Dr. Dulay & Associates P.A. · Tamarac, FL · Since 2004
Gum Disease Is Treatable. Left Alone, It Isn't.
Dr. Rajvinder Dulay treats periodontal disease in-house with scaling and root planing, a structured maintenance program, and honest guidance on when a specialist is the right next step.
What Is Periodontal Disease?
Periodontal disease is a bacterial infection of the structures that support your teeth — the gums, the ligaments, and the bone underneath. It starts as gingivitis, an inflammation of the gum tissue that's reversible with professional cleaning and improved home care. Left untreated, it progresses into periodontitis: the infection moves below the gumline, begins destroying bone, and creates pockets between the teeth and gums where bacteria continue to accumulate.
At that stage, routine cleaning doesn't reach the problem. The bacteria are below where a standard cleaning works, protected inside those pockets. This is why gum disease that has crossed into periodontitis requires a different level of treatment — and why the distinction matters.
The difficult part is that periodontal disease is often painless until it's advanced. Patients don't always know they have it. That's one of the most important things a thorough exam at Dr. Dulay & Associates P.A. catches.
Signs Worth Taking Seriously
Some symptoms are obvious. Others are easy to dismiss. Here's what we look for — and what you should bring to our attention if you notice it between visits.
Healthy gums don't bleed. Occasional bleeding is one of the earliest signs of gum inflammation — don't ignore it.
Gum tissue should be firm and pale pink. Changes in color or texture signal inflammation that needs evaluation.
Recession exposes root surfaces, increases sensitivity, and is a sign that the supporting structures are under stress.
Bacteria living below the gumline in periodontal pockets produce odor that doesn't respond to brushing or mouthwash.
Movement in teeth that were previously stable indicates bone loss — a later-stage sign that needs prompt attention.
Exposed roots from recession are more sensitive to temperature and pressure. It's worth distinguishing from other causes of sensitivity.
Gum Disease Doesn't Stay in Your Mouth
The research on this has become difficult to ignore. Periodontal disease is associated with an increased risk of cardiovascular disease, complications in diabetic patients, adverse pregnancy outcomes, and respiratory conditions. The mechanism isn't fully settled, but the leading explanation is straightforward: chronic bacterial infection in the gums creates systemic inflammation, and systemic inflammation affects more than your teeth.
For patients managing diabetes, the relationship runs in both directions — uncontrolled blood sugar makes gum disease harder to treat, and active periodontal disease makes blood sugar harder to control. Managing one helps the other.
We don't say this to alarm you. We say it because gum disease is frequently treated as a cosmetic or comfort issue when it's actually a health issue — and it deserves to be taken seriously as one.
Scaling & Root Planing: How We Treat It
Scaling and root planing — sometimes called a deep cleaning — is the standard non-surgical treatment for periodontitis. It's different from a routine cleaning in both depth and purpose. We work below the gumline to remove bacterial deposits from the root surfaces and smooth the roots so the gum tissue can reattach properly and pockets can close.
The procedure is done in quadrants with local anesthetic so you're comfortable throughout. Depending on the extent of involvement, it may be completed in one appointment or across two.
Dr. Dulay measures pocket depths around every tooth to map exactly where disease activity is present and how severe.
The area being treated is fully numb before we begin. Deep cleaning without anesthesia is not how we work.
Bacterial deposits, tartar, and biofilm are removed from root surfaces and out of periodontal pockets using ultrasonic and hand instruments.
Root surfaces are smoothed to remove bacterial toxins and create a clean surface the gum tissue can reattach to.
What you do at home between appointments directly affects how well treatment works. We'll go through exactly what your routine should look like during healing.
We bring you back six weeks after SRP to measure pocket depths again and assess the tissue response. This tells us whether in-house maintenance is the right path forward or whether a referral to a periodontist is warranted.
What to Expect After Treatment
Some tenderness and sensitivity in the treated area is normal for a few days after scaling and root planing. Gums may look slightly more receded as the swelling resolves — this is the tissue returning to a healthier position, not new recession. Over-the-counter pain relief is usually sufficient, and most patients return to normal eating within a day or two.
Sensitivity to cold is common for a few weeks as the roots adjust. If sensitivity is significant or persists beyond that, let us know.
The most important thing during the healing period is your home care. The work we did in the chair sets the stage — what happens at home determines whether the tissue actually heals and reattaches. We'll be specific about what to do and what to avoid.
Maintenance Is Where Treatment Holds
Periodontal disease doesn't have a one-time cure. Once the active infection is under control, the goal shifts to keeping it that way — and that requires more frequent professional care than a standard twice-yearly cleaning schedule provides.
Patients who complete SRP and respond well at their six-week re-evaluation move into our in-house periodontal maintenance program. Visits are every three months. At each appointment we re-measure pocket depths, clean the areas that a standard cleaning doesn't reach, and monitor for any signs of reactivation. Catching a problem at three months is very different from catching it at twelve.
One-Year Maintenance Package
We offer a structured one-year maintenance package that covers your quarterly periodontal maintenance visits — so you're not managing individual appointments and bills across the year. Ask us about current pricing and what's included when you come in for your evaluation.
(954) 722-9020 — Ask About the PackageIf your six-week re-evaluation shows that pockets aren't closing adequately or disease is more advanced than in-house maintenance can manage, we'll refer you to a periodontist. We'll be direct about when that's the right call — keeping a patient in-house when they need a specialist doesn't serve them.
Common Questions
Honest answers about periodontal disease and how we treat it at Dr. Dulay & Associates P.A.
Is a deep cleaning the same as a regular cleaning?
No. A routine cleaning — called prophylaxis — removes plaque and tartar from above and slightly below the gumline on healthy or mildly inflamed tissue. Scaling and root planing goes significantly deeper, into the periodontal pockets that have formed around the roots. It's a different procedure for a different problem, done with local anesthetic, and billed differently by insurance.
Will I need surgery?
Many patients do not. Scaling and root planing, combined with diligent home care and consistent maintenance visits, controls the disease for a significant portion of patients without surgical intervention. If pockets remain deep at your six-week re-evaluation or if bone loss is extensive, we'll discuss referral to a periodontist who can evaluate whether surgical treatment is appropriate. We won't keep you in-house if that's not the right answer for your case.
How long does the procedure take?
It depends on how many teeth are involved and the severity of disease. We typically treat one or two quadrants per appointment. A full-mouth case may take two appointments. We'll give you a clear picture of what to expect at your evaluation so you can plan accordingly.
Why every three months for maintenance? Can I go back to twice a year?
Bacterial colonies in periodontal pockets re-establish themselves within about 90 days. A three-month interval disrupts that cycle before the bacteria can cause further damage. Once you have a history of periodontal disease, twice-yearly cleanings aren't frequent enough to manage the risk — even if things look stable. Some patients eventually transition to a less frequent schedule if they maintain for years without any sign of reactivation. That's a conversation we have based on what the numbers actually show.
Does my insurance cover this?
We're out-of-network with all insurance carriers. Many plans have out-of-network benefits that cover a portion of periodontal treatment — we'll verify yours and walk through your estimated cost before any work begins. Scaling and root planing is a covered benefit under most dental plans at some level; the specific reimbursement depends on your plan. If you need flexible payment options, we offer financing through Sunbit and Cherry.
My gums don't hurt. Do I really need treatment?
Yes — if your exam and X-rays show active periodontal disease. Gum disease is largely painless until it reaches an advanced stage, which is precisely what makes it dangerous. By the time it hurts, significant bone loss has usually already occurred. Pain is not a reliable indicator of whether treatment is needed.
The Sooner You Address It, The Better the Outcome
Periodontal disease responds well to treatment when it's caught before significant bone loss has occurred. If you've noticed any of the signs above — or if it's been a while since a thorough exam — call Dr. Dulay & Associates P.A. and let's take a look.