Periodontics is a branch of dentistry that involves diagnosing, treating, and preventing diseases of the teeth and their supporting structures, such as the gums and jawbone.
A periodontist treats the gums and the bone that anchor your teeth, and places dental implants. That takes three years of training beyond dental school. Dr. Daniel Nejat, DMD, has done this work at Sola Dental Spa since 2007 and holds the field's board certification, Diplomate of the American Board of Periodontology.
See a periodontist when gum trouble moves past a routine cleaning: gums that bleed when you brush, gums pulling away from the teeth, breath that will not clear, a loose tooth, a shifted bite, or bone loss on an X-ray. You also see one for dental implants, because placing an implant is surgery on the bone. The gum work and the crown, veneer, or implant that follows happen here, so you are not sent elsewhere between them.
Gum disease is treated by stage. Gingivitis, the early form, clears with a thorough cleaning and better home care. Periodontitis has moved below the gum line into the bone; it needs deep cleaning, and in advanced cases surgery to remove infection and rebuild what was lost. The disease is usually painless until it has done damage, so bleeding when you brush is the signal not to ignore.
Watch for red or swollen gums, bleeding, breath that will not improve, gums receding so teeth look longer, new gaps, loose teeth, a changed bite, or pus at the gum line.
| Condition | Typical approach |
|---|---|
| Gingivitis | Thorough professional cleaning and improved home care guidance to reverse inflammation. |
| Periodontitis | Deep cleaning (scaling and root planing) to remove tartar and bacteria from below the gum line, then a maintenance schedule. |
| Gum recession | Gum grafting or the Pinhole technique to cover exposed roots and protect the tooth. |
| Bone loss | Bone grafting and regeneration therapy, often required before placing implants. |
Scaling and root planing is the first treatment for periodontitis: local anesthetic, one or two visits, removing the hardened deposits a normal cleaning cannot reach. Cleanings then move to every three or four months. Gum disease also tracks with heart disease, blood sugar control, and pregnancy complications, so treating it is not only about your teeth.
Gum grafting rebuilds tissue over roots that recession has exposed. It calms sensitivity, protects the root from decay, and restores the gum line. Recession comes from gum disease, hard brushing, grinding, thin tissue, or orthodontics, and it does not grow back on its own.
Dr. Nejat secures a small amount of tissue, from the roof of your mouth or a donor source, over the exposed root. It takes about an hour per area under local anesthetic, heals in one to two weeks, and settles fully over a few months. Whether a graft or the Pinhole method below fits depends on your tissue thickness, how deep the recession runs, and whether bone has been lost. Aftercare is simple: soft foods, leave the site alone for a few days, and one follow-up.
For many cases, the Pinhole Surgical Technique fixes the gum line without cutting or stitches. Dr. Nejat loosens the existing gum through a small entry point and guides it back over the root. Recovery is quicker than a graft, several teeth can be done in one visit, and there is no second site on the roof of the mouth.
Pinhole needs enough healthy tissue to move; where recession is severe or the gum is very thin, a graft holds up better. That call is made with measurements and photos at the consultation. Either way the goal is the same: cover the root and stop the recession.
The gum line frames the teeth, and a periodontist can reshape it. Gum contouring evens a gummy or uneven line. Laser gum surgery treats diseased tissue and reshapes gums with less bleeding and faster healing than a scalpel. Both are often planned with veneers or a smile makeover, since the ratio of tooth to gum decides whether the result looks balanced.
Crown lengthening is related: removing a little gum, and sometimes bone, to expose more of a tooth, for looks or to seat a crown on a tooth broken near the gum line. With a periodontist and cosmetic dentists in one practice, the gum work and the cosmetic work that follows are planned together.
Can you get implants if you have gum disease? Usually, once the infection is controlled and there is enough bone to hold the implant. Dr. Nejat treats the disease first, then reads the bone on a cone beam CT scan. If bone is thin, a graft or sinus lift rebuilds it before placement; if it cannot be rebuilt safely, he says so and offers another option rather than risk a failure. For candidacy, cost, and real cases, see the dental implants in Staten Island page.
The first visit is a diagnosis, not treatment. Dr. Nejat measures the pocket depth around each tooth, checks for bleeding and movement, reads your X-rays or a cone beam CT for bone level, and photographs the gum line so changes can be tracked. Those numbers set the stage of the disease, and the stage sets the plan. You leave with the plan in writing, the order of visits, and the cost of each.
The visit is not rushed. Paraffin hand treatments, aromatherapy, heated neck pillows, and noise-canceling headphones come with every appointment, including this one. If you have put off the dentist over your gums, you are in good company here, and the plan starts from where you are.
After treatment, gums stay healthy with maintenance visits every three or four months. These are more thorough than a routine cleaning: pockets are re-measured, any spot bleeding again is cleaned below the gum line, and the schedule flexes to how your gums respond.
The rest is home care: a soft brush twice a day, cleaning between the teeth daily, and, for smokers, quitting, which is the single biggest controllable risk for gum disease and for graft or implant failure. Patients who keep the schedule keep their teeth.
Periodontal treatment is priced by the case, because the same diagnosis can mean one area of deep cleaning for one patient and full-mouth surgery for another. Cost turns on the stage of disease, how many teeth are involved, whether grafting is needed and of what kind, and whether the work is preparing for implants.
Most dental plans cover scaling and root planing and maintenance at least in part, and many cover some surgery when it is medically necessary; cosmetic work like gum contouring usually is not. Sola Dental Spa takes dental insurance, CareCredit, and major cards, and offers financing to spread a staged plan. You get the exact cost of each phase in writing before any work begins.
Gingivitis, the early stage, reverses with a cleaning and better home care. Once it becomes periodontitis it cannot be reversed, but it can be stopped and held steady with deep cleaning and, if needed, surgery.
A general dentist handles cleanings and gingivitis. A periodontist trains three extra years in the gums, the supporting bone, and implants. At Sola Dental Spa that is Dr. Daniel Nejat, Diplomate of the American Board of Periodontology.
No. You can book directly, and we coordinate with your general dentist when it helps.
Most people are back to normal in a day or two. The gum heals over one to two weeks and settles fully over a few months. Aftercare is soft foods, leaving the site alone at first, and one follow-up.
Rarely too late, but earlier is easier. A graft or the Pinhole method can help as long as enough healthy gum and bone remain, which is checked at the consultation.
Most plans cover deep cleaning and maintenance at least in part, and some surgery when it is medically necessary. Cosmetic gum work usually is not covered. We verify your benefits first and offer financing.
If your gums bleed, recede, or feel different, or you are planning implants, a consultation with Dr. Nejat answers two things: what is going on, and what it takes to fix it. More questions are answered in the patient FAQ.
Book your consultation or call 718.948.3777. Open Sundays.
Medically reviewed by Dr. Daniel Nejat, DMD, Diplomate, American Board of Periodontology. Reviewed September 2026.
One visit answers everything: candidacy, your best option, and the exact cost before any work begins.
Book your consultation