What is a Periodontist?
A Periodontist is a dental professional who specializes in the diagnosis and treatment of periodontal disease, also referred to as gum disease. A Periodontist focuses on the areas of the mouth surrounding the teeth, including the gums, bones, and connective tissues.
Periodontists are top experts in their ﬁeld and must complete a minimum of three years of dental school followed by a minimum of three years of specialized training in periodontics before treating patients.
What procedures does a Periodontist perform?
The early onset of periodontal (gum) disease, known as gingivitis, is characterized by swollen, bleeding gums and can typically be treated by a general dentist. However, patients with advanced cases are typically referred to a Periodontist for specialized treatment. A periodontist specializes in surgical and non-surgical procedures to treat various stages of periodontal infection. Common surgical procedures a periodontist may perform include:
- Pocket depth reduction - Excess bacteria in the mouth can slowly destroy the gum tissue and bone around the tooth, causing deep "pockets" to form around the tooth. Bacteria grow in these pockets which can lead to tooth loss. In this procedure, the periodontist folds back the gum tissue, removes the bacteria from around the root, and then secures the gum tissue back in place.
- Soft tissue grafts - This procedure helps to reduce and repair receding gums and prevent further bone loss. The periodontist typically takes gum tissue from the patient's upper palate to cover the exposed root of the tooth.
- Dental implants - When a patient loses a tooth to infection, the periodontist may suggest installing a dental implant, which is an authentic-looking artiﬁcial tooth. Unlike dentures or a bridge, dental implants are permanent and can be surgically placed in the bone (endosteal implants) or in the gum (subperiosteal implants).
- Non-surgical treatments a Periodontist may perform include scaling and root planing (the removal of plaque and other deposits above and below the gum line, and the smoothing of root surfaces), laser treatments (a specialized cleaning to remove bacteria and help repair diseased gums), and root surface debridement (the removal of damaged gum tissue). Periodontists can also perform a range of cosmetic dentistry procedures to improve a patient's smile, which may include dental implants and tissue grafts.
What causes periodontal (gum) disease?
Periodontal disease (or periodontitis) is caused by the buildup of plaque, the sticky, bacteria-ﬁlled ﬁlm that forms on teeth. If left untreated, periodontal disease can cause deterioration of the gum tissue and bone, which can lead to receding gums and tooth loss. It may also cause medical problems and advanced, serious medical conditions in patients with Alzheimer's disease, high blood pressure, and diabetes. Other systemic diseases that interfere with the body's inﬂammatory system may worsen the gums, such as cardiovascular disease and rheumatoid arthritis. To help avoid a visit to the periodontist, it is essential to brush and ﬂoss at least twice daily, visit the dentist at least every six months, eat a healthy diet, and not smoke.
You may be at risk for periodontal (gum) disease if you:
- Do not practice good oral hygiene
- Smoke or chew tobacco
- Have heart disease, diabetes, respiratory disease or osteoporosis
- Have a family member diagnosed with periodontal disease
- Are pregnant or thinking of becoming pregnant
In addition, the following types of prescription drugs may also increase the risk of periodontal disease. Talk with your dentist if you are taking:
- Cancer therapy drugs
- Oral contraceptives
- An anti-epilepsy drug
- A calcium channel blocker
Periodontal disease is considered "silent" because pain does not always accompany its warning signs. See your dentist if you experience:
Changes to Teeth, Bite or Dental Work
- Loose or separating teeth
- A change in the way your teeth fit together when you bite
- Bridges or partial dentures that no longer fit properly
- Fillings that have become defective
Changes to Gums
- Recurring redness, puffiness, tenderness, or swelling of your gums
- Bleeding gums while brushing teeth, flossing, or eating hard foods
- Gums that are receding from your teeth, causing them to look longer
Bad Mouth Odors and Tastes
- Persistent bad breath
- Persistent metal taste in your mouth
- Pus between your gums and teeth
- A sore or irritation in your mouth that does not improve within two weeks
There are many patient-specific variables involved with treating periodontal disease. Much depends upon the stage of infection and the amount of deterioration involving your gums, teeth, supporting tissues, and bone.
After reviewing your X-rays and performing a thorough periodontal exam, your periodontist will discuss non-surgical or surgical treatment options with you, answer your questions, and explain what to expect:
- During and after the procedure(s)
- The number of office visits required for treatment
- What to do at home as your gums heal
- How to keep periodontal disease under control after treatment is complete
The most well-known type of non-surgical treatment is scaling and root planing. This under-the-gum procedure involves a careful removal of plaque and tarter from the tooth roots. During this procedure your roots are smoothed to expose and remove harmful bacteria. Root smoothing along with the practice of good oral hygiene can help prevent plaque from accumulating again.
Periodontal surgery may be needed to eliminate bone infections or to regenerate lost bone. The most common surgical treatments include:
During this procedure, a local anesthetic is applied. The gum tissue isfolded back to expose deeper tissues. Then, harmful bacteria are removed. Irregular surfaces of the damaged bone may need to be smoothed to expose otherwise hidden areas of bacteria before it is removed. Gum tissue is then closed and sutured in place.
During this procedure, a local anesthetic is applied. The gum tissue is folded back to expose deeper tissues. Then disease-causing bacteria are removed. Membranes, bone grafts, or tissue-stimulating proteins are used to encourage your body's natural ability to regenerate bone and tissue and reverse some of the damage of periodontal disease.
Excess gum and bone tissues are then reshaped to expose more of the natural tooth. This can be done to one tooth to even out the gumline, or to several teeth to expose a natural, broad smile. Gum tissue is then closed and sutured in place