Gum disease
Periodontitis treatment in Downtown Brooklyn
Periodontitis is a bacterial infection of the gums and the bone that holds your teeth in place. Left untreated it destroys that bone permanently, which is why teeth loosen and are eventually lost. At Brooklyn Periodontics treatment begins non-surgically in almost every case: deep cleaning below the gumline, local antimicrobials where they help, correction of the risk factors driving the disease, and then re-measurement of the same sites to prove it worked.
Periodontitis is the leading cause of adult tooth loss and it is usually painless until it is advanced. Bleeding gums, bad breath, and gum recession are the early signals.
What is periodontitis?
Bacteria collect below the gum line and the body responds with chronic inflammation. That inflammation, not the bacteria alone, dissolves the attachment and the bone around the root. The space that forms is called a pocket, and once a pocket is deep enough you cannot clean it at home.
Gingivitis, the earlier and reversible stage, involves inflammation without bone loss. Periodontitis means bone has already been lost. Bone loss does not reverse on its own, but the disease can be stopped and kept in remission, and that is the goal of treatment.
Signs you should be evaluated
Gums that bleed when you brush or floss
Bleeding is not normal, and it is the earliest reliable sign of active inflammation.
Persistent bad breath or a bad taste
Often the first thing patients notice, caused by bacteria in deep pockets.
Gums pulling away from the teeth
Recession, longer-looking teeth, or newly sensitive roots.
Loose or shifting teeth
A sign that supporting bone has already been lost. This warrants prompt evaluation.
Your dentist mentioned deep pockets
Numbers of 5mm and above, or bone loss on x-rays, are the standard reason for a periodontal referral.
How treatment is performed here, least invasive first
01
Full periodontal diagnosis
Every site charted, x-rays and in-office 3D imaging where indicated, and a staged, graded diagnosis you can see rather than a vague warning.
02
Non-surgical therapy
Scaling and root planing under local anesthesia to remove deposits and bacterial biofilm from the root surfaces, with local antimicrobials in selected pockets.
03
Risk factor correction
Smoking, diabetes control, grinding, bite forces, a high filling margin, or a poorly fitting crown all drive disease. Treating the infection without these fails.
04
Measured re-evaluation
The same sites are re-probed six to eight weeks later. Most patients need nothing more than maintenance from here.
05
Surgery only where numbers stay high
If specific pockets do not respond, we discuss access surgery or regenerative grafting for those sites only, not the whole mouth.
06
Periodontal maintenance
Specialist cleanings on a three or four month interval with re-charting, because remission is maintained, not cured.
Why see a periodontist rather than a general dentist
A periodontist completes three years of surgical specialty residency after dental school focused entirely on gums, bone, and implants. Dr. Zidile and Dr. Choi trained at NYU, are board certified in periodontics, and hold teaching and faculty appointments.
General dentists treat early gum disease well, and most of our patients arrive on their dentist's referral precisely because the case has passed that point. We treat the disease and return you to your dentist for fillings, crowns, and routine care.
Alternatives and least invasive options
There is no medication that cures periodontitis, and no laser that replaces removing the deposits. What we can do is treat the smallest number of sites necessary, non-surgically wherever possible, and prove the result with measurements before recommending anything surgical.
Questions patients ask
Periodontitis questions
- Can periodontitis be cured?
- It can be arrested and held in remission, but not cured in the sense of never returning. Bone already lost does not grow back on its own, though some defects can be regenerated with grafting.
- Is scaling and root planing painful?
- It is done with local anesthesia so the appointment itself is comfortable. Gums can be tender and teeth briefly sensitive for a few days afterwards.
- How many visits does treatment take?
- Most patients are treated in one or two visits, then re-evaluated six to eight weeks later. Maintenance follows every three to four months.
- Will I lose my teeth?
- Not usually, if the disease is caught and treated. Prognosis is given tooth by tooth after charting so you know exactly which teeth are at risk.
- Do I still need my regular dentist?
- Yes. We treat the gums and bone; your dentist continues fillings, crowns, and routine care. We send them a written summary.
- Does gum disease affect the rest of my health?
- Periodontitis is associated with diabetes, cardiovascular disease, and adverse pregnancy outcomes. The relationship with diabetes runs both ways: uncontrolled blood sugar worsens gum disease and vice versa.
- What happens if I do nothing?
- Bone loss continues, usually painlessly, until teeth loosen. Replacing teeth later with implants costs substantially more than treating the disease now.
- Does insurance cover periodontal treatment?
- Most plans cover a meaningful portion of scaling and root planing and periodontal maintenance. Our insurance team files electronically as a courtesy and gives you a written estimate before treatment.
- Do you offer laser treatment for gum disease?
- Lasers can be an adjunct in selected cases, but they do not replace removing the deposits from the root surfaces. We will not recommend one as a shortcut.
- Can I be treated if I smoke?
- Yes, and treatment still helps, though healing is measurably worse and relapse more likely. We will be direct with you about that and help you plan around it.
Related
Bleeding gums, or deep pockets on your chart?
Request a consultation. You will get a measured diagnosis, the least invasive plan that will work, and the fee in writing.