Periodontal disease develops when bacteria, plaque, and tartar form on the teeth and inflame the gums. The bacteria and your body’s response to this inflammation can cause your gums to separate from your teeth and can destroy the supporting tissue and bone. This can eventually lead to tooth loss.

Dr. Israel Puterman is both a periodontal specialist and an expert in dental implant procedures. As a result, he is experienced in assessing and repairing damage from periodontal disease for patients. Depending on your needs, he can address areas of gum recession, rejuvenate tooth-supporting bone, and restore lost teeth to their original aesthetic and functional state with dental implants.

Understanding Periodontal Disease

Proper oral hygiene and regular dental visits promote healthy teeth and gums and help prevent the development of plaque and tartar. However, many people do not practice the right technique when brushing and flossing, or they aren’t consistent in their routine. Genetics also plays a significant role, as some patients are genetically more likely to develop periodontal disease regardless of how dedicated they are to taking care of their teeth.

Periodontal disease has two general stages:

Gingivitis. Inflammation from bacteria may cause your gums to become red, to swell, and to bleed easily. Dr. Puterman recommends that patients seek treatment as early as possible when they recognize these symptoms. A general dentist can usually intervene when the disease is in the gingivitis stage.

Periodontitis. If left untreated, gingivitis can progress to periodontitis and cause damage that may require treatment by a periodontist. Your gums may begin to separate from your teeth and develop pockets that become infected. Toxins from the bacteria combined with your body’s response to the infection can erode supporting bone and tissue, eventually leading to tooth loss.

This process frequently causes no discomfort, so it is possible to have either gingivitis or periodontitis and not experience tooth pain or sensitivity. As a result, the symptoms of the disease can often be subtle until you sustain permanent damage. Your general dentist can typically identify the degree to which your periodontal disease has progressed by measuring the pockets between the teeth and gums. Healthy readings are in the 1-3 mm range. Readings greater than that imply that the gum tissue is loosening its attachment around the teeth.

Before & After Gallery

Dr. Puterman’s Approach to Repairing Damage from Periodontal Disease

Specialized periodontal procedures can remove the source of the disease and prevent problems from getting worse. Dr. Puterman begins treatment with non-surgical care to reduce the pockets, as this is the most minimally-invasive approach. This frequently results in sufficient pocket reduction that no other treatment is necessary. In other cases, additional treatment is necessary using various techniques meant to reduce the pockets more definitively. In any scenario, periodontal disease is a life-long affliction that requires regular maintenance with Dr. Puterman and your General Dentist in order to maintain the gains achieved.   

Gum Grafting

Periodontal disease can sometimes cause the gums to recede from your teeth. A common symptom is if one or more of your teeth appear longer than neighboring teeth. Gum recession can progress to the point that your tooth roots become visible.

With gum grafting, Dr. Puterman will use donor tissue or tissue from the roof of the mouth to restore the area of recession. He will sculpt this replacement tissue in a way that it blends seamlessly with your natural gum line.

Bone Grafting

When periodontal disease destroys tooth-supporting bone, it can weaken your jaw and cause your teeth to loosen. You may also notice changes in the appearance of your smile.

Dr. Puterman can apply bone grafts to areas of loss to strengthen these sites. The bone graft material may also encourage the growth of new bone. The procedure is relatively predictable and can make a significant improvement in the function and health of your teeth.

Dental Implants

Patients may lose teeth due to damage from periodontal disease. Dental implants are an effective option for restoring these teeth, the aesthetics of your smile, and the function of your bite.

A dental implant will replace the structure of the lost tooth from the root up. Dr. Puterman will place the implant in the jaw bone, and a restorative doctor will connect a new dental crown to it to complete the treatment. Dental implants have a natural appearance, are durable, and function just like your original teeth. Dr. Puterman is an expert in the procedure and is one of few professionals to have completed a three-year residency program in dental implants.


Severe periodontal disease—along with a lifetime of wear—can result in damage to the full arch of teeth. The All-on-4 treatment option offers patients a way of rejuvenating both the upper and lower arches with new, natural-looking teeth.

In the procedure, Dr. Puterman will extract all of the original teeth and places four, six, or eight dental implants. A restorative doctor will connect a full arch of replacement teeth to these implants, completely replacing the teeth with a strong, cosmetically appealing set.

If you have experienced damage to your gums, supporting bone, or teeth because of periodontal disease, you may benefit from one of the above procedures. In your consultation with Dr. Puterman, he will perform a thorough examination to determine the best course of treatment for your care.

Learn more about repairing damage from periodontal disease. Patients can schedule an appointment with Dr. Puterman online or by phone at (301) 652-0939.