Chronic disease anywhere in the body is insidious, thus advanced symptoms may only appear late after significant damage has occurred.

Warning signs of periodontal (gum) disease include:

- Redness, tenderness, pain, swollen gums
- Bleeding while brushing, flossing or biting into an apple
- Insufficient long term flossing over a lifetime
- Receding gums, frequently described ‘getting long in the tooth’
- Teeth moving or shifting
- Loose teeth
- Appliances no longer fit comfortably
- Previous history of tooth loss including parents
- History of smoking, diabetes or other metabolic diseases