A periodontist does not typically perform routine tooth extractions. This dental specialty focuses on the structures that surround and support the teeth; their primary goal is preservation. Their training centers on treating the gums and bone tissue to maintain a patient’s natural teeth. Therefore, if a tooth needs to be removed, a referral to a different dental professional is usually necessary.
Defining the Periodontist’s Specialty
A periodontist is a dental specialist who completes three additional years of post-doctoral training focused on periodontics. This field involves the prevention, diagnosis, and treatment of diseases affecting the supporting tissues of the teeth, including the gums and jawbone. Their expertise lies in managing inflammatory conditions like gingivitis and periodontitis, which destroy the soft tissue and bone anchoring teeth.
General dentists manage early-stage gum disease, but refer patients to a periodontist when the condition becomes moderate to severe. The central philosophy of periodontics is to halt disease progression and regenerate lost tissue, saving teeth.
Tooth Extraction: A Different Specialty
Tooth removal, known as extraction, generally falls outside the scope of a periodontist’s daily practice. Simple extractions are commonly performed by a general dentist. More complicated extractions, such as impacted wisdom teeth or those requiring complex surgical techniques, are the domain of an oral and maxillofacial surgeon.
Oral surgeons possess distinct training in surgical procedures involving the mouth, face, and jaw, making them the primary specialists for surgical tooth removal. The oral surgeon’s expertise focuses on safe and effective surgical removal when a tooth is deemed non-restorable.
A periodontist may be involved in the decision-making process when severe, advanced periodontal disease has rendered a tooth hopeless. The tooth may be removed as a necessary step before placing a dental implant or performing a more extensive bone grafting procedure. While they could technically perform the removal, the periodontist frequently refers the extraction to an oral surgeon to streamline the patient’s care and focus their efforts on the subsequent foundation-building treatments.
Common Treatments Performed by a Periodontist
Periodontists focus on a wide range of treatments designed to manage disease and rebuild the mouth’s structural integrity. Non-surgical therapy is often the first line of defense against established periodontitis. This includes scaling and root planing, a deep-cleaning procedure where the periodontist meticulously removes bacterial plaque and calculus from the tooth root surfaces below the gum line.
This deep cleaning smooths the root surface, which discourages the reattachment of bacteria and allows the gum tissue to reattach to the tooth. Following this initial treatment, patients enter a phase of periodontal maintenance therapy, which involves more frequent, specialized cleanings to prevent the recurrence of disease progression. When non-surgical methods are insufficient, a periodontist employs various surgical techniques to access and treat deeper disease.
Surgical Procedures
Pocket reduction surgery (osseous surgery) involves lifting the gum tissue to gain direct visibility of the infected root and bone. This allows for thorough debridement and reshaping of the damaged bone to eliminate deep pockets where bacteria thrive.
Other common procedures include gum grafting, performed to cover exposed tooth roots and prevent further recession, and regenerative procedures, such as bone grafting, which stimulate the growth of new alveolar bone.
Dental Implant Placement
The placement of dental implants is a significant part of a periodontist’s practice. As specialists in the bone and soft tissue foundation, they are ideally suited to surgically place the titanium implant post into the jawbone. This procedure often requires precise attention to the surrounding bone volume and density, frequently necessitating preparatory bone augmentation to ensure the implant is firmly integrated.