Gingivitis is the initial form of periodontal disease. It is a mild form of periodontal disease that causes the gums to swell, become red and bleed. Gingivitis is caused by the build up of dental plaque due to poor oral hygiene. It can also be caused by side effects of medication or poor nutrition. Patients might not experience pain from gingivitis, but they should seek dental care if these symptoms arise.

Periodontal diseases (periodontitis) are infections of the tissues supporting the teeth. These tissues include the gums and bone that surround the teeth. The main cause of periodontal disease is the accumulation of dental plaque. Plaque is a mass of bacteria that adheres to your teeth and tissues in your mouth. Plaque irritates the gums and causes them to bleed, become red, swollen and tender. If not removed, the inflammation of soft tissues worsens and the gums separate from the teeth, causing periodontal pockets to form. Plaque can also become a hard material known as calculus (tarter). Calculus cannot be removed by brushing alone. A periodontist can remove it to stop the disease process.

Over time, the tissues that attach the gums to the teeth are destroyed by plaque and its by-products. The gums retract from the teeth and pockets form. Plaque and calculus continue to fill these pockets and ultimately the bone that once supported the teeth are destroyed. The upshot is tooth loss.

Dr. Barbra Berwald is a specialist in Periodontics and Implantology. She received her D.D.S. degree from The School of Dental Medicine @ Suny Stony Brook in 1998. Dr. Berwald continued her studies at Stony Brook (1998-2001) to obtain a certificate in the speciality of periodontics. She received her undergraduate degree from Brandeis University in 1998.

Dr. Berwald has practiced clinical periodontics for the past decade. She is a current member of The American Academy of Periodontology, The Northeastern Society of Periodontics, The American Dental Association and The Glen Cove Study Club.

Dr. Berwald practices the complete scope of periodontics. These procedures include, non-surgical and surgical treatment of periodontal (gum) disease, dental implants, cosmetic periodontal treatment, facial cosmetics (botox and facial fillers) and oral pathology.

Dr. Berwald will complete an in depth medical and dental health history. She will complete a thorough clinical and radiographic periodontal examination. An oral cancer screening will also be done at this time.

We will need current x-rays in order to do a comprehensive periodontal exam. If your referring dentist has taken x-rays, you may request that they be forwarded to us. We can also call your dental office prior to your initial visit to have x-rays transferred to our office.

Since all patients are different, Dr. Berwald must complete your examination before establishing your treatment plan and corresponding fee for care. The fee for periodontal treatment can vary considerably depending on the type of problems and the complexity and length of treatment. An approximate fee can usually be determined at the initial visit; but on occasion, some initial treatment or further diagnostics must be completed before the final treatment plan can be established. Our practice participates in many insurance plans. Feel free to contact the office regarding you insurance carrier.

Not everyone needs periodontal surgery. If treated early, gum disease can be controlled without surgery. We will make recommendations based on your individual situation. Dr. Berwald believes in conservative treatment to obtain treatment goals and periodontal health when indicated.

The recent advances in periodontal treatment allow us to successfully treat most teeth. Dr.Berwald will make a complete diagnosis and prognosis of your case, and will discuss treatment options with you.

Our office and your Dentist will work closely together. If crowns and fillings are needed your Dentist will provide them. Regular visits to your Dentist are an important part of periodontal maintenance.

Periodontal disease is a progressive, painless infection. Delay can cause you further bone loss and more expense. The longer you wait to seek treatment the more destruction will occur and you will lose teeth that could otherwise been saved.

Periodontal disease is a chronic condition like diabetes. It is important to establish an ongoing program to maintain the improvements achieved during active treatment. Periodontal maintenance treatment intervals are best determined by your periodontist, and can range from 2-6 times per year. For patients with a significant amount of periodontal disease, the ADA, AAP and our office recommend visits every 3 months. These sessions are designed to preserve the healthy state of your gums and stabilize your bone levels. On-going treatment success is based on your home care compliance and the cleanings you receive in your periodontists offices.