Periodontitis care · Barcelona · Stages I–IV
Understand your gum disease.
Make a plan to control it.
Periodontitis affects the tissues and bone that hold your teeth in place. At OsteoPerio, we start with a full diagnosis, explain what is driving the disease and agree a plan to protect your teeth.
Bleeding, receding gums, persistent bad breath or loose teeth deserve assessment. Periodontitis can also progress with little discomfort.
At a glance
- Confirm the extent of gum diseaseMeasurements and appropriate X-rays show loss of tooth support. Your stage, grade and risk factors guide the plan.
- Start with cleaning and reassessmentHome care and professional cleaning come first. Surgery is considered only where needed after reviewing the response.
- Coordinate care in advanced casesAdvanced disease may need additional care for tooth movement, missing teeth or chewing. Periodontal control and ongoing maintenance stay part of the plan.
Understand what changes
The problem extends below the gum.
Inflammation damages the attachment and bone. A deeper pocket can hold bacterial deposits that a toothbrush cannot reach.
Educational cross-section, simplified and not to scale. These are concepts, not photographs or a predicted treatment result.
Diagnosis before treatment
We measure first.
Then we explain your findings.
A periodontal chart records pockets, bleeding and attachment loss around the teeth. Relevant radiographs show bone support. We also assess mobility, your bite, medical history and previous treatment.
Why is this happening?
Bacterial plaque triggers an inflammatory response, but susceptibility differs between people. We review cleaning difficulties, smoking, diabetes control and relevant family history. This is about finding what we can improve together, without blame.
You leave the discussion understanding which teeth need attention, your treatment options, the expected benefits and limitations, and what you can do at home.
Stage I
Early loss of support
Detect the damage and establish control.
Stage II
Moderate damage
Treat the affected sites and reduce further risk.
Stage III
Severe, more complex disease
Assess deep pockets, defects and the outlook for each tooth.
Stage IV
Severe disease with added complexity
Also plan for lost teeth, tooth movement or difficulties with the bite and chewing.
Stage describes damage and treatment complexity. Grade A, B or C estimates slow, moderate or rapid progression. Your diagnosis also records how widely the disease is distributed. These are clinical assessments, not categories to choose from symptoms or a photograph.
The EFP treatment pathway
Four steps. A plan shaped around your response.
We follow the stepwise approach in the European Federation of Periodontology’s S3 guidelines. The aim is control of disease and teeth you can maintain over time.
- 1
Daily care + risk control
Build the foundations
Learn how to clean the areas that need attention. We remove accessible deposits, address plaque traps and support smoking cessation and diabetes control where relevant.
- 2
Non-surgical treatment
Clean below the gum
Careful cleaning of affected root surfaces removes bacterial deposits and tartar beneath the gum. Local anaesthetic can help you stay comfortable. We then allow healing before reassessment.
Pause. Measure. Decide together.
After healing, we repeat the gum measurements and review bleeding and home care. The next step follows your response, not a fixed package.
Treatment goals reached → Step 4
Pockets still need treatment → Step 3
- 3
Only when indicated
Treat sites that still need help
Some pockets need repeat cleaning; others benefit from surgery for access or, in suitable defects, regeneration. The choice depends on the remaining pocket, bone shape and your ability to keep the area clean.
- 4
Long-term supportive care
Keep the disease controlled
Regular measurements, professional cleaning and support with home care help detect recurrence. Visits are tailored to your risk: often every 3–6 months, within the EFP’s individualised 3–12-month range.
Original educational illustrations. Step 3 is followed by another review; home care and risk-factor control continue throughout.
What do you check at reassessment?
We compare pocket depths, bleeding, plaque control and healing. Residual pockets deeper than 4 mm that bleed on probing, or pockets of 6 mm or more even without bleeding, need further consideration. A measurement alone does not automatically mean surgery; the defect, overall response and your preferences guide the choice.
Stage IV · coordinated care
Control the disease.
Then rebuild comfort and function.
Advanced periodontitis can affect how teeth meet, move and function. Periodontal care may need coordination with restorative dentistry or orthodontics. The plan considers which teeth can be maintained and whether missing teeth need replacing.
Rehabilitation is planned from the outset and timed around periodontal control. It may include stabilisation, tooth movement or replacement teeth. Implants are an option in selected cases, not an automatic answer to stage IV disease.
- 1
Agree the whole plan
Periodontal findings + bite + your priorities
- 2
Establish periodontal control
Treat inflammation and reassess the teeth
- 3
Restore function where needed
Coordinate the appropriate rehabilitation
- 4
Maintain both gums and restorations
Ongoing care with clear responsibilities
Your consultation guide
A clear record of what comes next.
We use this OsteoPerio worksheet during diagnosis to explain your stage, grade, relevant risk factors and treatment sequence. Keep it with your individual plan and bring your questions to your review.
This is our Spanish consultation handout, not an EFP publication or a self-diagnosis test. Your periodontist completes and interprets it with you.
Cómo tratamos su periodontitis
Spanish · 1 page · PDF · 363 KB
Read alongside your clinical plan. The worksheet groups phases differently from the four EFP steps above. Deep pockets can need treatment even without bleeding; your periodontist interprets the measurements and sets the timing.
Important notes for using the worksheet
The pocket-depth shortcut in the PDF is simplified: a deep pocket may need treatment even without bleeding. At review, we also assess pockets deeper than 4 mm that bleed and pockets of 6 mm or more. This does not make surgery automatic.
EFP step 4 is supportive periodontal care; rehabilitation is an additional phase when needed. The worksheet’s 4–8-week review and 3–6-month maintenance intervals are guides, adjusted to healing and risk.
For cleaning between teeth, we select suitable interdental brushes where they fit; floss can help in tighter spaces. Both tools are not required in every space. Family susceptibility can inform the assessment but cannot be changed.
Before your appointment
Can periodontitis be controlled?
Treatment and consistent home care can help control the disease and preserve teeth. Lost support does not automatically return, and recurrence is possible, so ongoing periodontal maintenance remains part of the plan.
Does everyone need surgery or antibiotics?
No. Non-surgical treatment comes first. Further care depends on the response and remaining defects. Routine systemic antibiotics are not recommended by the EFP; they are reserved for selected situations after clinical assessment.
Will my teeth look or feel different after treatment?
As inflammation settles, the gums may shrink and spaces between teeth may become more visible. Sensitivity can occur; surgery can also cause swelling, discomfort and recession. We discuss likely changes, alternatives and aftercare before you decide.
What does the first assessment include?
Dr. Sahand Shirzadi Maryan and Dr. Sergi Rivas Frau study your case together and attend the diagnostic discussion. We explain the findings, priorities, suitable options and sequence. Full diagnostic assessments normally cost €80–€150, depending on the case; any additional radiographs or investigations can cost more. Bring existing records for us to review.
Let’s understand your gum health together.
Send your concern and tell us whether you already have radiographs or a periodontal chart. We see patients by appointment at collaborating clinics in Barcelona; the location is confirmed with you.
Request an assessment