A periodontist is a specialized dentist focused on the prevention, diagnosis, and treatment of conditions affecting the structures that support the teeth, such as the gums and bone. They are experts in managing inflammatory diseases and conditions that compromise the stability of the dentition. This specialist focuses on the foundation that holds the teeth in place, offering advanced care beyond what a general dentist typically provides.
Defining the Scope of Periodontology
Periodontology is the branch of dentistry dedicated to the complex tissues surrounding the teeth, collectively known as the periodontium. These tissues include the gingiva (gums), the alveolar bone, the cementum (covering the tooth root), and the periodontal ligament, which connects the tooth to the bone. A periodontist’s primary role is to maintain the health and function of this entire support system.
General dentists refer patients to a periodontist for advanced cases involving these supporting structures. This specialized focus also extends to the surgical placement and maintenance of dental implants. Implants require extensive knowledge of both hard (bone) and soft (gum) tissues to ensure long-term stability and health.
The Path to Becoming a Specialist
The journey to becoming a periodontist begins with earning a Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD) degree, which typically takes four years after undergraduate education. This initial degree provides a comprehensive understanding of general dentistry, but it is only the first step toward specialization.
After dental school, the aspiring periodontist must complete an additional, rigorous residency program specifically in periodontology. This post-doctoral training usually lasts three years and involves intensive clinical and didactic education focused on the prevention, diagnosis, and treatment of periodontal diseases and implant surgery. Upon completing this residency, some specialists pursue board certification, which represents the highest level of achievement and expertise in the field.
Recognizing When You Need Specialized Care
A referral to a periodontist is necessary when gum disease progresses beyond the early stage of gingivitis. The advanced stage, known as periodontitis, involves the destruction of the bone and ligaments that hold the teeth in place, requiring specialist intervention. Signs suggesting specialized care include gums that bleed easily, persistent bad breath, or gums that appear red, swollen, or tender.
Patients may notice gum recession, which exposes the root surfaces and can lead to increased sensitivity. A more concerning symptom is loose or shifting teeth, which indicates significant bone loss caused by bacterial infection. Other issues requiring consultation include a change in how teeth fit together when biting, or the need for pre-prosthetic procedures like soft tissue grafting before receiving a crown or bridge.
Common Periodontal Treatments and Procedures
A periodontist employs a range of non-surgical and surgical techniques to restore and maintain the health of the periodontium. For early to moderate periodontitis, the primary non-surgical intervention is scaling and root planing, often called a deep cleaning. This procedure involves removing plaque and calculus (tartar) from the tooth surfaces above and below the gumline, followed by smoothing the root surface to eliminate bacterial toxins and encourage reattachment.
When non-surgical methods are insufficient, a periodontist performs various surgical procedures, such as osseous surgery or flap surgery, to reduce the depth of periodontal pockets and reshape damaged bone. For gum recession, soft tissue grafting is performed, often taking tissue from the palate to cover exposed tooth roots. Advanced techniques focus on regeneration, using procedures like bone grafts and membranes to stimulate the regrowth of lost bone and supporting tissues. Periodontists are also specialists in the surgical placement of dental implants, which involves embedding a titanium post into the jawbone to serve as a stable root for a replacement tooth.