Dr Ortuso and his staff at the dental practice on the Via Casilina in Rome always want to remind us that the first defence against periodontal disease is prevention with periodic examinations, at least every six months, and specialist oral hygiene.

All this must be accompanied by scrupulous hygiene of the patient at home, who should help the dentist in his work by preventing gingival inflammation and thus periodontal disease.

Many patients visit the dentist in the centre of Rome after the onset of the disease or when the periodontitis has become chronic or has caused irreversible damage, such as the vertical sagging towards the apex of the periodontium and an increased sensitivity of the teeth to heat/cold and to chemical agents such as lemon sugars, etc., not to mention the increasingly noticeable mobility of the affected teeth.

It is estimated that at least ten million Italians suffer from such diseases after the age of thirty. With periodontal disease, 'attachment' (epithelial attachment, which is not actually lost, but moves apically, away from the tooth towards the root) and alveolar bone are lost. These anatomical changes in the periodontium are consequences of the disease, leading to two possible clinical manifestations:

• gingival recession (sagging gingiva that is evidenced by a longer tooth);
• periodontal pocket (gingiva in the correct position, but the bone and attachment have moved apically along the root)

By contacting the offices of the specialist in periodontology and orthodontics in Rome, the diagnosis will be quick and the treatment certainly easier.