Teeth need regular care from a professional, and a general dentist can provide much of that care. General dentists can provide cleanings, check for problems, educate patients on effective oral hygiene, and administer standard treatments like filling cavities. Some problems require a specialist; often that specialist is a periodontist.
Periodontists specialize in the prevention, diagnosis, and treatment of gum disease (periodontal disease) and problems with other structures that support the teeth. They also help patients in need of dental implants or suffering from oral inflammation. They are skilled in a number of cosmetic procedures.
HOW IS A PERIODONTIST TRAINED?
After receiving an undergraduate degree, individuals must first complete four years of education at an accredited dental school.
After receiving a DDS degree, candidates study and train for an additional three years in an approved post-graduate periodontics program. This additional education prepares them to diagnose underlying causes responsible for gum disease, apply a range of treatments and restorative procedures, and work in collaboration with general dentists to treat periodontal disease and prevent a recurrence. They also master cosmetic dentistry.
Upon completing the periodontics program, individuals are qualified to work as periodontists according to the standards of the American Dental Association (ADA).
WHO SHOULD SEE A PERIODONTIST?
General dentists can often provide for all of a particular patient’s needs. But gum disease generally requires the attention of a periodontist. The patient’s general dentist can make a referral upon diagnosing the problem, or patients can seek the services of a periodontist themselves if they suspect periodontal disease is present.
Gum disease is sometimes associated with other chronic diseases of aging. When this is the case, the expertise of a trained specialist can provide a favorable treatment outcome. The same is true when periodontal disease has progressed to moderate or severe levels, or when a case involves various complex medical issues. Patients may also wish to consult a periodontist to improve the look of their smiles with cosmetic periodontal surgery.
HOW DOES A PERIODONTIST TREAT A PATIENT?
On the first visit, a periodontist will perform a thorough examination. This involves examining the gums, checking for gum line recession, seeing how the teeth fit together when biting, and looking for loose ones. Using a measuring instrument called a probe, the periodontist will also determine the depth of spaces between the teeth and gums (periodontal pockets). All this provides an evaluation of the health of the gums. The periodontist may take X-rays to evaluate the condition of bone below the gum line.
The periodontist will also review the patient’s medical and dental histories. It is essential to determine if the patient is taking any medication or otherwise receiving treatment for a condition that can affect periodontal treatment, such as pregnancy, diabetes, or heart disease.
Once the evaluation is complete, periodontists can provide a number of treatments depending on the needs of each patient.
SCALING, ROOT PLANING, AND COMPARABLE MEASURES
Scaling and root planning are the least invasive and expensive procedures for the treatment of gum disease, if they can clear up the problem. If not, the periodontist has other treatments available.
The periodontist uses special instruments to clean the root surfaces of the teeth. Some patients receive antimicrobial medication. Removing plaque and hardened tartar (calculus) can sometimes control gum disease by itself. This is especially true if the patient follows up with an appropriate oral hygiene program.
POCKET REDUCTION SURGERY
If the gum no longer fits snugly against the teeth, the periodontist may perform gum surgery, cutting a small flap in the gum and removing infected tissue and bacteria from the periodontal pocket. Once this infected material is removed, healthy gum tissue can regrow and attach to the bone. This is a highly effective treatment that very often controls the problem of gum disease.
Gum disease can lead to tooth loss by eroding the bone in the jaw and damaging other tissues that support the teeth. Periodontists can employ bone and gum grafts and tissue-stimulating growth factors to repair the damage and prevent further tooth loss.
In some cases it is just not possible to save a tooth. Should this prove to be the case, the periodontist can remove the tooth and place a dental implant. A dental implant is a natural-appearing and fully functional artificial tooth that may last for the rest of a patient’s life.
Patients may also consult periodontists because they want to improve the appearance of their smiles. Periodontists can, for example, address gum recession with gum graft surgery, a procedure that covers the exposed roots of teeth with healthy gum tissue. This can be accomplished with the patient’s own tissue or tissue purchased. The surgery improves the appearance of the smile and can have the added benefits of reducing tooth sensitivity and protecting against decay.
Crown lengthening is sometimes one aspect of tooth restoration, but a periodontist may also use it simply to alter a “gummy” smile, one in which there appears to be too much gum and too little teeth to give a normal, appealing appearance. Crown-lengthening surgery reshapes the gum to allow more of the teeth to show.