A periodontist is a dentist with extra training in treating gum disease and placing dental implants. Your general dentist will refer you to a periodontist for complex tooth extractions or when your periodontal (gum) tissue is unhealthy.
Periodontists perform gum plastic surgery to treat conditions like a “gummy smile.” They remove excess gum tissue and bone to expose more of the natural teeth for an attractive, symmetrical smile.
Prevention
Getting to the periodontist in the first place is key to avoiding serious gum issues down the road. Visiting the dentist every six months for a routine cleaning and exam allows the dental professional to catch any potential issues before they progress, including gingivitis (the first stage of gum disease).
Gingivitis can be reversed by regular oral hygiene, including daily brushing and flossing, plus using additional methods such as water picking or go-between brushes. If caught in the early stages, gingivitis can be treated by a general dentist or a periodontist with routine deep cleanings and scaling and root planing to remove any plaque buildup.
Receding gums can be a sign of late-stage gum disease, but they also occur for other reasons, such as injury from brushing hard or genetic factors. In these cases, a periodontist may perform gum recession surgery to repair the damaged tissue and promote healthy growth, or they might recommend gum grafts to cover any exposed roots and lower the risk of future complications. They can also fix any loose or shifting teeth, which can help prevent further damage and improve your smile’s appearance. In addition, they can treat any jawbone damage caused by the progression of gum disease. The underlying philosophy supporting this individual approach draws upon a biomedical model that focuses on mechanical biofilm control, reduced putative bacterial load and eliminating high risk behaviors such as smoking.
Diagnosis
In addition to treating gum disease, periodontists are also experts in tooth replacement with dental implants. As specialists, they have a much deeper understanding of tooth sockets and the health of underlying bone tissue than general dentists do. They use X-rays to evaluate the root of a tooth and its surrounding bone. They also perform cosmetic procedures such as crown lengthening and reshaping the gum line to expose more natural teeth and improve a “gummy” smile.
Patients who have advanced periodontitis, which is characterized by severe bad breath, swollen and bleeding gums that ooze pus, and loose teeth should schedule a consultation with a periodontist right away. This will allow the specialist to eradicate bacterial infection, halt gum recession, and repair damage to the jawbone. Visiting a periodontist can help prevent serious health conditions such as heart disease, diabetes, and osteopenia or osteoporosis, which have been shown to be associated with periodontitis.
During the consultation, the specialist will take a biopsy of the gums to evaluate the extent of bacterial infection and the quality of underlying bone. A treatment plan will be developed that may include surgical and nonsurgical options. They will also discuss strategies for maintaining healthy gum tissues, including a consistent oral hygiene routine. Patients with a history of gum disease should also visit the periodontist for routine checkups, which can help detect and intercept problems when they are still minor.
Treatment
Periodontists offer a wide range of nonsurgical treatment options to promote healing and restore dental health. Often, these include scaling and root planing (similar to a deep dental cleaning), where the dentist or dental hygienist cleans the surfaces of your teeth and beneath your gum line — where harmful bacteria hide — and smoothes the surface of your tooth roots to discourage further buildup of plaque and tartar. Your periodontist may also prescribe oral antibiotics to reduce infection levels beneath your gums.
Moderate gum disease (gingivitis) is usually reversible with proper dental care and routine visits, but left untreated it can lead to more advanced periodontitis with serious consequences like loose teeth and bad breath. During the periodontal exam, your periodontist will measure the depth of your gum pockets (called periodontal pocketing) using a probe and then make an evaluation of the supporting bone structure. This information is gathered and analyzed to form a diagnosis, which will guide your subsequent treatment.
If your gums have receded, exposing the roots of your teeth, your periodontist may recommend gingivectomy, or removal of the excess tissue. This procedure can be used to repair cosmetic problems such as a “gummy smile,” or to lessen sensitivity to hot or cold foods caused by root exposure. Your periodontist may also perform a bone graft to stimulate the growth of new bone where periodontal disease has eroded the underlying structure, or to prepare the site for a dental implant.