Non-Surgical Procedures


Manhattan periodontist Dr. Scott Kissel ’s practice provides a variety of non-surgical services. We pride ourselves on the fact that we are very conservative in our treatment recommendations and limit surgery to the areas only when it is absolutely necessary.

Many times, the early stages of periodontal disease are best treated with non-surgical periodontal therapy. Even in severe cases, non-surgical periodontal therapy often precedes surgical therapy. This is done to improve the overall tissue quality prior to surgery and also to help limit the areas requiring surgery.

Antibiotic Therapies

Antibiotics or irrigation with anti-microbials (chemical agents or mouth rinses) may be recommended to help control the growth of bacteria that create toxins and cause periodontitis. In some cases, Dr. Kissel may place a local antibiotic in the periodontal pockets after scaling and planing. This may be done to control infection and to encourage normal healing.

Scaling & Rooting

The initial stage of treatment is usually a thorough scaling and rooting, which is a periodontal professional cleaning. It may include scaling to remove plaque and tartar deposits beneath the gum line. The tooth roots may also be planed to smooth the root surface allowing the gum tissue to heal and reattach to the tooth. In some cases, the occlusion (bite) may require adjustment.

When deep pockets between teeth and gums are present, it is difficult for Dr. Kissel to thoroughly remove plaque and tartar. Patients can seldom, if ever, keep these pockets clean and free of plaque. Consequently, surgery may be needed to restore periodontal health.

Oral-Cancer Screening

Oral cancer is 90% curable when found in its early stages. Unfortunately, 70% of oral cancers are diagnosed in the late stages, III and IV, because they are not visible to the human eye. Oral cancer found in these late stages can lead to a five-year survival rate of 57%. Dr. Kissel uses ViziLite Plus, a technology that has proven successful in identifying soft tissue abnormalities in other areas of the body. A ViziLite Plus exam is particularly important if you are at increased risk for developing oral cancer.

How ViziLite Plus Works

As ViziLite Plus passes over oral tissue that has been treated with the rinse solution, normal healthy tissue will absorb the light and appear dark, abnormal tissue will appear white. The purpose of using ViziLite Plus is to identify tissue changes at their earliest stage; once abnormal tissue has been identified it is up to your dental professional to determine what the appropriate next steps are.


Occlusal Therapy

Occlusual Therapy is used to resolve jaw joint and bite problems. The way in which teeth meet together is called an occlusion or a bite. The jaw joint, which keeps the bite aligned, consists of a ball that fits snugly into its socket. The jaw joint can move in three dimensions: side-to-side, front to back and up and down. It is this healthy flexibility that allows us to move our lower jaw freely.

Some discrepancies in the bite can cause problems with the teeth, the jaw joints and the muscles that control the opening and closing of the jaws. This may present itself as:

  • Facial Muscle Tenderness (which can extend to the neck or shoulders)
  • Joint clicking or locking
  • Loose teeth
  • Migraine Headaches
  • TMJ pain aka temporomandibular joint pain
  • Tooth pain

Occlusal therapy involving bite analysis, possible splint therapy and occlusal adjustments can improve these problems and symptoms and often provide a complete solution.