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Periodontics/RE: 50% bone loss


Hi Dr. Scharf,

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?


Hi Todd:

It is possible that what appears to be a change on bone level on xray is really an artifact and not real bone change.  Are the pocket depths increasing?  Is there recession?  If in fact you have lost that amount of bone I such a short time I would strongly urge you to see a periodontist for a thorough evaluation.  That is what would be indicated to determine the cause and proper course of treatment.   A periodontist  is a dentist who is an expert in gum diseases.  

Best of luck
Dr. Scharf


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David Scharf


I am a board Certified periodontist which means that I am an expert in treating gum disease (periodontal disease) and placing dental implants. I can answer questions related to treating gum disease, bleeding gums, maintaining healthy gums, and structural issues with the gums such as recession, to gummy a smile, crown lengthening etc. I am also certified in Laser Periodontal therapy which allows me to treat gum disease with a laser rather than a scalpel. I can address those questions as well.


I have been practicing periodontics and placing dental implants since 1990. I have treated thousands of patients for both gum disease and dental implants. I currently an a Clinical Assistant Professor in the Department of Periodontics and Implant Dentistry at the nations largest dental school.

Journal of the American Dental Association, Journal of Periodontology, International Journal of Oral and Maxillofacial Surgery, International Journal of Oral and Maxilofacial Implants

BA/DMD Boston University Cum Laud. Certificate of Advanced Graduate Study in Periodontics fro New York University. Board Certification in Periodontics 1995

Awards and Honors
e was elected to Omicron Kappa Upsilon (the "Phi Beta Kappa" for dentists), and received the Boston University award for Excellence in Periodontology, the Boston University Predoctoral Prosthetic Award for Excellence in Prosthetics, and the Academy of General Dentistry Outstanding Senior Student Award, the Boston University Operative Dentistry Special Achievement Award, and the Quintessence Publishing Company Outstanding Senior Award for Excellence in Clinical Practice. Following dental school, Dr. Scharf completed a year long General Practice Residency at The Long Island College Hospital in Brooklyn, New York. As a resident at this top New York program, he gained extensive clinical experience in such fields as prothodontics, periodontics, endodontics, orthodontics, oral surgery, management of the medically compromised patient, and general dentistry. This experience was completed by clinical rotations in the departments of general medicine, anesthesia, and emergency medicine.

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