Gum disease treatment in Miami starts with one question: are your gums only inflamed, or has the problem reached the bone that holds your teeth? At Prana Dental in Edgewater, Dr. Aakash Rana, DDS measures your gums, explains the numbers in plain words, and treats most early and moderate cases in our office with deep cleaning and a maintenance plan built around you.
Price: it depends on how many areas need a deep cleaning, how deep the pockets are and which X-rays you need. You get the exact price in writing before any treatment starts.
Gum disease is inflammation and infection of the tissues around your teeth. It is driven by plaque, the sticky film of bacteria that forms on teeth every day. Plaque that stays put hardens into tartar (also called calculus), and a toothbrush can't remove tartar. The gums react by swelling, reddening and bleeding.
That first stage is gingivitis. It affects only the gum tissue, and the bone underneath is still intact. With a professional cleaning and steady home care, gingivitis usually clears up. Periodontitis is the later stage. The inflammation works below the gumline, the gum starts to pull away from the tooth, and the bone that anchors the tooth begins to break down. Lost bone generally doesn't grow back on its own, so treatment aims to stop the disease and keep it stable.
Most people can't tell which stage they are in by looking. Early gum disease rarely hurts, and bleeding can look the same at both stages. Our article on gingivitis vs periodontitis goes deeper into the difference.
| Gingivitis | Periodontitis | |
|---|---|---|
| What is affected | Gum tissue only | Gums, the fibers that hold the tooth, and bone |
| Bleeding gums | Common | Common, though smokers may bleed less |
| Pocket depth | Usually 1 to 3 mm, sometimes deeper from swelling | Usually 4 mm or more |
| Can it be reversed? | Usually, with a cleaning and home care | Bone loss usually can't, but the disease can often be controlled |
| Typical treatment | Regular cleaning and better home care | Deep cleaning, then maintenance cleanings |
Gum disease often builds quietly for years. These are the signs that tell us it is time for a proper gum exam:
Smoking reduces blood flow to the gums, so smokers can have active gum disease with little or no bleeding. That is one reason measurements matter more than how your gums look in the mirror.
Between each tooth and the gum there is a small groove, called a sulcus or pocket. In healthy gums it is shallow. During a gum exam, a thin, blunt measuring tool called a periodontal probe is slid gently into that groove at several points around every tooth, and the depth is recorded in millimeters. Most people feel light pressure. Inflamed gums can feel tender, and we can numb an area if you need it.
Here is roughly how the numbers are read:
Pocket depths alone don't show the bone. X-rays do, so a full diagnosis usually needs both. Your first visit is free and covers an exam, a digital 3D scan and a smile preview. X-rays are a separate step, and we confirm their cost with you before they are taken.
We show you your numbers and keep them on file. At later visits you can see for yourself whether each area is getting shallower, holding steady or getting deeper, which takes much of the guesswork out of deciding what comes next.
When pockets are deep and tartar has built up below the gumline, a routine polish can't reach it. The standard first treatment for periodontitis is scaling and root planing, usually called a deep cleaning. Dr. Rana performs it in our office as part of our general dentistry care. For how it differs from a routine visit, see deep cleaning vs regular cleaning.
The mouth is divided into four sections called quadrants. Depending on how many need treatment, a deep cleaning is often split over two visits, one side of the mouth at a time, or done in one longer visit. Splitting it means you can still chew comfortably on the other side. We plan it around your schedule, including evenings and Saturdays.
The section being treated is numbed with local anesthetic, the same type used for a filling. Once it has taken effect, most people feel pressure, vibration and water rather than sharp discomfort. If dental visits make you anxious, oral sedation is available; our page on sedation dentistry explains how it works and who it suits.
Using an ultrasonic scaler and fine hand instruments, plaque and tartar are removed from the tooth surfaces above and below the gumline, all the way to the bottom of each pocket. The ultrasonic tip vibrates deposits loose while a stream of water flushes them away.
Next, the root surfaces are smoothed. Rough patches on a root give bacteria a place to cling. A smoother root makes it harder for plaque to settle back in and gives the gum a better chance to tighten up against the tooth as it heals.
The pockets are rinsed, and before you leave we go over what is normal over the next few days and how to clean the treated areas without irritating them. Each session usually takes about an hour, sometimes more for a heavily affected mouth.
Gums need time to respond, so we measure again a few weeks later, often somewhere around four to eight weeks. In many people the pockets get shallower and bleeding drops a lot. Areas that haven't improved get a closer look, and that is the point where we talk about whether a referral makes sense.
Most people go back to work or their day right after a deep cleaning. Here is what to expect while your gums settle down:
Periodontitis is managed over time, a bit like blood pressure. After a deep cleaning, most people move to periodontal maintenance visits, often every three to four months instead of every six. The bacteria behind gum disease tend to regroup in deep areas within a few months, and a shorter interval keeps them from getting a foothold again.
A maintenance visit includes cleaning above and below the gumline, re-measuring the areas we are watching, and checking how your home care is going. If your gums stay stable for a long stretch, the interval can sometimes be lengthened. If you only had gingivitis, a regular teeth cleaning schedule is usually enough.
Skipping maintenance is the most common reason gum disease comes back. A deep cleaning resets the clock, but it doesn't stop the clock.
What you do between visits matters as much as what we do in the chair. These habits make the biggest difference for most people:
Plaque is the cause, but some things make gums more likely to break down or slower to heal:
Having a risk factor doesn't mean you will get gum disease. It means regular measurements are worth it, so changes are caught early.
Researchers have found associations between periodontitis and several health conditions, including heart disease, diabetes and some pregnancy complications. An association is not proof that one causes the other, and treating your gums is not a treatment for heart disease. What is reasonably well supported is that periodontitis is a long-lasting source of inflammation, and that diabetes and gum disease can make each other worse. Our article on gum disease and heart health covers what the research does and doesn't show.
Before treatment, tell us about your health conditions and every medication you take. If you have diabetes or a heart condition, are pregnant, or take blood thinners, we may coordinate with your doctor first.
Dr. Rana is a general dentist. He does gum exams, cleanings, deep cleanings and maintenance visits himself. A periodontist is a dentist with additional years of training focused on the gums and the bone around teeth, including gum surgery. We refer you to one when:
If we refer you, we send your measurements and X-rays so you don't start from zero, and we tell you plainly why we think you need it. In many cases people go on to alternate maintenance visits between the two offices, if the periodontist agrees. If a tooth can't be saved, we talk through replacing it once the gums are healthy, from a bridge to dental implants.
We can't quote a fair number before measuring your gums, because two people told they have gum disease can need very different care. One may need a single area treated; another may need the whole mouth, plus frequent maintenance for years. The exact price is confirmed in writing before any treatment. The main things that move the cost:
We accept most major dental insurance. Plans differ, but many cover preventive visits at a high percentage and treat scaling and root planing as a basic service, often paid at a lower percentage after your deductible. Some plans limit how often a deep cleaning can be repeated, or count periodontal maintenance visits differently from regular cleanings. Annual maximums, often in the $1,000 to $2,000 range, and waiting periods can also apply. We check your benefits for you before you commit to anything.
If you'd like to spread out what insurance doesn't cover, 0% financing is available on approved credit through CareCredit, Cherry and LendingClub. Details are on our financing page.
We are at 3050 Biscayne Blvd, Suite 703, on Biscayne Blvd at NE 30th St in Edgewater, with building parking and street parking. Patients from Midtown, Wynwood and the Design District are only minutes away, and Downtown, Brickell and Miami Beach are an easy drive depending on traffic. We're open, with hours Monday to Saturday from 8am to 8pm, and the team speaks English and Spanish. Directions are on our contact page.
Dr. Aakash Rana, DDS is a general dentist trained at NYU College of Dentistry, with more than $100,000 in continuing education. He plans and treats each case at Prana Dental himself, works with our in-house lab, and refers to a specialist when a case needs one.
Gingivitis, the early stage, can usually be reversed with a professional cleaning and good daily brushing and flossing. Periodontitis can't be fully reversed, because bone that has been lost generally doesn't grow back on its own. It can often be stopped and kept stable with a deep cleaning and regular maintenance visits.
The area is numbed with local anesthetic first, so most people feel pressure and vibration rather than pain during the cleaning. Gums are often tender for a day or a few days afterward, and teeth can be sensitive to cold for a while. Oral sedation is available if you are anxious about dental work.
It depends on your measurements. A regular cleaning works above and just below the gumline, which is right for healthy gums and gingivitis. If you have pockets of 5 mm or more with tartar below the gumline, a regular cleaning can't reach it, and the disease is likely to keep progressing. We show you the numbers so you can see why we are recommending it.
Many people need periodontal maintenance visits every three to four months, at least at first. The bacteria that cause gum disease tend to return to deep areas within a few months. If your gums stay stable for a long time, the interval can sometimes be stretched.
The most common reason is inflammation from plaque along the gumline, which is gingivitis. Brushing too hard, a new flossing habit, hormone changes and some medications can also play a part. Bleeding that lasts more than a week or two of gentle, regular cleaning is worth a gum exam.
Sometimes, a little. When inflammation calms down after treatment, some slightly loose teeth firm up. Teeth that have lost a lot of bone usually stay loose, and some may need a periodontist's care or eventually need to be replaced.
Many dental plans cover scaling and root planing as a basic service, usually at a lower percentage than preventive care and after your deductible. Plans can limit how often it is covered and how maintenance visits are counted, and annual maximums apply. We check your benefits for you and give you the price in writing before treatment.
Bleeding or receding gums? Call or text (786) 579-0521 to start with a free first visit (exam, 3D scan and smile preview).