Periodontal Disease
in Long Island, NY

What Is Periodontal Disease?

Periodontal disease is a bacterial infection and inflammation of the tissues that surround and support your teeth, including the gums and the bone that holds your teeth in place. It begins with plaque, the sticky film of bacteria that keeps forming on your teeth. When brushing and flossing do not remove it, the bacteria irritate the gums and trigger inflammation. Plaque left on the teeth can also harden into tartar, also called calculus. Brushing cannot remove tartar; only a dental professional can.

The Stages of Periodontal Disease

Periodontal disease develops in stages, and the stage at which it is found determines whether the damage can be reversed.

Gingivitis: The Early, Reversible Stage

Gingivitis is inflammation of the gums alone. Your gums may look red or puffy and bleed easily when you brush or floss, yet gingivitis usually causes little or no discomfort, so it is easy to miss. Because no bone has been lost at this stage, gingivitis can usually be reversed with a professional cleaning and consistent brushing and flossing at home.

Periodontitis: When the Infection Reaches the Bone

If gingivitis is not treated, it can advance to periodontitis. Plaque spreads below the gum line, and the gums begin to separate from the teeth, forming pockets where more bacteria collect. The bacteria, along with the inflammation your body produces to fight them, break down the bone and connective tissue that anchor your teeth. As the pockets deepen and more bone is lost, teeth can loosen or shift, and some may eventually need to be extracted.

Periodontitis cannot be reversed, and bone lost to the disease does not grow back on its own. Professional treatment can slow the disease and keep it under control, and in some cases regenerative procedures can help rebuild lost bone.

How Periodontists Stage and Grade Periodontitis

Periodontists describe periodontitis using a classification system published in 2018 by the American Academy of Periodontology and the European Federation of Periodontology. Each case is given a stage, from Stage I, the mildest, to Stage IV, the most advanced, based on how severe and complex the disease is. Each case is also given a grade from A to C, based on how quickly the disease is progressing. Together, the stage and grade describe how much damage has occurred and how likely the disease is to keep advancing.

How Periodontal Disease Is Diagnosed

Because gum disease is often painless, an exam may find it before you notice anything. The CDC notes that a dental check-up at least once a year allows gum disease to be detected and treated early.

At your first visit, Dr. Scharf or Dr. Mukhtar performs an in-depth dental and periodontal exam, including measurements of the pockets between your gums and teeth. X-rays show whether bone has been lost around your teeth. Our office uses a digital X-ray system and takes only the images needed for diagnosis and treatment planning, and no X-rays are taken until they have been explained to you and you agree. We also use PreViser periodontal risk assessment software to help tailor your treatment plan. After the exam, you will have a personalized treatment conference to review your options, either right away or at a later visit that fits your schedule.

How Periodontal Disease Is Treated

Treatment depends on the stage and grade of your disease, your health history, and your goals. Early periodontal disease can often be treated without surgery, and our office offers several nonsurgical options. Treatments available include:

• Scaling and root planing: A deep cleaning that removes plaque and tartar from below the gum line and smooths the root surfaces, making it harder for bacteria to reattach.
• Perioscopy: A nonsurgical treatment that uses a tiny dental endoscope to send a magnified image of the tooth root to a monitor, so tartar below the gum line can be seen and removed without incisions.
• LANAP laser therapy: The Laser-Assisted New Attachment Procedure uses a laser to target diseased tissue and bacteria inside gum pockets without incisions or sutures.
• Periodontal pocket reduction: A surgical procedure that removes infected tissue and reshapes the area so the pockets are shallow enough to keep clean at home.
• Tissue reconstruction and bone grafting: Procedures that restore lost bone or gum tissue to support the teeth, often used in advanced cases or to prepare a site for dental implants.
• Periodontal maintenance: Professional cleanings after active treatment, scheduled at intervals based on your needs, to help keep bacteria from returning to treated areas.

For a full overview, see our gum disease treatment page.

Frequently Asked Questions About Periodontal Disease

Is gum disease the same as periodontal disease?

Yes. The two terms describe the same group of conditions, which range from gingivitis to periodontitis.

Can periodontal disease be reversed?

Gingivitis, the earliest stage, can usually be reversed with a professional cleaning and better daily care. Periodontitis cannot be reversed, but treatment can slow it and keep it under control. For more detail, read Can Gum Disease Be Reversed? Gingivitis vs. Periodontitis.

Does periodontal disease hurt?

Often it does not. Gingivitis usually causes little or no discomfort, and periodontitis may not cause noticeable symptoms until it is advanced. Regular exams matter even when nothing hurts.

How common is periodontal disease?

Very common. According to the CDC, about 42% of U.S. adults age 30 and older have periodontitis, and about 8% have severe periodontitis.

What happens after periodontal treatment?

After active treatment, periodontal maintenance visits let our doctors monitor your gums and help keep bacteria from returning to treated areas. How often you come in depends on your individual needs.