Implantologist Dr. Radoslav Simeonov, Head Dentist at the Dentatime Clinic talks on the challenges of Periodontal disease and the best dental treatment solutions available in its three major stages.


What is Periodontal Disease?


Periodontal disease (Periodontitis) can be characterised as an inflammation of the gums that surround the teeth, that can progress and lead to painful damage of the soft tissue and the bone that supports them. Bone can be lost, teeth may loosen or eventually fall out. In certain cases the disease leads also to teeth removal.

Common Causes of Periodontal Disease

There are several common causes and risk factors for periodontal disease that include:

  • Bacterial plaque and accumulation of tartar.
  • Poor oral hygiene.
  • Smoking.
  • Diabetes.
  • Certain medicine’s intake.
  • Hereditary disease.
  • Aging.

Periodontal Disease Symptoms

Some of the main symptoms that patients with developing periodontal disease face are swollen gums that bleed easily, painful chewing, apparent bone loss, loose or wobbly teeth, as well as their complete loss at a certain stage.

These symptoms are extremely important to follow up on, as they are directly linked to risks of other diseases and to the patient’s overall health condition. Above all, Periodontitis can increase the risk of cardiovascular disease and lead to a number of lung infections. Most often this happens through aspiration of bacteria located in the gum (periodontal) pockets.

Periodontitis can also cause damage to the overall immune system, as the human organism falls into a constant state of receiving inflammation signals. Patients with periodontal disease face high levels of bacteria in their blood flow and their body lives in a permanent state of weakened immunity.

What Are the Stages of Periodontitis?


There are three main stages of periodontal disease:

Stage 1 –  Gingivitis

Gingivitis is an early stage inflammation of the gums and at this point damage can still be reversed by observing strict oral hygiene and attending regular dental consultation for following appropriate treatment.

Stage 2 – Periodontitis

Periodontitis the stage that is described by the severe damage of the supporting bone and soft tissue. The progress of the disease is now marked by the following symptoms:

  • Gums bleeding while being brushed (blood on the toothbrush)
  • Lack of stability and pain when chewing
  • Extreme teeth sensitivity
  • Recurring inflammation in the gums surrounding the teeth

Gums may also pull aside at this stage and form pockets below the gum-line, which trap food and plaque (bacteria). This Second stage is also a period where periodontal pockets can still be subject to treatment.

Professional dental cleaning for plaque, calculus and stain removal is performed and at our Dentatime Clinic and we also offer Platelet-rich fibrin (PRF) treatment – a preferred dental procedure for better bone and soft tissue healing that help for reducing the inflammatory symptoms – pain, bleeding, teeth stability.

Stage 3 – Advanced Periodontitis

If treatment advised in the previous two stages has not been applied, this may well lead to the third stage of Advanced, severe and deep Periodontitis. This is the part where the fibers and bone supporting your teeth are destroyed, which can cause them to shift, loosen and even fall out or may also lead to the necessity of their removal.

How is Periodontitis Treated?

The success of the treatment process in the Advanced stage is highly dependent on all necessary actions taken in the previous two for approaching and holding back the inflammation progress. Professional deep teeth cleaning, soft tissue surgery, PRF treatment and teeth splinting are among the most common and obligatory procedures to be applied in the early stages.

During the last, Advanced stage, soft tissue being most often irreversibly destroyed,  teeth extraction and titanium implant replacement often are the only and best available treatment procedures. About 80% of all patients suffer a significant bone loss when reaching this stage and there are two major dental implant solutions that can be applied:

  • Classic, two-piece dental implants, with titanium rough surface that involve also bone augmentation and two-stage placement. A major disadvantage here is that this is an expensive and time-consuming procedure.
  • Basal (immediate) titanium implants that are covered with a No-Itis® protection polished surface that keeps bacteria away thus providing for periodontal prevention. Basal implants are one piece implants, placed into the basal cortical bone, known for being resistant to resorption (melting) and characterized by a faster and stable repairing capacity. They allow also immediate loading, meaning that patients can have their crown or bridge installed within the very next day or within 3 to 5 days. Given all said, Basal implants are the best long-term solution for patients suffering Advanced periodontal disease.

Treating Advanced Periodontitis with Immediate Basal Implants

In summary, our conclusion is that Basal Implantology is the best modern treatment practice for patients with Advanced periodontal disease. Basal (cortical) implants are the safest and fastest way that can help restore your smile and overall oral health. In the same time, they are the best long-term solution, research showing that they do not lead to gum disease around implants (peri-implantitis) and these implants can be immediately loaded,  so patients can quickly return to their normal life.

At our Dentatime Clinic, dental implant treatment starts with a complete check-up and detailed assessment of your bone quality and the general tooth/teeth replacement area. We ask patients to take an OPG x-ray and /or 3D digital scan (CBCT), after which we invite them for a detailed consultation on their individual treatment plan options.

Dr. Radoslav Simeonov

Implantologist and Head Dentist at Dentatime


Read more on Basal(cortical) Implants in the two related articles below:

Immediate Load Basal Dental Implants – Implants with Crowns in Three Days

Top 7 Most Common Dental Implants Myths