A periodontist is a dental specialist who focuses on the prevention, diagnosis, and treatment of periodontal disease and the placement of dental implants. These highly trained professionals have completed dental school plus several additional years of education to develop expertise in maintaining the health of the tissues that support your teeth.
When gum disease advances beyond what a general dentist typically treats, a periodontist steps in with specialized knowledge and techniques. Their advanced training allows them to offer treatments for severe gum conditions and provide surgical care that can save teeth and restore oral health.
The Role of a Periodontist in Dental Healthcare
A periodontist is a dental specialist who has completed dental school and then received three additional years of specialized training in a periodontics residency program accredited by the American Dental Association. This extensive education equips them with in-depth knowledge of gum disease, its causes, progression, and treatment. Periodontists are experts in the latest techniques for diagnosing and treating periodontal disease, performing cosmetic periodontal procedures, and placing dental implants when teeth cannot be saved.
Periodontists vs General Dentists
- Educational Background: While all dentists learn about periodontal disease in dental school, periodontists receive an additional three years of specialized training focused specifically on gum health and supporting structures of teeth.
- Scope of Treatment: General dentists typically handle basic periodontal care and maintenance, while periodontists manage complex and severe cases of periodontal disease that require surgical intervention.
- Specialized Procedures: Periodontists are trained in advanced procedures such as root surface debridement, pocket reduction surgery, and regenerative treatments that general dentists may not routinely perform.
- Dental Implant Expertise: Though some general dentists place implants, periodontists receive extensive training in implant placement and are often called upon for complicated cases requiring bone grafting or other specialized techniques.
- Focus on Prevention: Both professionals emphasize prevention, but periodontists develop personalized treatment plans specifically targeting periodontal disease and its risk factors.
What is Periodontal Disease?
Periodontal disease is a chronic inflammatory condition that affects the gums and bones supporting the teeth. It begins when bacteria in plaque build up along and under the gum line, causing inflammation that can damage the attachment between gums and teeth, creating pockets where more bacteria can collect. As the disease progresses, these pockets deepen, allowing bacteria to destroy more gum tissue and bone, eventually leading to tooth loosening and loss if left untreated. Periodontal disease is both preventable and treatable, especially when caught in its early stages.
5 Stages of Periodontal Diseases
- Gingivitis: The earliest and only reversible stage of periodontal disease, characterized by red, swollen gums that may bleed during brushing or flossing. At this stage, proper oral hygiene and professional cleanings can completely resolve the condition.
- Early Periodontitis: Inflammation begins to destroy the supporting tissues and bone, with slight bone loss becoming evident. Pockets of 4-5mm depth may form between teeth and gums, allowing bacteria to penetrate deeper.
- Moderate Periodontitis: More significant bone loss occurs (30-50%), with noticeable pocket depths of 5-7mm. Teeth may begin to loosen, and gum recession becomes more apparent.
- Advanced Periodontitis: Severe bone loss (over 50%) leads to very deep pockets exceeding 7mm. Teeth become extremely loose, shift position, and may fall out or require extraction. Patients often experience pain when chewing and significant bad breath.
- Necrotizing Periodontal Disease: A rare but severe infection characterized by tissue death (necrosis) in the gums, periodontal ligament, and bone. It typically affects people with compromised immune systems.
4 Risks of Periodontal Disease
Tooth Loss
Periodontal disease is the leading cause of tooth loss in adults. As the disease progresses, it destroys the supporting structures that hold teeth in place, including gum tissue, periodontal ligaments, and alveolar bone. The resulting bone loss weakens tooth attachment, causing teeth to become loose and eventually fall out. Even with treatment, advanced periodontal disease may make it impossible to save severely affected teeth, requiring extraction and replacement with dental implants or other prosthetics.
Cardiovascular Health Complications
Research has established significant links between periodontal disease and heart health. The bacteria associated with gum disease can enter the bloodstream through inflamed gum tissue and contribute to the formation of arterial plaque. This inflammation may increase the risk of atherosclerosis (narrowing of the arteries), potentially leading to heart attacks and strokes. Studies show that people with periodontal disease are nearly twice as likely to have coronary artery disease compared to those with healthy gums.
Diabetes Complications
Periodontal disease and diabetes have a bidirectional relationship that can create a harmful cycle. People with diabetes are more susceptible to infections, including gum disease, due to reduced immune function and impaired healing. Conversely, periodontal inflammation makes blood sugar more difficult to control, potentially worsening diabetic complications. When periodontal disease is properly treated and managed, many patients experience improved blood sugar control, highlighting the importance of oral health in diabetes management.
Respiratory Issues
The bacteria present in the mouth of someone with periodontal disease can be aspirated into the lungs, potentially causing or aggravating respiratory conditions. Research indicates associations between poor oral health and increased risk of pneumonia, chronic obstructive pulmonary disease (COPD), and bronchitis, particularly in vulnerable populations such as the elderly or hospitalized patients. Regular dental care, including periodontal treatment, may reduce the risk of developing these respiratory complications.
9 Signs You Should See a Periodontist
- Bleeding gums during brushing or flossing: Even minor bleeding is never normal and indicates inflammation that could be the first sign of periodontal disease. If this persists despite improved oral hygiene, a periodontist can identify the underlying cause.
- Red, swollen, or tender gums: Healthy gums should be pink and firm. Persistent redness, puffiness, or tenderness suggests inflammation that may require specialized treatment.
- Receding gums or teeth that appear longer: As gums pull away from teeth due to periodontal disease, more of the tooth surface becomes visible. This recession can lead to increased sensitivity and vulnerability to root decay.
- Persistent bad breath or a bad taste in your mouth: Chronic halitosis that doesn’t improve with brushing, flossing, or mouthwash may indicate bacteria accumulating in deep periodontal pockets.
- Loose teeth or changes in how your teeth fit together: As supporting bone is lost, teeth may shift position, creating changes in your bite or spaces between teeth that weren’t there before.
- Pus between your teeth and gums: This clear sign of infection indicates advanced periodontal disease requiring immediate professional attention.
- Pain when chewing: Discomfort during eating often signals that periodontal disease has progressed to affect the supporting structures of teeth.
- Sensitive teeth: Increased sensitivity, particularly at the gumline, may occur when roots become exposed due to gum recession.
- A family history of gum disease: Genetic factors can increase susceptibility to periodontal disease, making preventive care with a specialist particularly important.
5 Common Dental Services for Treating Periodontal Disease
Scaling and Root Planing
Scaling and root planing is a non-surgical deep cleaning procedure that serves as the foundation of periodontal therapy. During scaling, the periodontist carefully removes plaque and tartar from above and below the gum line, cleaning all the way to the bottom of the periodontal pocket. Root planing follows, smoothing rough spots on tooth roots where bacteria tend to gather and removing bacterial toxins that have become embedded in the root surface. This comprehensive cleaning helps gum tissue heal and reattach to the tooth surface, reducing pocket depths and controlling infection.
Pocket Reduction Surgery
Pocket reduction surgery, also known as flap surgery, is performed when periodontal pockets are too deep to clean effectively with non-surgical methods. The periodontist folds back the gum tissue to remove disease-causing bacteria and smooth damaged bone, allowing the gum tissue to reattach to healthy bone. By reducing pocket depths, this procedure makes it easier to maintain oral hygiene at home and decreases the areas where harmful bacteria can hide. Although more invasive than scaling and root planing, this surgery is often necessary to halt the progression of advanced periodontal disease.
Gum Grafting
Gum grafting is a surgical procedure that addresses gum recession by taking tissue from one area of the mouth (typically the palate) and attaching it to areas where gums have receded. This technique covers exposed tooth roots, reducing sensitivity and protecting vulnerable root surfaces from decay. Beyond the functional benefits, gum grafting also improves the aesthetic appearance of the smile by creating a more even gumline. The grafted tissue integrates with existing gum tissue over time, becoming indistinguishable as it heals.
Dental Implants
Dental implants provide a permanent solution for replacing teeth lost to periodontal disease. A periodontist surgically places titanium posts into the jawbone to serve as artificial tooth roots, providing a strong foundation for replacement teeth. Once the implant integrates with the bone through a process called osseointegration, it can support a crown, bridge, or dentures. Unlike removable dentures, implants preserve bone structure, prevent further bone loss, and function like natural teeth in terms of appearance, comfort, and chewing efficiency.
Laser Therapy
Laser therapy represents an advanced approach to treating periodontal disease using concentrated light energy. The periodontist uses the laser to precisely target and remove infected tissue while preserving healthy tissue. This minimally invasive technique offers several advantages, including reduced bleeding, faster healing times, and less post-operative discomfort compared to traditional surgical methods. Laser energy also has a sterilizing effect that kills bacteria in periodontal pockets, helping to control infection while promoting tissue regeneration.
9 Tips for Preventing Periodontal Disease
- Maintain a thorough daily oral hygiene routine. Brush your teeth at least twice daily for two minutes using fluoride toothpaste and a soft-bristled toothbrush. Pay special attention to the gumline, where plaque tends to accumulate.
- Floss daily without exception. Flossing removes plaque and food particles from between teeth and below the gumline which your toothbrush cannot reach. Consider using interdental brushes or water flossers if traditional floss is difficult to use.
- Use an antimicrobial mouthwash. Incorporate a therapeutic mouthwash into your routine to help reduce plaque, prevent gingivitis, and reach areas missed by brushing and flossing.
- Schedule regular dental checkups and professional cleanings. Even with excellent home care, professional cleanings every six months are essential to remove hardened plaque (tartar) that brushing and flossing cannot eliminate.
- Eat a balanced, nutrient-rich diet. Limit sugary foods and beverages that feed harmful bacteria in your mouth. Instead, choose foods rich in vitamins C and D, calcium, and antioxidants that support gum health and immune function.
- Quit tobacco use in all forms. Smoking and chewing tobacco significantly increase your risk of periodontal disease and impair healing. Quitting improves your oral health and reduces your risk of developing gum disease.
- Manage stress effectively. Chronic stress weakens your immune system, making it harder for your body to fight infections, including gum disease. Incorporate stress-reduction techniques such as exercise, meditation, or adequate sleep into your routine.
- Control related health conditions. If you have diabetes, heart disease, or other chronic conditions, work with your healthcare providers to keep these conditions well-managed, as they can impact your periodontal health.
- Replace your toothbrush regularly. Switch to a new toothbrush or electric toothbrush head every three to four months, or sooner if the bristles become frayed. Worn bristles don’t clean effectively and can harbor bacteria.
Conclusion
Understanding the crucial role periodontists play in treating periodontal disease can make all the difference in preserving your oral health for a lifetime. These specialists offer expertise that goes beyond general dentistry, providing targeted solutions for gum disease at every stage. With their advanced training and specialized techniques, periodontists help patients maintain their natural teeth and restore healthy smiles.
If you’re experiencing any signs of gum problems or have risk factors for periodontal disease, don’t wait until the condition worsens. Schedule an appointment with us at Juanita Bay Dentist to evaluate your periodontal health. Connect with us on Facebook and Instagram for more oral health tips, and check out our positive patient experiences on Yelp to see why so many trust us with their smiles.