Treatment for Gum Disease, Bone Loss | Periodontal Disease


Philadelphia and Main Line Periodontist, Dr. James Vito is a specialist trained in the diagnosis, treatment and management of gum disease and bone loss - also known as periodontal disease. Dr. Vito received his specialty training in Periodontics and Periodontal Prosthesis-Fixed Prosthodontics from the University of Pennsylvania School of Dental Medicine. Dr. James Vito has been consistently recognized as one of the Best Dentists and Dental Implant specialists of the Main Line since coming to the area in 1999. Philadelphia and Main Line patients can have their Periodontal procedures (Gum Disease Treatment) performed in our Wayne Dental Office either with or without gentle IV sedation.

Importance of Dental Care

Are you experiencing irritable gums? Don't let it get worse!


Dental Problems: Halitosis, Swollen Gums, Bleeding Gums, and Loose Teeth

Periodontics Wayne, PA

What is the root of most dental problems?

The root of most dental problems is plaque. Plaque is a combination of food, bacteria and dead skin that lines the mouth. This combination forms an acidic, slimy film that readily adheres to the teeth. This plaque then hardens over time to form a barnacle like substance called calculus (tartar). This acidic film results in two destructive dental processes: dental decay, followed by periodontal disease.

Dental Decay

The first process is dental decay, a destructive bacterial process that destroys tooth structure.

Periodontal Disease

The second process, periodontal disease, is a destructive inflammatory progressive disease that begins initially in the gums and progresses to the surrounding bone, resulting in irreversible bone loss. This inflammatory process can only be resolved by the removal of the plaque, corrective periodontal surgery, and/or bone regenerative techniques. Regular hygiene maintenance appointments are key to maintaining periodontal health and minimizing additional problems, which may necessitate further periodontics treatment.

Symptoms of Periodontal Disease:

  • Inflamed gum tissues
  • Bleeding gums
  • Migration movement of teeth (loose teeth)
  • Dental decay
  • Dental abscesses
  • Root canal
  • Halitosis
  • Metallic taste
  • Irreversible bone loss
  • Tooth loss

Recently, periodontal disease and the bacteria associated with it has been linked to an increased likelihood of heart attacks in people with a history of heart disease, complications with pregnancy resulting in premature low birth weight infants, increased periodontal problems in the elderly who live in a community setting, and increased infection complications with patients who are either diabetic or who are undergoing cancer therapy. With these consequences, the field of periodontics can help you maintain, not only the health of your teeth, but also your overall health.

As a multi-specialty dental office, our job, in addition to treating dental disease, is to educate our patients about gum disease and stress the importance of the complex interaction between the host (patient) and the pathogenic bacteria that resides in the mouth. It is important to resolve the problem early and make sure periodontal patients understand the importance of keeping their regularly scheduled hygiene maintenance appointments, determined by their specific needs. This is key to preventing and/or minimizing future problems of either a restorative or a periodontal nature.

Dental Solutions: Periodontal Evaluation, Treatment, and Maintenance

There is no cure for periodontal disease or dental decay. However, the appropriate periodontal treatment can control and limit the progression of both these disease processes by minimizing the bacterial buildup in one’s mouth. The bacteria responsible for dental decay and periodontal disease inhabit the mouth 24 hours a day. Only through the proper diagnosis and treatment of the specific periodontal problem and adherence to a strict hygiene maintenance schedule based on one’s disease activity can minimize the severity of periodontal disease or tooth decay. There must be a partnership between our office and our periodontal patients. Dr. Vito and his staff will help educate and treat you, while the patient must understand their dental condition, be an active and cooperative participant in their treatment, and exhibit good oral hygiene on a daily basis. Through this partnership a patient can expect to have not only a smile that is healthy, functional, and aesthetic, but also one that should last a lifetime!

Four Stages of Periodontal Disease


A periodontal condition characterized by irritation of the surrounding gum tissue and swollen bleeding gums. There is no bone loss associated with this process.

Mild Periodontal Disease

A periodontal condition similar to gingivitis but with radiographic evidence of bone loss, up to 10% of the total volume of bone.

Mild Periodontal Disease

Moderate Periodontal Disease

Gingivitis with radiographic evidence of bone loss, up to 50% of the total volume of bone. Additional symptoms include tooth mobility, shifting of teeth, halitosis, metallic taste, and spontaneous bleeding of the gums upon probing.

Moderate Periodontal Disease

Advanced Periodontal Disease

A periodontal condition of severe gingivitis with radiographic evidence of bone loss greater than 50% of the total volume of bone. This stage is marked by extremely visible mobile teeth, shifting, and spacing of teeth under normal function, persistent halitosis, and metallic taste. Tooth loss is probable and will require extensive corrective work to repair.

Advanced Periodontal Disease

Dental Problems: Gummy Smile, Uneven Gum Line, and Exposed Tooth Surface

Dental Solutions: Aesthetic Periodontal Surgical Techniques (Aesthetic Periodontal Gum Treatment)

The art and science of aesthetic periodontal surgical techniques can be performed to enhance and improve not only the gingival health, but also the aesthetics of your smile. By performing simple surgical procedures, results can be achieved and maximized that may not be attained through restorative dentistry alone.

The art and science of aesthetic dentistry is to create a picture utilizing the color, shape, position, symmetry, and luminescence of the teeth, which is then framed by healthy gum tissue to achieve a smile that is healthy, youthful, and natural. For more information, contact Dr. Vito's periodontics practice in Wayne.

Dental Problem: Bruxism (Extensive loss of tooth structure due to grinding)

Bruxism, or grinding, results in a progressive loss of tooth height and structure. This is due to unintentionally bringing the teeth together under pressure and rubbing them together. This will cause the tips of the teeth to take on a flattened, roughened look. This situation can continue to the point where the enamel is rubbed off, exposing the inside of the tooth, called the dentin. When exposed, dentin may become sensitive. Bruxers may also experience pain in their TMJ (Tempro Mandibular Joint), which may manifest itself as popping and clicking.

Bruxism is seen in people under stress or with certain personality types. Anger, pain, and frustration can trigger bruxism. People who are aggressive, competitive, and hurried are also at a greater risk for bruxism.

It is interesting to note that most patients who clench or grind their teeth are not aware that they have this very unique, destructive dental habit.

Dental Solutions: Bite Guard Appliance or Combination Treatment

Treatment, if the problem is recognized early, is accomplished with a hard acrylic bite guard appliance. This appliance is designed to fit on the biting surface of the upper teeth. This will not prevent the grinding habit, but it will absorb the force of the grinding and protect the teeth. The patient will create wear patterns, holes, or even destroy the acrylic appliance, which is much softer than the opposing lower teeth, leaving the teeth intact. The bite appliance is more economical to repair or replace than the teeth themselves. Thus, when worn on a daily basis, the bite guard will prevent or greatly reduce the attrition process.

If this grinding pattern is not recognized or treated in a preventative fashion, then a multidisciplinary approach is necessary to repair the structure. Root canal therapy must be performed due to the exposed nerve or the close proximity of the nerve to the tooth surface; periodontal surgery removes some of the supporting bone so that the teeth can be made longer for the restorative phase where the teeth are then crowned. A bite guard appliance is then made to protect the newly restored teeth.

Three Stages of Bruxism

The attrition of the teeth occurs in three stages over time.

Physiologic Stage

The initial, or physiologic stage, is the wearing away of the enamel, resulting in the flattening of the teeth and the exposure of the next tooth lawyer, the dentin.

Transitory Stage

In the second, or transitory stage, the dentin layer is more visibly exposed. The tooth is noticeably shorter, jagged, and rough edges may become more pronounced. The tooth may also become sensitive to chemical and thermal stimulation.

Senile Stage

In the final, or senile stage, there is continued reduction of tooth height, and continued wear through the dentin layer results in an exposed or nearly exposed nerve, resulting in increased tooth sensitivity.

For more information on our periodontal practice, serving the Philadelphia and Main Line area contact our Wayne, Pennsylvania office 610-971-2590


Serving the Main Line: Ardmore, Wynnewood, Haverford, Bryn Mawr, Villanova, Radnor, Wayne, Devon, Malvern, Paoli, King of Prussia, Newtown Square and West Chester