diabetes, medication). The plan is built from there.

In most cases the first phase is not surgical: subgingival tartar is removed with causal therapy, home hygiene technique is corrected, and the situation is reassessed after some weeks. Only if deep pockets remain is a surgical approach considered. A decisive and often underrated part is maintenance: check-ups and hygiene sessions at personalised intervals, because periodontitis is controlled over time.

What depends on you

Two factors weigh heavily and are in your hands: daily interdental cleaning (a toothbrush alone is not enough) and smoking, which WHO lists among the main risk factors and which masks bleeding, delaying diagnosis.

When to book

If you notice bleeding that does not settle after one or two weeks of correct hygiene, or even one of the other signs, it is time for a periodontal assessment. The earlier you act, the more tissue you keep: lost bone does not grow back.

Sources

Frequently asked questions

Can periodontitis be cured?

It can be controlled rather than «erased»: bone that has already been lost does not grow back. With causal therapy and regular maintenance the inflammation settles and the situation stabilises over time.

Is periodontal therapy painful?

Causal therapy is carried out under local anaesthesia and most people describe it as well tolerated. Discomfort in the following days is usually modest and manageable.

How often are check-ups needed afterwards?

The interval is personalised according to risk, generally between 3 and 6 months. Maintenance is what makes the difference in the long run.

Clinical review: Dr. Massimo Ferrara

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