What is a periodontist? What are the most common periodontics procedures?

Nichole McKenna

Written by Nichole McKenna DDS, Richard Hattaway DDS

A periodontist is an expert in preventing, diagnosing, and treating periodontal disease. They are also involved in the process of dental implant placement. These specialists concentrate on oral inflammation as well. Periodontists explore how it can influence your oral health and tooth restoration options.

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Periodontist vs. other dental specialists

Periodontists go through 3 additional years of training after dental school. During that time they learn to perform both surgical and non-surgical treatments of gum issues. They can also perform cosmetic surgery inside the mouth.

Minor gum issues can be treated by a general dentist, but more complicated cases are referred to periodontists. These specialists are often confused with endodontists. The difference is that the latter deal almost exclusively with the pulp inside the tooth.

Periodontists come out favourably in price comparisons with other specialists. Nonetheless, make sure to find an affordable dentist in your area and avoid overpaying.

What is considered periodontics?

Periodontics is a dental specialty that focuses on inflammatory disease within the mouth as well as disorders of structures surrounding teeth. That includes both the hard and soft tissues, namely the gums, alveolar bone, cementum, and the periodontal ligament.

This is reflected in the name, as, from Ancient Greek, “peri” means around and “odon” means tooth. Periodontists might also be called “gum specialists”.

Here are some of the most common procedures they perform.

Scaling and root planing

SRP procedure for periodontal disease

Picture by Authority Dental under CC 2.0 license

The ADA reports that over 47% of US citizens over the age of 30 are affected by some type of gum disease. It is an infection of the gums that can lead to heart and respiratory diseases as well as tooth loss.

Scaling and root planing is often the only procedure necessary to treat periodontal disease. The dentist uses scaling instruments to clean out plaque and tartar that are infecting the gums. If SRP is not performed in time, those can accumulate around the roots and in periodontal pockets, making them wider and deeper.

Bone grafting

Bone grafting procedure

Picture by Authority Dental under CC 2.0 license

Periodontal disease can develop to a point that the bone that supports teeth becomes destroyed. When this happens, bone augmentation procedures are necessary. This way the patient can keep the living tooth. If this point has passed, the periodontist can recommend a dental implant.

Bone grafting is basically adding sourced bone into an area where it is too sparse. This procedure is a simple process and can take place immediately after a possible extraction. Healing takes 3-6 months.

Dental implants

Single dental implant for front tooth

Picture by Authority Dental under CC 2.0 license

Dental implants are a great, yet expensive, way to restore teeth. They consist of titanium rods surgically placed in the jawbone. If your teeth were damaged by periodontal disease beyond repair, this can be a good pick for you.

This type of restoration requires a lot of healing and, most importantly, excellent oral health before treatment. Your dentist will work closely with a periodontist before and after the procedure. This is to make sure you are a good candidate and that your implants have fused to the bone properly.

An experienced specialist plays a key role in securing successful treatment. You can find one by using the best-rated dentist near me service.

Tooth extraction

Simple tooth extraction

Picture by Authority Dental under CC 2.0 license

A periodontist also deals with tooth extraction when it is necessary due to gum disease. He or she will treat the damaged soft and hard tissues around it. This can stop infection and prevent other teeth from becoming damaged.

You can discuss restoration options as well. The most durable choice is a dental implant, something else your periodontist is an expert in. He or she will let you know if it’s the right way to go for you.

Gum grafting

Using hard-bristled toothbrushes, wearing braces, oral piercings, gingivitis, and poor oral hygiene can all lead to gum recession. When gums recede they can no longer do their job, which is protecting the teeth and roots from infection. Gum grafting is done when this is severe. This helps patients avoid further recession, bone loss, and deep mucosal pockets.

The procedure carries both functional and aesthetic benefits. Tissue can be sourced from the palate to cover an exposed root. The periodontist thus evens out the gumline and reduces sensitivity.

Pocket reduction surgery

The periodontist will take a small instrument called a probe and insert it between the gums and teeth to measure the depth. If periodontal probing exposes widened pockets, surgery may have to be conducted to treat them. Deep mucosal pockets make gums prone to infection and teeth likely to fall out.

The process is simple. The periodontist will fold back your gums. This may involve surgical cuts and later, stitches. Bacteria will be cleaned out. He or she may also smooth the surface of the roots for easier attachment of soft tissue during the healing period.

Crown lengthening

Crown lengthening is usually cosmetic but can also precede restorative procedures. For instance, when a cavity extends too far beneath the gumline to make a crown possible or when a tooth has broken and more structure is required to hold a restoration. Periodontists also perform it on patients who have a “gummy” smile. This is when the teeth appear short due to excess soft tissue around the crown.

The gum is surgically removed under local anesthesia. Since soft tissues heal quickly, this treatment is not invasive.

FAQ

Why do I need to see a periodontist?

When a general dentist finds signs of excessive periodontal disease, he or she is likely to refer you to an expert in the field. That is what a periodontist is. When a case is complex, it’s best to go with a specialist who spent years treating the exact problem you are having.

What questions should I ask my periodontist?

It’s best to make sure you get an accurate diagnosis and treatment plan. Ask your periodontist whether you will lose any teeth on the account of your gum disease. Restoration options are a good thing to discuss as well. The condition of your soft tissues is very important here.

What can I expect at a periodontist consultation?

First of all, you should disclose your full medical history and any medication you are taking. That way treatment can be individualized to your health state.

The periodontist is likely to perform probing to check mucosal pocket depth and may request X-rays to be done. Those can show whether hard tissues have suffered. The process will likely seem very similar to the full exam that is completed by general dentists.

How often should you see a periodontist?

If you have trouble with gum disease, you are likely to be asked to visit every 2-4 months. Otherwise, book an appointment only if your dentist refers you.

Why are periodontists so expensive?

Periodontists often deal with complicated cases, ones that have been neglected for a while. This means they need extensive knowledge, training, and skills to make sure the disease is eradicated fully.

References

  1. Oral Inflammatory Diseases and Systemic Inflammation: Role of the Macrophage - NCBI
  2. Periodontal Ligament - ScienceDirect
  3. The American Dental Association Releases Guideline on Gum Disease Treatment - ADA
  4. A new role for periodontists in the 21st century - NCBI
  5. Periodontal probing: what does it mean? - PubMed
  6. Diagnosis and Treatment Approaches to a "Gummy Smile" - PubMed