Fifth Ave Perio

Improving Smiles

Indications for Gum Grafting

When New York City patients come in to Fifth Avenue Periodontics with gum recession, Dr. Cliff Melnick can help regenerate the lost tissue with a procedure called Connective Tissue Grafting, also called Gum grafting, or gingival grafting. It is a regenerative procedure to reverse gum recession. The goal is to recontour the gums to cover exposed root surfaces which protects the teeth and supporting bone from damage, and and improves your smile.

Recession is usually caused by normal activities like brushing, eating, teeth grinding and aging. If recession is not treated, the teeth, supporting tissue and bone can become so damaged that it may result in tooth loss.

What are the indications for connective tissue grafting?

New York City patients suffering from gum recession do not automatically require connective tissue grafting. There are five main indications for connective tissue grafting:

1. Esthetics: Recession of the gingival (gums) can result in unsightly yellow root exposure, as well as abnormally long appearing teeth. Connective tissue grafts can cover up most, and sometimes all of the recession that has taken place. Once the regenerated tissue has healed and matured the tooth will look more natural, with a beautiful, healthy appearance.

2. Inadequate Gingiva: The tough, pink tissue called gingiva, is found around the teeth and helps form a tight cuff or seal around the tooth. When the gums pull away from the teeth, the tight seal is broken, which creates the perfect environment for bacteria to grow resulting in deep pockets, infection, and recession. A connective tissue graft will regenerate a band of gingiva to reform the tight biologic seal around the tooth. This will help halt recession, reduce sensitivity, improve healthy tooth function, and improve the appearance of your teeth and smile.

3. Pre-Orthodontic: You may have consulted with your orthodontist and were told you need to have connective tissue grafting done before you start your orthodontic (braces) treatment. The gums must be healthy to allow for tooth movement during orthodontic treatment. Moving teeth into proper alignment with inadequate gum tissue can lead to recession. If this is the case, we can regenerate the tissue that has been lost to keep your orthodontics moving ahead.

4. Root Decay: Patients with gingival recession are at increased risk for decay on their root surfaces. The white, hard tooth structure we see is enamel, and it is meant to be exposed to the oral environment. The root surface, which tends to be more yellow, is made of dentin, which is much softer than enamel. Covering the roots back up will reduce your risk to root decay, and help prevent other periodontal conditions.

5. Tooth Sensitivity: When roots are exposed this can cause the roots to be very sensitive to hot, cold or touch. Just drinking a cold glass of water or hot tea or coffee can cause discomfort. Covering up the roots can go a long way towards reducing tooth sensitivity.

How are connective tissue grafts done?

First, Dr. Melnick will make a pouch in your gums. Then Dr. Melnick will borrow some tissue from the roof of your mouth, place the tissue into the pouch and close the flap back up. In essence, we are using your own gum tissue as a Band-Aid. The roof of your mouth will also be sutured and the tissue will regenerate. This tissue will integrate with your gums. Usually we can cover up most and sometimes all of the recession that has taken place.

What type of healing can I expect?

In the early days you can expect your graft to look worse before it looks better. There will be a whitish/yellowish appearance on the surface. This is simply the surface cells of the graft dying off. A few days later you will see a raw, reddish appearance. This is a good sign that the graft is receiving an adequate blood supply. When you return for your post-op appointment 10 days later we will remove the sutures for you. The graft may appear to be lumpy and bumpy. If there is excess tissue regenerated, then this is a wonderful problem to have. Your body will remodel and reshape the graft with time and as it matures, it will blend in beautifully. If, after 3-4 months, there are still some residual lumps and bumps we can usually reshape the tissue in just a few minutes. There is no additional charge for any reshaping. Will it hurt? The site where the graft goes usually does not cause any significant discomfort. The site where the tissue came from (the palate) can be mildly uncomfortable but for more patients, they report little to no pain.

LANAP Laser vs. Osseous Surgery

With recent advancements in periodontal laser technology, New York periodontist Cliff Melnick, DMD offers a minimally invasive alternative to traditional gum disease treatment. Laser Assisted New Attachment Procedure (LANAP) is a breakthrough procedure that is less painful, and more successful than conventional surgery. Patients suffering from periodontal disease now have an excellent alternative to traditional gum surgery.

Periodontal Disease and Osseous Surgery

Gum disease (periodontal disease) is an infection of the gum tissue that damages your gums, teeth and jawbone. Gum and bone tissue should fit tightly around healthy teeth, creating a protective cover from bacteria.  Patients diagnosed with periodontal disease suffer lost supporting tissue and bone. This results in the formation of pockets around the teeth where bacteria accumulate. Over time, these pockets grow and provide a larger environment in which bacteria thrive. As bacteria multiply around the teeth, they advance under the gum tissue, into the bone. Osseous surgery also known as “pocket depth reduction” is a surgical procedure that removes diseased tissue surrounding the teeth. When the pockets are too deep to clean with daily home care,  Dr. Melnick recommends professional care using LANAP.

LANAP vs. Traditional Gum Surgery

One major difference with LANAP vs. traditional periodontal surgery is the use of precise lasers instead of scalpels. For patients with anxiety about dental surgery, this fact alone makes LANAP the clear choice. While this is an important decision-making consideration, LANAP offers equally beneficial advantages for health, comfort and recovery. During traditional gum surgery, an incision is made into your healthy gums, using a scalpel, to gain access and visibility to the site that requires treatment. While this incision will be stitched up after the close of the procedure, the action of cutting and sewing your healthy gum tissue can result in gum recession. Traditional gum surgery can cause your gum line to recede up to 15 millimeters, which creates the need for additional treatments, such as gum grafts. With LANAP, however, there is no need to cut or suture your healthy tissue, as it will remain intact. This also greatly reduces tissue shrinkage, discomfort and healing times during gum surgery recovery.

The PerioLase® MVP-7™ allows Dr. Melnick to control and minimize any bleeding, utilizing blood coagulation to facilitate the recovery from gum surgery by producing a healthier healing environment. This procedure can also reduce up to 90 percent of the inflammation in your treated gum tissues after just one session of laser gum disease treatment in the New York City. And recent studies found that LANAP induced periodontal regeneration- growth of new bone and new tissue that will regenerate back to its original structure.

It is important to our office that our patients are comfortable throughout their laser gum care treatment. LANAP offers a long term health benefit that is unrealized with traditional gum surgery, and that is improved bone health. During the procedure, the laser is utilized to stimulate the bone at the tooth root and spurs the regeneration of bone. This allows Dr. Melnick to save teeth that may otherwise be hopeless.

Why Should You Choose LANAP?

  • 24 Hour Recovery Time with Minimal Discomfort
  • 98% of Laser Treated Patients Remain Stable After Five Years
  • Greater Predictability for Reattachment of Gum Tissue and Bone Regeneration
  • Less Time in the Dental Chair
  • Reduced Risk of Infection
  • Decreased Sensitivity and Less Bleeding
  • Minimum to No Gum Recession

Dr. Cliff Melnick has been a practicing periodontics in New York City for over 30 years. Dr. Melnick has been voted one of America’s Best Dentist in 2016. Dr. Melnick is dedicated to researching and finding the best dental technology to ensure the highest level of periodontal care for his patients. For patients in New York City who need periodontal disease treatment, Dr. Melnick chooses LANAP. If you would like to experience less discomfort and faster gum surgery recovery times with LANAP®, schedule a consultation at Fifth Avenue Periodontics today.

A Healthier Smile in the New Year

Healthier Overall Health

When you look at your New Year’s resolutions that you penned right before midnight on December 31st, you might notice that there are a few trends.  You might have goals to avoid using your cell phone as much.  You might have thought it would be ideal to spend more time reading throughout the year.  Or maybe you want the opportunity to hit the gym more often in 2014.

Many resolutions may have something to do with improving one’s personal health, but when most think about health, oral care is generally forgotten.  Through Dr. Clifford Melnick’s blog, you will learn some of the ways that you can improve your overall dental health with our top laser dentistry procedures.  Keep reading to learn more about a healthier smile and body in the New Year!

Your Smile and Overall Health

At our Fifth Avenue Periodontics office, we offer laser dentistry to our patients as a safe and effective way to maintain the support structures of the teeth.   Laser dentistry is used for a multitude of procedures including:

  • Modifying the shape of the gum line in cosmetic dentistry
  • CO2 laser technology is used to remove tumors or lesions.  This technology allows for Dr. Clifford Melnick to have exceptional control in performing a wide variety of periodontal treatments.
  • Laser dentistry can be used to minimize the amount of anesthetics or sutures needed during a procedure.  Laser dentistry can also minimize the amount of recovery time, reduce bleeding, minimize the chances of bacterial infection, and help patients recover faster.

Laser dentistry is safe for individuals of all ages, including women who are pregnant, patients with diabetes, and individuals with pacemakers.  At Fifth Avenue Periodontics, we are passionate about delivering only the best in laser dentistry procedures to ensure that our patients spend less time in the dentist’s chair, and more time smiling.  With this dental technology, we are able to transform smiles more quickly, efficiently, and with less reported pain in the process.

Learn More about Your Dental Health

If you would like to learn more information about your oral health, do not hesitate to contact Dr. Clifford Melnick.  Dr. Melnick and his dental team will answer all of your questions about our oral services, and offer guidance about the procedures that would best serve your individual needs.  At Fifth Avenue Periodontics, we believe that your health is of the utmost importance and we strive to offer unparalleled treatments to each one of our patients.

To find out more information about laser dentistry and Dr. Clifford Melnick, please call our New York office today.  Improve your oral health today with changes that can last for a lifetime.


Gum Recontouring and You

Gum Recontouring and Your Smile

For many individuals, their gum line has never enhanced their smiles.  Some many have overly gummy smiles, while others may find that black lines are visible from dental crowns.  Whatever your reason for not liking your gum line, Dr. Melnick is here at Fifth Avenue Periodontics to help.

Dr. Clifford Melnick’s expertise in gum recontouring allows for him to reshape the gum line with dental lasers.  The procedure can yield dramatic results for many of our patients, and can help to transform a wide variety of gum line issues.  To learn more about gum recontouring, keep reading Dr. Clifford Melnick’s blog.

Dr. Clifford Melnick and Gum Recontouring

At Fifth Avenue Periodontics, gum recontouring is used for a variety of procedures to help patients achieve their desired results.  Dr. Clifford Melnick uses the latest state-of-the-art dental technology and lasers to transform the gum line.  Gum recontouring is most commonly used to:

  • Cover any black lines due to exposed crown margins.
  • Retreat the gums found with gummy smiles.
  • Add gum with connective tissue grafting.  In this procedure, the gum is moved from a palate donor site to an area that is lacking gum tissue.
  • Aid with lateral pedicle grafts.  Through this gum recontouring procedure, the gum is moved from an adjacent tooth to add gum tissue over an exposed tooth root.

All of these procedures can provide our patients with the smile lines that are highly desirable.  During a consultation, Dr. Clifford Melnick will learn more about your individual concerns with your smile, and perform a detail evaluation.  Through this analysis, Dr. Melnick will be able to determine if you could benefit from gum recontouring, and what results you can expect from the procedure.

Learn More about Gum Recontouring

If you would like to learn more information about gum recontouring and other smile line aesthetic features, do not hesitate to contact Dr. Clifford Melnick.  Dr. Melnick and his dental team will answer all of your questions about our gum recontouring services and help you understand if alterations to your smile line could make a difference for you.

We are passionate about offering unparalleled care and services to all of our dental patients.  To learn more about the Fifth Avenue Periodontics difference, please contact our New York dental office today.


Crown Lengthening

What Is Crown Lengthening?

Crown lengthening is a procedure that lengthens the clinical crown of the tooth so that a tooth can be sealed and bacteria cannot enter when the general dentist makes the crown(cap).  Patients who suffer from a tooth that has broken or decayed below the gum line can have their teeth saved from extraction and additional damage.   In addition, when a tooth is broken down from a fracture, crown lengthening can create more length to make space for reconstruction.

Through this blog, Dr. Clifford Melnick will address what a crown lengthening procedure requires.  Patients will be able to understand the purpose of crown lengthening procedures, and learn more about the crown lengthening procedure process.

All about Crown Lengthening

Patients can require a crown lengthening procedure to remove gum tissue and bone surround the teeth to expose a healthier tooth below.  Excess gum tissue is removed and small incisions are made so that the surrounding bone can also be reduced.  Patients who undergo a crown lengthening procedure that is assisted with soft-tissue lasers can expect to experience less healing time and little pain during the recovery process.

Procedures for crown lengthening that utilize CO2 dental lasers are safe and effective for all patients, including those with health restrictions including: pregnancy, pacemakers, and organ transplants.  The Deka Ultraspeed CO2 Dental Laser yields reduced recovery times and a decrease in the need for sutures and extensive aesthetics.  Some local anesthetics may be used during the time of the procedure to ensure that a patient is comfortable throughout the entire dental surgery.

Crown lengthening is a common surgical procedure, and can be completed require little recovery time with an expert such as Dr. Clifford Melnick.  Within weeks, the gum line can heal properly to allow for other restorative dentistry procedures to take place.  After the procedure is completed, a more decay-free tooth surface is accessible, which allows for a dental crown or filling to be placed without the risk of irritation or infection.

With Dr. Melnick, patients can relax knowing that they are with a dentist who cares about comfort, quality care, and satisfaction. Learn more about why you should consider Dr. Melnick for all of your periodontal  procedure needs by contacting our New York office today.

Learn More about Our Oral Procedures

If you would like to learn more about crown lengthening and our other dental procedures, do not hesitate to contact Dr. Clifford Melnick and his dental team.  We are here to answer all of your questions about the crown lengthening procedure so that you can feel comfortable with the process from the beginning to the end.

To find out more information about Dr. Clifford Melnick, dentistry, or periodontics, please contact our New York office.  We believe that our patients should feel comfortable and confident with their smiles—learn how we can make these goals a reality for you.



Considering Gummy Smile Surgery

Transforming a Gummy Smile

You have never felt overly confident about your smile.  Every time you look into a mirror, one thing always strikes you—too much of a gummy smile.  Your teeth appear like they are much smaller than the average size and your gums seem to engulf them.

Dr. Clifford Melnick of Fifth Avenue Periodontics can help transform your smile with gum recontouring.  Gum recontouring is a minor procedure that can lead to significant changes in the amount of gingiva or gums that appears.  If a patient has a gummy smile or a gum line that appears uneven, then gum recontouring might be a procedure to consider.  Through this blog, gum recontouring will be discussed in detail so you can start to consider whether you are good candidate for this cosmetic dental procedure.
What Is Gum Recontouring?

Gum recontouring is a minor surgical process that can make a major difference in smile aesthetics.  This procedure is typically recommended for patients who experience the following:

  • Patients with uneven gum contours, which make the teeth, look misshapen or even misaligned when they are in excellent condition.
  • Individuals who have an overly gummy smile, which may make the teeth appear to be shorter or smaller than they really are in reality.  Excessive gingiva can cover the teeth and negatively impact the smile’s profile.


The gum recontouring procedure usually only takes about one hour, and is performed in-office.  An anesthetic is administered to numb the area before any contouring takes place.  Dr. Melnick reshapes the gum line by removing excess gum tissue with laser technology.  The advancement in dental technology makes procedures like gum recontouring practical and relatively painless. Diode lasers are unique in that they cauterize while they cut, resulting in less bleeding, chance of infection and reduced healing time.

The surgery is with minimal risk, and most patients only experience minor gum soreness after the procedure is complete.  For the first week its is recommended to stay away from foods that may irritate the gums including spicy foods and foods containing high levels of citric acid such as orange juice. If pain persists Dr. Melnick recommends an over the counter pain reliever such as ibuprofen to help reduce the pain. A patient will be able to see results as soon as the procedure is finished, and a gummy smile or a misshapen gum line will no longer frame the smile.

For patients who are discontented with their smiles, gum recontouring might be the right procedure to consider.  During a consultation, Dr. Melnick will explain what to expect from the procedure.
Learn More about Dr. Clifford Melnick
If you would like to learn more information about Dr. Clifford Melnick and gum recontouring surgery, do not hesitate to contact our New York dental office.  We are here to answer all of your questions about periodontal care and laser dentistry, as well as our other dental procedures.

For many patients, smile recontouring surgery can help transform a smile in less than an hour.  To learn more about how you can reveal your most beautiful smile, contact Dr. Clifford Melnick today.