Larry P. Bleier D.M.D.
205 Washington Avenue Endicott, NY, 13760
Diplomate American Board of Periodontology
Specialist in Periodontics
Call Us Today!
(607) 785-3007

Ask a Periodontist

Frequently Asked Questions


Your general dentist has determined that your gums require special care, and has referred you to a periodontist. Periodontists are dentists who specialize in the diagnosis, treatment and prevention of gum disease. By referring you to a periodontist, your dentist is showing a strong commitment to optimal dental care.

To help you understand why the treatment might be needed, and how your teeth can be saved, Dr. Bleier will attempt to provide answers to some of the most frequently asked questions about periodontal therapy.
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Periodontal disease is the major cause of about 70 percent of adult tooth loss, affecting three out of four persons at some point in life.

The main cause of gum disease is bacterial plaque, a sticky, colorless film that constantly forms on your teeth. If the plaque is not removed, it hardens into a rough, porous deposit called calculus, or tartar. Toxins (or poisons) produced by the bacteria in plaque irritate the gums and can make them red, tender, swollen and more likely to bleed easily.
As the disease progresses, the toxins destroy supporting tissues around teeth, forming pockets that fill with more plaque. Bone that supports the tteth may be permanently damaged. Unless treated, the affected teeth can become loose and eventually lost.

Conscientious removal of plaque by brushing, flossing and professional cleanings can minimize the risks of gum disease. However, other factors can affect the health of your gums, such as hereditary factors, stress, diabetes and pregnancy.
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Periodontists have had extensive advanced training in the treatment of periodontal disease, a minimum of two years in addition to dental school. As specialists, they devote their time, energy and skill to helping people who need periodontal treatment. Periodontics is one of the eight specialties recognized by the American Dental Association.
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After reviewing your medical and dental history, the periodontist will examine your gums, teeth and mouth. This examination will include looking at the color and firmness of your gums, studying which teeth are loose and checking how much gum tissue has been lost. Necessary radiographs may be taken to evaluate the bone supporting the teeth.

After gathering this information, the periodontist will discuss your condition with you and suggest the most helpful treatment for your dental health.

In the earlier stages of gum disease, most of the treatment involves scaling and root planing, which means removing plaque and calculus in the pockets around the tooth and smoothing the root surfaces. In most cases of early gum disease, scaling, root planing and proper daily cleaning of the teeth are all that are required for a satisfactory result, others require topical or systemic antimicrobials. Treatment is tooth or site specific with many teeth restored to good periodontal health without the need for the surgical phase of treatment.

More advanced cases may require surgical treatment. The goals of this treatment are to remove calculus from deep pockets around the teeth, shrink the pockets, smooth root surfaces and arrange gum tissue into a shape that will be easier to keep clean. The periodontist is trained to deal with many varieties of gum disease. Whatever your treatment plan entails, the periodontist's goal is to bring you to a state of good oral health, and then help you maintain it.
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No. Dr Bleier and his hygiene team have excellent clinical skills that do not require ever using local anesthetics or pain controlling drugs for non-surgical treatments such as scaling and root planning or regular periodontal recall maintenance visits. If teeth are sensitive or painful, he will find out why and treat the cause(s) before beginning periodontal therapy at those specific teeth, to ensure your comfort.

Improved equipment, local anesthetics and modern techniques make periodontal treatment more comfortable now than ever before. Effective medications (although often not necessary) are available to give you comfort after treatment. As with other aspects of periodontal treatment, considerations for your comfort during and after treatment will be tailored to best suit your individual needs.
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The cost of the periodontal treatment will vary depending upon your needs. After the periodontist has examined you and determined the appropriate treatment, he or she can provide you with an estimate of the cost. As you consider this health investment, keep in mind that treating gum disease is less costly - and better for your health - than replacing teeth lost to untreated gum disease.
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Periodontal treatment is an investment in your health. Treating periodontal problems will help you achieve a healthy mouth as well as help you keep a healthy and help prevent tooth loss. In fact, with prompt treatment, proper home care and regular dental visits, the great majority of patients can keep their teeth for a lifetime.
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  1. Your Dentist
    Your dentist and periodontist work together as a team to provide you with the best possible care. They will combine their experience to formulate the best treatment plan for you while keeping each other informed about your progress.
  2. The Periodontist
    After active periodontal treatment is completed, the periodontist will refer you back to your general dentist, but may also see you periodically for follow-up care and periodontal treatment.
  3. Self Referrals
    Dr. Bleier frequently sees new patients who are self referred. These patients know they have a dental periodontal problem after speaking with physicians, friends and family members. They are savvy from reading health related articles on the connections between periodontal diseases and systemic diseases such as cardiovascular diseases, diabetes, respiratory diseases, cancer, dementia and osteoporosis. Dr. Bleier, at the appropriate time during or after active periodontal treatment and as needed will consult with your physician and will gladly refer you to one of the outstanding general dentists he regularly consults with for the best interests of you, the patient.
  4. The Patient
    In closing, remember that the most important member of the team is you. Your interest, participation and commitment are essential to make your treatment a success.
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Despite the large number of research publications, there is still controversy among clinicians regarding the application of dental lasers to the treatment of chronic periodontitis.

Based upon careful review of the literature of peer-reviewed articles, when lasers are used for non-surgical periodontal therapy, the evidence for supporting laser-medicated periodontal treatment over traditional periodontal non-surgical therapy is minimal at best. The treatment gain in clinical new gum and bone attachment growth is still greater with traditional periodontal therapy than with laser therapy when performed by a skilled clinician in periodontal therapy, such as a Periodontist. From reviewing the literature, one can determine that the use of lasers in periodontal treatment is still in the earlier stages of research investigation and therefore, remains in the experimental mode of use in clinical practice. The cost of lasers in use in the dental field cost $40,000 to $70,000 or more for each laser unit and one must justify the cost when considering their use. Please read the enclosed research publication provided by link as one will realize the doctor may be playing while the patient is paying with no additional improvement in treatment outcomes when lasers are used as an adjunct to scaling and root planing and even antimicrobials as part of non-surgical periodontal treatment.
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