Periodontics is a field of specialization in dentistry, and periodontists are dentists who specialize in diseases of the periodontium, which is the collection of tissues that support the teeth and hold them securely in the mouth. These tissues include the gum tissue, the bone that supports the teeth, the ligaments that hold the teeth to the bone and gums, and the calcified cementum that covers the roots of the teeth. Periodontists diagnose and treat periodontal diseases and devise plans to prevent their recurrence, and they also place dental implants and design implant treatment plans, in addition to performing cosmetic surgery procedures in the mouth. Regular periodontal examinations should be included in everyone’s oral health care routine, as periodontal examinations are often the most effective way to diagnose periodontal diseases, which can usually be reversed when detected early. Certain people face a higher risk of periodontal disease; see your periodontist regularly if you smoke or otherwise use tobacco, or if you have heart disease, respiratory disease, or osteoporosis. Patients with diabetes face a particularly higher risk of implant failure, especially when the disease is not properly controlled, and diabetic dental implant patients will work with their periodontist along with their primary care provider to make sure diabetes is managed before placing implants, throughout the healing process, and beyond.
All dentists must graduate from an undergraduate institution before graduating from dental school. Accredited dental schools confer the Doctor of Dental Surgery (DDS) degree, and the Doctor of Medical Dentistry (DMD) degree. To become a periodontist, a dentist completes three to seven years of training and residency in a periodontology residency program that is accredited by the American Dental Association. Once this program is complete, graduates can earn board certification with the American Board of Periodontology by earning satisfactory scores on comprehensive examinations that evaluate knowledge of every phase of periodontal disease and its corresponding treatment and by successfully presenting clinical reports that address specific procedures and treatments provided by the candidate during their residency. Periodontists must fulfill continuing education requirements and demonstrate competence in current technologies in periodontics in order to be recertified, and recertification is required every six years. Periodontists can work in the private sector, and they can work in hospitals, dental schools, government agencies, and business, and they can focus their careers on research related to treatment innovations or the characteristics of systemic inflammatory diseases and how these affect periodontal health.
If you’re looking for a periodontist, there are several things you should think about as you select the right periodontist for you. The best way to find a reputable periodontist is to ask your general dentist for a referral. If you’re researching candidates on your own, make a list of questions that will help you assess their qualifications. These questions should aim to answer things that are important to you and can be as simple or complex as you prefer. How long has each periodontist been practicing, and what continuing education courses have they completed? How recently did they complete their most recent recertification? What would each periodontist propose for your specific diagnosis and treatment plan, and how many options do they offer? What are their opinions about each of these options? Does the periodontist have experience treating your specific condition, or performing the procedure you need? It may be particularly important for you to budget appropriately for a dental implant procedure, so ask each periodontist about estimated costs and insurance coverage. Some periodontal procedures are unlikely to be covered by insurance, so ask if the periodontist offers financing options for costs that aren’t covered. If you are anxious about a periodontal procedure, you could ask what medication options are offered and how pain is mitigated during and after a procedure.
Of course, it’s important to enjoy the company of any health practitioner you’ll be spending time with, and that’s part of the evaluation process, too. Pay attention to the chairside manner of the periodontist and the behavior and demeanor of the staff, who should be accommodating and professional. Find out who your periodontist works with; ask who is in their referral network, and evaluate those practitioners, too. Choose a periodontist that has a convenient location and convenient hours, and, if you have specific criteria to evaluate, like translation options or disability accommodations, ask relevant questions as you collect information about prospective periodontists.
Periodontists perform a variety of procedures, both non-surgical and surgical, at all stages of periodontal disease, and they also perform periodontal plastic surgeries.
In its earlier stages, periodontal disease is most commonly treated with a scaling and root planning procedure, which is a dental deep cleaning that removes plaque and tartar from periodontal pockets and smooths the root of the tooth to prevent future infection. Once the area is sufficiently disinfected, it may be treated with antibiotics and antimicrobials, and, in conjunction with effective home health care, this treatment is usually effective when treating gingivitis.
When surgery is necessary in cases of more advanced periodontal disease, periodontists have access to a variety of procedures. Tissue regeneration surgeries rely on growth-stimulating proteins, bone grafts, or tissue-guiding filters to encourage the growth of healthy bone and gum tissue; these materials are placed into the bone after the area is thoroughly disinfected, under the gum tissue, and then the gums are reattached while the area heals. Periodontists also perform pocket reduction surgery, in which diseased tissue and bacteria are removed from periodontal pockets before the tissue is trimmed and secured back into place, and gingivectomy, in which gum tissue is trimmed away and allowed to heal, restoring the shape of the gum line.
When left untreated, periodontal disease can lead to the loss of the natural teeth, and periodontists can address this, too. Periodontists are experts in the placement of dental implants, the most popular dental restoration option currently in use for patients who seek to replace one or more missing teeth. In a dental implant procedure, a tiny cylinder made of medical-grade material is placed into the jawbone, where the root of a healthy tooth would usually be.
This implant cylinder fuses with the bone in the jaw as it heals, in a process that is called osseointegration. Once osseointegration is complete and the implant has fully connected with the bone, an artificial tooth or row of teeth can be attached to the implant post, providing a long-lasting, natural-looking, and natural-feeling dental restoration. Periodontists also perform plastic surgery procedures like gingival sculpting or crown lengthening, which addresses excess gum tissue that contributes to a gummy smile; tissue grafting, which uses tissue from the palate or another area of the mouth to cover and protect an exposed tooth root; and ridge augmentation, which reshapes the jaws and the gums and enhances the natural appearance the tissue that surrounds and supports dental restorations.
The first time you see your periodontist, you’ll have your entire medical and dental history evaluated. Be sure to tell your periodontist about any medical conditions you have and any medications you take, as these can affect the health of the oral cavity, and, if you smoke, talk to your periodontist about a smoking cessation plan; smoking increases both the risk and the severity of periodontal disease. Your periodontist will examine your mouth and your throat, your gums and your teeth, and your neck and jaw joints and will also take x-rays to assess the amount and areas of bone loss. After completing this examination, you and your periodontist will work together to develop a treatment plan that accommodates your clinical needs and your personal desires. Periodontal treatment requires regular checkups and cleanings to ensure that periodontal disease is kept in control, so be sure to choose a periodontist who meets your needs and whose company you enjoy, to help make treatment go smoothly and succeed.