Gum Disease

Reducing Inflammation in the Entire Body

Both Dr. Maryam Edalat and Dr. Parviz Edalat at Cosmetic Dental Specialists are certified specialists in the field of periodontics. Periodontics is the diagnosis and treatment of gum disease. A healthy periodontal environment is the foundation of a healthy mouth and beautiful smile. One of the main advantages of Dr. Edalat’s cosmetic dental studio is that you can complete your entire treatment by certified specialists who communicate in detail all aspects of the treatment that are interrelated for optimal results. Most patients don’t like the inconvenience of having to go to different offices to complete their work. There is also the risk that the timing sequence to complete a certain treatment when it is being done at different offices may compromise the final result. Also since the work is being done in different offices there may be a miscommunication between the referring doctors which may also compromise the final result.

Periodontal disease is a destructive process, that often has few or very mild symptoms at the early stages and thereby may go undetected. At Cosmetic Dental Specialists in NYC we screen each patient carefully and on an on-going basis for any indications of periodontal disease and educate our patients on prevention before treatment is ever necessary.

We conform to the ideal that a strong mind-body connection is the ultimate in health and that our habits, the foods we intake and life-styles greatly affect our health in every way. We believe in a collaborative effort to create the best and most stable state of health in both the mouth as well as the entire body, because as we know nothing exists in a void but all is interrelated. We do this by offering the latest in patient education materials on how to reduce inflammation in the body as a whole while working to keep the periodontium healthy.


Diagnosing Periodontitis


Cardio Health & Perio

Plaque breaks off in carotid artery

Periodontal disease and heart disease

Some studies show that people with periodontal disease have a higher probability of being diagnosed with heart disease than those without periodontal disease.

Researchers suspect that is because inflammation is a characteristic of both periodontal and heart disease.

Bleeding gums, a sign of periodontal disease, are open wounds that allow the bacteria to enter your bloodstream.

Plaque restricts blood flow

One cause of heart disease is a build-up of plaque in the arteries that, over time, can restrict the flow of blood. Periodontal bacteria have been found in that plaque, which leads many researchers to believe there might be a relationship.

In addition to building up, the plaque in the arteries can rupture, forming a clot. The clot can block blood flow and trigger a heart attack.

The same thing can happen in your brain. If the bacteria settle in your carotid artery, the inflammation may lead to the build-up of fatty deposits. If these deposits break apart and are carried in your bloodstream, they can lodge in your brain, block a blood vessel, and cause a stroke.

Risk factors

You may also be at risk if you have damage to your heart or heart valve, ertain congenital defects, a history of endocarditis, an artificial heart or heart valve, or you have had a heart transplant.

We want to work with you and your physician to keep you in optimal health. And a healthy mouth is key to a healthy life.


Respiratory Infection & Gum disease

Periodontal disease and respiratory infections

If you have periodontal disease, you should know that it can contribute to respiratory infections.

Evidence suggests that the bacteria that cause periodontal disease can contribute to, or worsen, infections such as pneumonia, chronic bronchitis, emphysema, and chronic obstructive pulmonary disease.

These bacteria enter your lungs through normal breathing and swallowing, where they can multiply and inflame lung tissues.

This is especially true if you smoke, have a weakened immune system, or if you already have a respiratory condition.

If we determine that you have periodontal disease, we will recommend an appropriate treatment plan. We will review your home care and schedule you for regular cleanings.

We may recommend other procedures to remove the source of bacteria and allow your gums to heal.

By caring for your dental health, you will reduce your risk of respiratory infection and increase your overall health.


Replacing Bone Procedure

Bone loss caused by periodontal disease

Bone grafting surgical procedure

Placement of a membrane after bone grafting procedure

Periodontal disease destroys bone

When periodontal disease has destroyed the bone around your teeth, a bone grafting procedure can often be used to replace the missing bone.

Before we begin, we prepare the replacement material, which may be your own bone, bone from another source, or artificial bone.


Once the area is numb, we make small incisions in the gum and lift it away from the tooth.

Next, we remove any plaque and bacteria from the root surface of the tooth.

Then, we place the grafting material into the areas where the bone has been destroyed.

Depending on the circumstances, additional treatments, such as special proteins or platelet-rich plasma may be applied to encourage bone growth and help your gums reattach to the tooth.

We may also place a special membrane over the graft to prevent unwanted tissue from growing into the graft site.

The last step is to reposition the gum and close the grafting site.

Over the next several months, the bone will heal around the tooth.

Bone replacement has several benefits. It can—

  • fill in areas of bone loss.
  • stimulate new bone growth.
  • stimulate soft tissue growth.
  • significantly reduce gum pockets.

Replacing bone is an important step in preserving your healthy and beautiful smile.


Scaling & Root planing procedure

Homecare Scaling & Root Planing
Scaling and root planing aftercare

Now that you have had scaling and root planing therapy, it is important to follow these recommendations to speed healing.

Do not eat anything for 2 hours after surgery. When you do feel comfortable enough to eat, but you still have numbness, be careful not to bite your cheeks or tongue.

For the first 48 to 72 hours, restrict your diet to soft foods such as yogurt, scrambled eggs, and soup, until you can comfortably chew. Chew on the side of your mouth opposite of the surgery site.

Avoid alcoholic drinks and hot or spicy foods until your gums are healed. Do not use any tobacco products for at least 72 hours because tobacco slows healing.

If we used an anesthetic, take pain medication before the anesthetic wears off to control any discomfort, or as recommended. It is normal to experience some discomfort for several days after surgery.

For the first 6 hours after surgery, apply an ice pack, 20 minutes on and 20 minutes off, to decrease pain and swelling.

After 24 hours, reduce discomfort or swelling by gently rinsing your mouth with warm salt water 3 times a day. Use about 1 teaspoon of salt per glass of warm water.

Brush the treated area very lightly the first night. To make this more comfortable, first rinse your toothbrush under hot water to soften the bristles.

The next day, begin flossing lightly, and gradually return to your usual home care over the next week. It is normal to have some slight bleeding for the first few days when you brush and floss the treated areas.

Brush and floss the non-treated areas of your mouth normally.

Use a desensitizing toothpaste ifChoosing treatment your teeth are sensitive to hot, cold, or pressure.

If we prescribed a medicated mouthrinse, use it as directed. Avoid mouthwashes that contain alcohol.

Call us if discomfort is not diminishing day by day, or if swelling increases or continues beyond 3 or 4 days.

Surgical Flap Procedure

Gel is applied to the tooth root

Pocket reduction necessary

If you have deep gum pockets (greater than 5 mm) infected with periodontal disease, we may perform flap surgery to help the area heal.

The procedure, sometimes called a pocket reduction, may be necessary when gum pockets are so deep that scaling and root planing cannot remove the infection.


To begin the procedure, we first make sure all the areas are completely numb. Then, we gently separate the gums from the tooth. This creates a flap and gives us access to the bone and tooth root.

We remove plaque, tartar, bacteria, and infected tissue from the area.

We may then smooth the bone around the tooth. This will limit the areas where bacteria can hide and will help the gums reattach to the tooth.

In some cases, we may also apply antibiotics, special proteins or other treatments that help reattachment.

The gums are secured with a few stitches, and a dressing may be placed in the area to help prevent food impaction and promote faster and better healing after the surgery. As the gum tissue heals, it tightens more closely around the tooth.

Benefits of Periodontal flap surgery—
  • removes the source of infection.
  • reduces the size of the gum pockets.
  • helps the gum tissue heal and reattach to the bone.
  • makes it easier to keep the area plaque-free.

It is an effective method for treating deep-seated periodontal disease and restoring your health.

Medical Conditions & Periodontal Disease

in the oral cavity. Many medications that are prescribed for different conditions are known to have periodontal implications (overgrown, sensitive, bleeding gums). A few common medications are:

  • Calcium Channel blockers (such as Norvasc/Procardia) prescribed for high blood pressure
  • Anti-seizure medications (Dilantin)
  • Birth control pills

Recent studies have shown that certain conditions lead to increased inflammatory response in the body and these conditions are affected by the state of health or disease

Systemic conditions that are linked to periodontal disease are:

  • Heart Disease – Many factors play into your risk for cardiovascular diseases, such as fatty foods, lack of exercise and genetics. Recent studies show that people with periodontal disease, which is a bacterial infection of the gum and bone that support your teeth, may have twice as great a risk for having a fatal heart attack.
  • Diabetes – Diabetic patients are 3-4 times more likely to develop chronic periodontal infections, and the reverse also holds true. Periodontal infections can impair the ability to process and/or utilize insulin which can then make diabetes more difficult to control.
  • For more information on diabetes and gum disease visit this site: Click Here for the full article
  • Pregnancy – Pregnant women who have periodontal disease during their pregnancies may be twice as likely to develop preeclampsia. Scientific data also suggests that women whose periodontal conditions worsen during pregnancy are at significant risk of having a premature or low birth weight baby.

It is for these reasons that we actively promote and monitor a healthy body- oral cavity connection and overall health, because healthy gums lead to a healthier body.

Treatment provided by Cosmetic Dental Specialists in NYC

The treatment of periodontal disease begins with the removal of subgingival calculus (tartar). Scaling and root planning is commonly the first step in addressing periodontal problems, a process of deep cleaning which seeks to remove calculus by mechanically scraping it from tooth surfaces.

Later stages of periodontal disease may require surgical therapy to reestablish health to the periodontium. It is essential to create and maintain a healthy oral environment, not only to avoid further loss of bone and premature tooth loss, but also to maintain overall systemic health.

In addition to procedures to treat periodontal disease, we also perform cosmetic procedures to enhance a smile, such as clinical crown lengthening (done in order to place a more cosmetic as well as functional restoration), soft tissue grafts (in areas of recession that are both unsightly as well as sensitive) and ridge augmentations (often done for cosmetic purposes before bridge work).

Chronic infection

Periodontal disease is a silent and very serious condition.

It usually does not hurt at first, and it can progress slowly, so you might be tempted to ignore it.

Periodontal disease is a chronic infection that can become painful and destroy the bone that supports your teeth. Eventually, so much bone may be lost that your tooth will become loose, and in severe cases, have to be removed.

If you are diagnosed with this disease, your options are limited.

Overall health contributor

The bacteria that cause periodontal disease may also contribute to heart disease, respiratory infections, diabetes and pancreatic cancer.

Periodontal bacteria are also suspected of causing complications with pregnancy and low birth weight babies.

For the long term health of your teeth, it is important to get the disease under control.

Choosing treatment

First, we thoroughly discuss all of your treatment options. We do not recommend delaying treatment because periodontal disease is incurable, but it is treatable.

Treatment includes performing a scaling and root planing procedure to remove plaque and tartar below the gumline. We might insert medicine at the infection site, and in certain cases, surgery may be necessary. We schedule cleanings more than twice a year and instruct you about focused homecare techniques.

We give you the best treatment for your particular needs.

Periodontal disease may be silent and serious, but the sooner you begin treatment, the better chance we have of bringing it under control.

Our goal is to save your smile.


Periodontal disease and diabetes

If you have diabetes, you have an increased risk of developing periodontal disease. Diabetes contributes to periodontal disease in several ways. It can –

  • lower your body’s ability to fight infection.
  • slow healing.
  • cause dry mouth.
  • often result in high blood sugar levels.

Your blood vessels bring oxygen and nutrients to your tissues, including your mouth, and remove wastes. Diabetes causes the blood vessels to thicken and become less elastic, making you less resistant to infections, like periodontal disease.

Diabetics often experience a decrease in the flow of saliva. This can lead to a condition called dry mouth, or xerostomia.

A lack of saliva allows plaque, the sticky film of food and bacteria, to build up easily on teeth. This accumulation of plaque is the main cause of periodontal disease, which can result in bone loss.

Having poorly controlled diabetes also means that there is often an excess level of glucose in the blood and saliva.

Some think a higher glucose level may encourage the growth of the bacteria that live in plaque and are responsible for periodontal disease.

We will work with your physician to monitor your diabetes and keep you in good health. You have to do your part by maintaining a meticulous oral homecare routine.

Together, we can help keep you healthy and free of periodontal disease.


Diagnosing Bone Loss

Bone loss on X-ray

Diagnosing bone loss

One of the keys to the success of your implant is healthy jawbone. When bone in the jaw has been lost, it may not have enough height and width to securely hold an implant. Diagnosing the health of your jawbone is an important step in planning for stable, secure implants and maintaining a beautiful smile.

Causes of bone loss

Bone in the jaw can be lost for a number of reasons. These can include–

  • periodontal disease destroys the jawbone around the affected teeth.
  • development of a cyst or abscess creates a hole in the jawbone.
  • removal or accidental loss of teeth sometimes can injure jawbone.
  • missing teeth do not stimulate the jawbone through chewing, causing the jawbone to shrink.
Diagnosis and treatment

To determine whether your jaw has enough healthy bone to secure an implant, we do a thorough examination. First, we typically take x-rays, which can show us the height of the bone. In some cases, we may need additional, specialized x-rays, such as a CT (computerized tomography) scan, to provide more detail about your jawbone and the location of nerves and blood vessels in the jaw.

Then we perform a visual exam to look at the shape of the jawbone, and we may use a periodontal probe to check the height of bone around any neighboring teeth. Sometimes, we may also find defects in the jawbone while we are performing implant surgery.

If we discover that you have lost bone in your jaw, we will discuss the variety of techniques we can use to replace it.


Gingivitis Type Gum Disease

Gums swollen from gingivitis

Symptoms of gingivitis

Gingivitis, also known as gum disease, is inflammation of the gums. It is often the first stage of periodontal disease. Some of the warning symptoms of gingivitis include—

  • bleeding when brushing or flossing.
  • redness where the gums and tooth meet.
  • swollen gums.
  • bad breath.
Causes of gum disease

Gingivitis usually begins when plaque, the sticky, colorless film of bacteria and food particles that constantly forms on your teeth, is not cleaned away every day. It is hard to see plaque, but in the image below, a harmless dye stains it red. When plaque stays on your teeth for two or three days, it can harden into tartar. Tartar, which is stained blue in the image, can irritate your gums and lead to gingivitis. Gum disease can also be caused by certain medical conditions, some medications, trauma, smoking or chewing tobacco. During pregnancy, hormonal changes can contribute to gum disease.


To determine if you have gingivitis, we examine your mouth and look for red, swollen, or bleeding gums. Because gingivitis can advance to periodontal disease, we may take x-rays to check your bone levels. We may also check the depth of the sulcus around each tooth. A sulcus is the tiny groove between the base of the visible part of your tooth and the gum.


If you have gingivitis, we thoroughly clean your teeth and may schedule you for more frequent cleanings. We may also suggest a special mouthwash or rinse and discuss your homecare technique. The good news is that gingivitis is reversible. The sooner we catch it, the better chance you have of keeping your smile for a lifetime.


Alternative to Periodontal Treatment

Periodontal disease

Gingivitis pocket depth measurement with their probe

What is periodontal disease?

Periodontal disease is a serious infection and the number one reason adults lose teeth. As periodontal disease advances, the infection can destroy the ligaments and bone that support your teeth.

What are the symptoms?

If you have periodontal disease—

  • your gums may bleed when you brush or floss.
  • your gums may be soft, swollen, or tender.
  • your gums may start to pull away from your teeth.
  • your teeth may become loose.
  • you may have persistent bad breath.

It is also possible to have no noticeable symptoms. In fact, most people who have periodontal disease are not even aware of it.

What causes periodontal disease?

The main cause of periodontal disease is the long term build-up of plaque, the sticky, colorless film of food and bacteria that constantly forms on your teeth.

It is hard to see plaque, but plaque can clearly be seen after it is stained with a disclosing tablet. When plaque stays on your teeth for two or three days, it hardens into calculus, or tartar.

The bacteria in plaque invade the spaces between your teeth and gums and produce toxins. These toxins, combined with your body’s reaction to them, destroy the bone around your teeth. And once lost, bone never grows back on its own.

If there is not enough support for the teeth and they become loose, they might have to be removed.

Diagnosis and treatment

To determine if you have periodontal disease, we perform a thorough examination which includes taking x-rays to determine how much bone has been lost.

We measure the depth of the sulcus (a tiny groove between the tooth and gum) with a probe. A reading of more than 3 millimeters could be a sign of periodontal disease, and we pay careful attention to those areas.

If we find periodontal disease, we discuss your treatment options and proper homecare. We want to help you maintain the health of your teeth, gums and bone and restore your healthy smile.


Considering Extraction due to Periodontitis

When an extraction is necessary

When too much bone around a tooth has been lost due to severe periodontal disease (also called periodontitis), sometimes the best treatment is to remove the tooth to maintain the health of your mouth.

Periodontal disease causes bone loss

Teeth are held in place by the height and shape of the jawbone, but when teeth and gums are infected by the bacteria that cause periodontal disease, the disease process begins to destroy the bone that surrounds the teeth.

Left untreated, periodontal disease destroys so much bone that there is not enough support for the teeth. In severe cases, the teeth become very loose and cannot be saved.

Diagnosis and treatment

To determine if an extraction is right for your situation, we’ll do a thorough examination, which typically includes x-rays. In advanced gum disease, sometimes called periodontitis, x-rays show us low and uneven bone levels around the teeth. The condition is especially obvious when compared to x-rays of a healthy mouth, in which the bone comes up high around the necks of the teeth.

Many times we can save teeth. Aggressive periodontal therapy, frequent periodontal maintenance appointments in our office, and consistent homecare can halt the progression of periodontal disease and stop the bone loss. Sometimes we also recommend periodontal surgery to save teeth.

However, if your teeth continue to loosen and the destruction persists, our only option will be to remove the affected tooth. It’s important to extract a tooth that cannot be saved as soon as possible to prevent the spread of infection.


Gum Interdental Products


Periodontal & Brushing

Advanced bone loss from gum disease

Signs of periodontal disease

When plaque—that sticky, colorless film of food and bacteria—remains on your teeth, it can progress to forming deep gum pockets. Deep gum pockets are one sign of periodontal disease. The gums begin to recede and you may have lost bone around your teeth.

Regular brushing and flossing are not enough to effectively remove plaque from your teeth. Instead, it takes special tools and techniques to keep your teeth clean. Here is why.

Homecare problems caused by periodontal disease

In a healthy mouth, the space between your teeth and gums, called the sulcus, is about 2 to 3 millimeters deep, and your toothbrush and floss can effectively reach these areas. However, with periodontal disease, the sulcus deepens and forms a pocket that is more than 3 millimeters. Regular cleaning tools just cannot clean that deeply.

Also, in a healthy mouth, the bone level is high and the gums attach at the necks of the teeth. The exposed tooth surface is smooth; the floss can make full contact with the area to keep it thoroughly clean.

However, periodontal disease causes the bone levels to fall and the tooth attachments to recede. This exposes the root surfaces, which have indentions. Floss stretches across these indentions; it cannot remove the plaque that has formed in them.

Special cleaning tools

Special tools are necessary to reach below 3 millimeters and to thoroughly clean the gum pockets and root indentions. Each tool is useful in different areas of your mouth.

We will be happy to recommend the right tools for your situation. We will also show you how to use these tools effectively to keep your teeth and gums healthy.

We often recommend replacing an extracted tooth to preserve remaining jawbone and stabilize your bite, so we’ll talk with you about your replacement options.


My husband and I both needed extensive dental work…and so, we actually flew to New York to see Dr. Edalat, after meeting one of his students who had raved about Dr. Edalat and his office. Both my husband and I feel and look so much better after our treatment. We wouldn’t dream of seeing any other dentist ever again!”

Louise C. – Kent, England