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Periodontics/RE: 50% bone loss


Hi Dr. Kong,

I want to ask for your opinion.

I am 47 years old, non-smoker, non-drinker, exercise and eat very healthy.
My teeth were strong and healthy up until 2012.
However, in 2014 my x-rays revealed 15% bone loss on my lower 4 front teeth. My dentist said I have perio-maintenance.
I used to have mild periodontitis but it stopped a few years ago with my excellent oral hygiene.
I get my teeth cleaned every 3 months and my gums are always pink and teeth are healthy. I have always brushed and flossed twice a day.

Yesterday, I went in for another x-ray and cleaning.
I now have 50% bone loss on my lower 4 front teeth. Its getting worse.
My dentist is concerned and does not recommend a deep cleaning because there is no tartar or plaque around my teeth.
The bone loss is centralized. My entire mouth has full bone density except for a specific area.

What else could be causing this bone loss? We have talked about a bone graft and gum graft, but he does not recommend it because the bone loss in that area would not anchor the teeth properly and the bones loss will progress again.
He says possibly getting a bridge if my lower front teeth fall out.

I am not sure how to stop bone loss if I am doing everything right. Should I take extra calcium and Vit D?
I eliminated dairy from my diet years ago. I wonder if this could be causing it. I also take Advair steroid and used prednisone for asthma. Could this cause bone loss?


Dear Todd,

It could be occlusal trauma in the presence of gum disease that may be making your boneloss worse.  Anyway, this is something you should definitely see a periodontist for before you decide to extract teeth and have a bridge made.



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John Kong, DDS,


I am a board-certified periodontist and an expert on dental implants. I am currently in private practice at Better Living through Dentistry. I can answer questions related to the treatment of periodontitis (gum disease), dental implants, sinus lifts, bone grafts, gum grafts, surgical exposure of teeth, and minor orthodontics.


I have been practicing periodontics and placing dental implants since 2006 on the Upper West Side, Manhattan, NY and in Forest Hills, Queens, NY at Better Living through Dentistry. I am currently an attending and Chief of Implantology at Flushing Hospital Medical Center.

American Board of Periodontology, American Academy of Periodontics, American Dental Association, New York State Dental Association

Wesleyan University / Amherst College, BA; SUNY Stony Brook Dental School, DDS; University of Medicine and Dentistry of New Jersey, Certificate in Periodontics; New York University, 1-year program in Full-Mouth Reconstruction; Certified in Invisalign

Awards and Honors
Northeast Society of Periodontists Achievement Award

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