When to See a Periodontist

A periodontist is a specialized dentist who focuses on preventing, diagnosing, and treating infections and diseases in the soft tissues surrounding the teeth and the jawbone that supports the teeth. To become a periodontist, dentists must undergo an additional three years of training beyond regular dental school. They acquire advanced knowledge and skills in treating periodontal disease and placing dental implants. Periodontists also perform various cosmetic procedures to enhance the smile.

Periodontal disease begins when plaque toxins attack the soft tissues, known as the gingival tissue, surrounding the teeth. Bacteria in the plaque multiply and cause an infection that embeds itself in the gums. As the infection progresses, it burrows deeper, causing inflammation and irritation between the teeth and gums. In response, the body tries to destroy the infected tissue, resulting in gum recession. The formation of pockets between the teeth worsens, and if left untreated, the infection affects the jawbone, leading to unstable teeth and tooth loss.

There are different ways to seek treatment from a periodontist. During a regular dental check-up, if a general dentist or hygienist detects signs of gingivitis or rapidly progressing periodontal disease, they may recommend a consultation with a periodontist. However, a referral is not always necessary for a periodontal consultation.

It is important to schedule an appointment with a periodontist if you experience any of the following signs and symptoms:

1. Bleeding while eating or brushing: Unexplained bleeding during meals or daily oral hygiene routines is a common sign of periodontal infection.

2. Bad breath: Persistent halitosis, even with proper oral hygiene, can indicate periodontitis, gingivitis, or an infection in the gum tissues.

3. Loose teeth and gum recession: Teeth appearing longer may signify gum recession and bone loss due to periodontal disease. As the disease progresses and affects the jawbone, teeth may become loose or lost.

4. Tissue gangrene: Diagnosis of gangrene in the soft tissues, alveolar bone, or periodontal ligament requires examination by a general dentist or periodontist.

5. Related health conditions: Conditions such as heart disease, diabetes, osteopenia, and osteoporosis are often associated with periodontitis and periodontal infections. Bacterial infections can spread through the bloodstream and affect other parts of the body.

Before initiating any dental treatment, the periodontist conducts a comprehensive examination of the gums, jawbone, and overall tooth condition. Once gingivitis or periodontal disease is diagnosed, the periodontist has several surgical and non-surgical treatment options available:

1. Gingivitis/mild periodontal disease: If gum pockets exceed 4mm in depth, scaling and root planing may be performed to remove debris and promote healing. The periodontist provides education and advice on maintaining an effective oral hygiene routine.

2. Moderate periodontal disease: Deeper gum pockets, ranging from 4-6mm, may require more extensive scaling and root planing, usually performed with local anesthesia.

3. Advanced periodontal disease: Gum pockets exceeding 6-7mm, accompanied by bone loss and gum recession, may necessitate scaling and root planing as the initial nonsurgical treatment. Surgical treatment to reduce pocket depth may also be recommended.

4. Tooth loss: Dental implants are an effective option for replacing one or multiple missing teeth due to periodontal disease. If the bone provides a suitable anchor, the periodontist can place the implant. In severe cases of bone erosion, bone grafts may be performed to ensure a stable anchor for the new tooth or teeth.

If you have any questions about periodontal disease, periodontal treatment, or dental implants, consult with your dentist.