Services: Non-Surgical 

Periodontal infection is typically a chronic infection that works its way further into the gum and bone over a long period of time. Because the bacteria are organized and different from the normal bacteria in the mouth, and because the bacteria invade the gum and affect the bone, many times conventional/routine cleaning does not serve well to control the infection.

This infection is typically without symptoms, such as pain. However, it can give you signs of infection such as swollen gums, bleeding, bad breath and looseness of teeth.

Dr. John Y. Kwan, a Board Certified periodontist, has innovated a way to effectively control periodontal infection and help patients heal in a simple, less invasive and less expensive way. The technique is simply called "Cleaning and Disinfecting". The results of this technique have been shown to reduce "pockets", reduce bleeding and even regenerate bone. Dr. Kwan's technique has been statistically evaluated by recognized researchers at the University of Louisville, in Kentucky, and the State University of New York, in Buffalo. Results of his clinical study have been presented at the International Association of Dental Research, the American Academy of Periodontology, and published in the Journal of Periodontology.

The "Cleaning" is typically done using local anesthesia and with very small ultrasonically powered probes ("micro ultrasonics"). This technology eliminates the need for scraping of the roots with hand instruments. This cleaning technique very thoroughly cleans diseased roots and pockets with micro ultrasonic vibrations of the instrument, as well as with highly energized flushing with water irrigation. (Patients who are anxious about treatment can elect to be orally or intravenously sedated before the local anesthesia and during the treatment.)

To aid in visualization of diseased tooth roots, Dr. Kwan uses a fiber optic endoscope (Perioscopy). This micro camera slips into the gumline so root surfaces can be observed. For more information on Perioscopy click here

The "Disinfection" may be done with an antibiotic. Because there are specific bacteria that invade the gum tissue and affect the bone, Dr. Kwan has found that a course of a systemic antibiotic can help to eliminate any bacteria residual to the cleaning. The antibiotic used may vary based on patient tolerances to different medications. When the infection is generalized it is better to use systemic medications (oral pills). However, when the infection is more localized, a time-released antibiotic may be placed directly into the pocket to provide the disinfection. 

The results of "cleaning and disinfecting" together, have been shown to be much more effective than either one alone. The procedure is one of the best approaches for giving the body a fresh start at healing the gum and bone around the teeth.

After the initial procedure, patients typically have little or no discomfort. Subsequently, patients are asked to have supportive periodontal treatments at 3-4 month intervals for one year. These treatments are micro ultrasonic cleanings (without anesthesia and without antibiotics) and are performed to support healing by keeping the teeth above and below the gumline as clean as possible. Additionally, we help our patients improve the effectiveness of their cleaning at home.

After a year, selected x-rays are taken and a reevaluation of the healing response is performed. At that point long term management options are discussed. Rarely, surgical treatment is recommended. 


Examples of bone healing after micro ultrasonic endoscopic debridement and short term adjunctive antibiotic therapy

Before and After


Before and After


Before and After


The Perioscopy Solution

A non-surgical procedure, Perioscopy uses a miniature dental endoscope with advanced video, lighting, and magnification technology, enabling dentists or hygienists to diagnose and treat areas below the gumline.

Periodontics has made great strides in the surgical and non-surgical management of periodontal problems. With this innovative technique, Dr. Kwan has been able to allow many patients to reach periodontal health in a simple, effective, less invasive and more affordable way.

If you have any questions regarding this approach, please do not hesitate to contact us.